What is Health
Insurance

Health insurance covers medical expenses for you and your family, depending on the plan you choose. It pays for treatments, surgeries, hospital stays, and other healthcare costs arising from illnesses or injuries. You can either get reimbursed for your expenses or avail cashless treatment where the insurance company directly settles the hospital bill. It offers financial protection and peace of mind during unexpected medical emergencies.

Types of Health Insurance Plans

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Individual Health Insurance Plans

These policies cover yourself, your spouse, your children and your parents. These policies typically cover all kinds of medical expenses, including hospitalisation, day care procedures, hospital room rent and more. Under an individual health insurance plan, each member has their own insured amount.

Senior Citizens Health Insurance

These health plans have been designed specifically keeping the medical needs and requirements of senior citizens in mind. Since older citizens are more likely to have health issues, these policies may require a full medical check-up beforehand and are more expensive than regular insurance policies.

Family Floater Insurance Plans

A family floater plan allows you to cover your family members under a single policy and everybody shares the insured amount. These plans are typically more affordable than individual plans since the sum insured is shared.

Critical Illness Plans

Life style related Health issues such as cancer, stroke, kidney failure and cardiac diseases are on the rise these days and can be very expensive to treat and manage in long-term. That is why critical illness insurance policies have been created. They can either be purchased as a rider or add-on with your regular health insurance plan or separately as a unique plan. These policies offer cover for very specific issues and often provide claim pay out as a single lump sum payment after the diagnosis of a critical illness.

Personal Accident Insurance Plans

The number of road and other accident cases have increased over the years, and people end up losing their life or getting disabled, and bearing the treatment expenses. That is why today, there are dedicated types of health insurance in India to protect the citizens. Thus, availing of the personal accident insurance policy is a wise idea. This policy provides a lump sum amount to the victim or his/her family as support. Some of the plans also offer education benefits for kids, add-on coverage like temporary total disablement, assistance service, worldwide emergency, and accident in-patient hospitalisation with personal accident plans.

Top up Health Insurance

An individual can buy the Top Up Health Insurance plan if he seeks coverage for higher amounts. But there is a “Deductible Clause” added to this policy. Therefore, when the claim is made, the payment done is over and above the pre-defined limit that is mentioned in the policy. Moreover, there is also a Super Top-Up plan available for the individual. It provides additional coverage over the regular policy to increase the amount of sum insured. The Super Top-up plan can only be used once the insured sum of the regular policy gets exhausted.

Group Health Insurance

Group Health is a very upcoming and trending form of health insurance plan these days. Many medium and large-scale enterprises are offering this kind of insurance policy to their employees to cover for the hospitalisation and medical expenses of the employees and their families, as an attractive and tax efficient tool to retain employees. The premium of this policy is comparatively lower than the Individual Health Insurance Policy.

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Things to Consider While Buying Health Insurance

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Deductibles

It is essential to look into the deductibles involved in that policy before buying any type of health insurance policy. A deductible is an amount that is to be paid by the insured as a part of a claim whenever it arises, and the rest of the amount is paid by the insurance company

Age

The buyer needs to understand the importance of the age factor while buying the Health Insurance plans for oneself or for family members. There are various plans that depend upon the age of a buyer, and their premium, waiting period and renewability also play a role

Medical History of Family Members

At the time of buying a Health Insurance Policy, one must consider and discuss the medical history of the family members as it can impact the premium of the policy. If any of the family members is already suffering from a health problem, then the possibility of claiming the insurance rises

Exclusions

An exclusion in terms of policy is a provision that eliminates coverage for some type of risk. A few common exclusions in most of the Health Insurance Policies include pre-existing diseases, pregnancy, cosmetic treatment, medical expenses to treat injuries, alternative.....

Sum Assured

An insurance company extends insurance coverage in the form of a sum assured, which a policyholder gets in exchange for the premium you pay. Choose the best health insurance cover, which offers sufficient coverage at affordable premium rates.

Waiting Period

In the case of Health Insurance Policy, the waiting period refers to the amount of time you have to wait to avail the benefits under your insurance policy. The waiting period varies from plan to plan.

Lifetime Renewability

The different Health Insurance Plans offer different renewability options. So, you must be watchful before buying one for yourself or your family member.

Network Hospitals

While buying any Insurance Policy, a buyer must choose the insurance company that covers the widest network of hospitals in their list.

