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Health Insurance Policy

As a famous proverb goes "The greatest wealth is health", so safeguarding our health becomes a priority With growing medical expenses and unhealthy lifestyle leading to health problems, Health Insurance is need of the hour today. Health Insurance plans cover the insured for medical expenses in case of any surgery or health issues against a premium paid by him. Health Insurance prevents the insured from facing a financial crunch in case of any medical emergency.

Types of Health Insurance Policies in India

Below are the following types of health insurance policies

Maternity Insurance

This plan covers pre and post natal care, child delivery and any other maternity related expenses including vaccination

Family floater health plans

This is a single family health insurance that covers all your family members against medical expenses

Senior citizen plans

This health insurance covers illnesses and serious health problems that comes with old age

Critical illness cover

This insurance covers you against serious health emergencies such as cancer, heart attack, paralysis, kidney failure, coma, etc. but does not include pre-existing health conditions

Group insurance plans

This group health insurance covers a group of people like members of an organization or employees of a company

Pre-Existing Disease Cover Plans

Any illnesses existing before buying the policy are covered under this insurance after a waiting period of few years

Apart from these, there are health insurance plans which cover the healthy, disease specific plans, personal accident covers, top-up plans and other plans

Health Insurance Benefits

Below are some of the features & benefits of Health Insurance

  • Health Insurance policies can give you cashless benefit or subsequent reimbursement of medical expenses
  • Health Insurance can come to your rescue during medical emergencies; especially when you are facing a financial turmoil
  • A policyholder can claim tax benefit u/s 80D and 80DD of Income Tax Act 1961
  • Treating most of the major ailments can be expensive today, health insurance plans can cut down your financial burden
  • Several insurance companies waive off some amount of the premium as ‘no claim bonus’ in case insured doesn’t make any claims
  • You can get the best health insurance at a lower premium for a higher insurance cover if availed at an early age
  • With maternity expenses skyrocketing today, maternity insurance policy comes as a relief. Some health insurance policies cover certain expenses of new born child
  • The policy holder has a choice to get medical assistance from any of the hospitals associated with the insurance company
Exclusion

Your medical insurance policy comes with various exclusions depending on your policy and the provider. Please read the policy document carefully to check the inclusions and exclusions. Below are some general clauses excluded.

  • Pre-existing diseases: Health insurance companies do not cover medical conditions that you have had before the commencement of the policy. However, for some diseases there is specific waiting period usually 2-4 years, after which they get covered
  • Specific ailments: Certain diseases are either not covered under your health policy unless specifically mentioned or do come with a clock-in period
  • Alternative treatment: Most health insurance policies do not cover alternative therapies like ayurvedic, homeopathic, accupressure etc. Only allopathic treatment is usually covered
  • Pregnancy: Most health insurance policies do not cover expenses related to pregnancy and childbirth.
  • Cosmetic/Dental Surgeries: Any kind of cosmetic and dental surgeies are not covered under insurance policies except if they are recommended as a result of treament against injury or illness
  • Hospital Diagnostic Expenses: Expenses for laboratory tests or consultations at hospital are not covered unless they result positive in illness requiring hospitalization
  • Illness arising due to lifestyle habits like smoking or drinking are not covered unless specifically mentioned
  • Some diseases or damages are permanently excluded like war related impact or HIV etc. So, please read the policy document carefully
Claim Process

You can claim your medical health insurance in the following two ways, depending on the policy agreement

1. Cashless Hospital Treatment

You can avail a cashless treatment at any of the hospital network, that is in tie-up with your insurance policy provider. You do not have to make any upfront hospital payment. You will be required to provide your health insurance card and a valid government provided ID proof. However, to avail cashlesss treatment you will require prior TPA approval

2. Reimbursement Claim

You can reimburse the medical expenses (covered under your policy) later on. Contact your policy provider & submit your claim application along with your medical expense bills, prescriptions etc and other necessary documents (usually valid govt. ID proof). Pleae read the policy agreement before hand to know the claim procedure to avoid hassles at the last minute

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