Claim Settlement Ratio

The individual should pick up the insurance company that provides a fast claim settlement ratio.

Benefits of Health Insurance

Financial Assistance

The Health Insurance Policies ensures financial assistance to the insured family during any sort of medical emergencies in the form of reimbursement of medical expenses. This way, the family is saved of trying the meet the exorbitant costs of hospital bills apart from the trauma of the medical emergency itself.

Annual health check ups

Health Insurance policies provides you with the coverage benefits of annual health check-ups on high sum insured. Hence, the company looks after the expenses that are incurred in the insured person’s annual health check-ups

Tax Benefits

Buying a Health Insurance Policy will help you in tax deductions under Section 80D of the Income-tax Act.

Covers complex procedures

Health Insurance Policy provides coverage benefits for complex procedures such as organ transplants.

Deal with Medical Inflation

Investing in Health Insurance Policies will help you to deal with medical inflation in a much easier and a better way without putting any extra burden on your pockets.

Benefits for organ donors

Buying a health insurance policy will provide coverage benefits in case you are donating any organ. It offers coverage up to the sum that is insured.

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Frequently Asked Questions

What is health insurance?

Medical expenses can be a financial burden for individuals who fall ill or get injured. Health insurance is a policy that offers financial aid to such individuals. The insurer pays a fee to the policy provider who, in turn, covers some or all of the medical charges incurred.

Which is the best health insurance company in India?

Identifying the top health insurance company in India is challenging as it depends on individual needs. Considerations include scope of coverage, cost, claim settlement ratio, customer service, hospital network, and overall reputation before choosing a provider.

Which plan is the best health insurance plan?

The best plan depends on individual needs and budget. A comprehensive plan with a large hospital network and coverage for chronic conditions is ideal for those needing frequent medical care.

Can I take a health insurance plan from LIC?

Yes, LIC offers various health insurance plans. As a trusted life insurance provider, LIC's health products cater to a wide range of customer needs.

Who is eligible for health insurance in India?

Eligibility usually ranges from 18 to 65 years. Policies are available for individuals or as family floater plans that cover all family members under a single policy.

What is the best age to take health insurance in India?

The best time to buy health insurance is between 18 to 30 years, when premiums are lower and there are fewer health issues. Early purchase ensures uninterrupted coverage and benefits.

Why should I buy another health insurance policy if my company already provides one?

Employer-provided group insurance may be insufficient or temporary. A personal policy offers extra protection, covers more needs, and ensures coverage if you leave or switch jobs.

I am not happy with my health insurance plan. What should I do?

Evaluate other plans, seek expert advice, read reviews, and compare benefits. If switching isn't possible, try contacting your current insurer to resolve your concerns.

What is the meaning of portability of insurance policy? Will I lose the benefit of existing disease if I port my policy?

If a policyholder is not satisfied with the services or coverage provided by their current insurer and wishes to switch to a new one, they can do so without any disadvantage or loss of benefits.

The Insurance Regulatory and Development Authority of India (IRDAI) mandates that the portability of policies must be allowed for all health insurance policies issued by all insurers.

Is there a single health insurance plan where I can cover my entire family?

A family health insurance plan is designed to provide coverage for all members of a family, including spouses, children, and sometimes even parents or other dependents.

Can I take more than one health insurance policy?

Yes, you can take more than one health insurance policy. Some individuals may be covered under a group policy through their employer and may also hold an individual policy.

I do not have a network hospital close to my house. Should I still buy a health insurance plan?

Yes, you should still buy a health insurance plan. It provides coverage for a wide range of medical services beyond hospitalization, including diagnostic tests, prescriptions, and doctor consultations.

What is cashless claim?

A cashless claim allows the policyholder to receive treatment without paying upfront. The insurer directly settles the bill with the hospital, provided it’s in their network.

I am a regular smoker. Should I declare in the application form that I am a non-smoker?

No. Declaring false information, such as claiming to be a non-smoker while being a regular smoker, is unethical and could result in claim denial or policy cancellation.

Is it advisable to declare all my diseases and ailments in the insurance application form?

Yes, always disclose all pre-existing conditions honestly. Non-disclosure can lead to rejection of claims or cancellation of your policy in the future.

How can Deal Plexus help me to get a good Health Insurance Plan?

Deal Plexus is a professional advisory platform that helps individuals compare and choose from various health insurance policies based on their specific needs and budget.