What is health insurance?
In simple words, health insurance is an agreement between the insured (you) and the insurer (Health insurance company) to compensate or reimburse for medical or hospitalization expenses of the insured (for illness or accident) upto an agreed extent (as per policy). This cover can be treated as both cashless or reimbursement based on the list of network hospitals with your insurer. Usually, now-a-days most health insurance companies have an extensive tie-up with almost all popular and known hospitals offering you better coverage. Additionally, you can also claim deductions in the income tax for the premium paid under Section 80D of the income tax Act.
Why is health insurance more important than ever?
Recent COVID-19 pandemic that struck the world largely in 2020 has made everyone realize that medical emergencies are highly costly and unpredictable. Moreover, funds required to deal with such uncertainty can really bring a huge financial burden too. People globally have started taking medical contingency more seriously. With such unforeseen pandemic added with increased medical and hospitalization expenses it's essential to get some extra support for us and our families. Health insurance helps meet a vast degree of such financial precariousness and that too without compromising on the quality of treatments or medical treatment inflation.
Having health insurance policy saves you from the mental, emotional, and financial stress arising out of medical emergencies and hospitalization costs.
Health insurance consists of two types of plans - Indemnity Plans and Definite Benefit Plans. Indemnity plans cover hospitalization costs from the sum assured, whereas Definite benefit plans offer lump sum payment on detection of illness.
Lets learn more about some of the most commonly used health insurance plans in little brief:
Mediclaim (individual and floater)
Mediclaim policies are a sub-part of health insurance plans that focuses on offering your financial support by covering agreed medical or hospitalisation expenses incurred due to illness or accidental stay up to the sum insured. Premium under this policy is determined on the basis of age and several other factors of insured. Mediclaim can be availed for individuals only as well as for multiple family members known as family floater plans. Family floater plans offer better cover under a single policy where all the insured family members can be covered under a single policy against multiple diseases.
Mediclaim policy premium paid can also be claimed for tax-exemption benefits under section 80D of the Income Tax Act of India, 1961.
What Does a Mediclaim Policy Cover?
When taking up a Mediclaim policy, you must learn the inclusions and exclusions to understand what is and what not is covered under the policy. as it can vary between policies and insurers. Here are some of the most common inclusions of a Mediclaim policy:
Hospitalisation Costs
All medical expenses incurred during the hospitalisation of the policyholder or the beneficiaries of the policy. It covers expenses related to in-patient expenses, diagnostic procedures, nursing charges, surgery expenses, doctor’s fee, oxygen, anaesthesia OT charges, medicines, blood, x-ray, etc. Pre and Post-Hospitalisation Expenses: Medical expenses arising before 30 days of hospitalisation and up to 60 days post-discharge are covered under the Mediclaim policy (varies for different insurers). Day-Care Expenses: Medical expenses arising out of advanced medical treatments which do not require the patient to be hospitalised for more than 24 hours is covered. Hospital Room Expenses: Costs towards regular wards or Intensive Care Unit (ICU) are fully reimbursed or through the cashless facility. Doctor’s or Medical Professionals’ Fee: Doctor’s consultation fee or medical professionals’ charges such as nurses’ fee, etc. are covered.
What is Not Covered in Mediclaim Policy?
Here are some of the common exclusions in Mediclaim policies:
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Pre-existing and Sexually transmitted diseases -
Dental treatments, Plastic and cosmetic surgery -
Birth control, Vaccinations and hormonal treatments
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Obesity-related treatments -
Administrative charges, toiletries, etc
Senior Citizen Mediclaim Policy
Under this type of plan, senior citizens are covered for medical expenses incurred over treatments, surgery and accidental injuries with special provisions. Eligibility to enroll under this policy is that the age of the insured should be between 60 and 75 years at the time of entry. Senior citizen policy covers pre-existing diseases from the second year and policy enrollment does/does not require Pre-Insurance medical test. However, the premium may differ depending on the entry age and pre-existing disease. Similar to other mediclaim policies, pre-existing diseases can be covered after a waiting period of 2 years.
What Does a Mediclaim Policy Cover?
When taking up a Mediclaim policy, you must learn the inclusions and exclusions to understand what is and what not is covered under the policy. as it can vary between policies and insurers. Here are some of the most common inclusions of a Mediclaim policy:
Senior Citizen Mediclaim Polic
Under this type of plan, senior citizens are covered for medical expenses incurred over treatments, surgery and accidental injuries with special provisions. Eligibility to enroll under this policy is that the age of the insured should be between 60 and 75 years at the time of entry. Senior citizen policy covers pre-existing diseases from the second year and policy enrollment does/does not require Pre-Insurance medical test. However, the premium may differ depending on the entry age and pre-existing disease. Similar to other mediclaim policies, pre-existing diseases can be covered after a waiting period of 2 years.
Heart Plans
Heart is the most basic and essential organ of our body, without which its an assured failure of the whole system. Heart plans (also known as Cardiac Insurance Plan) are specially designed health insurance plans to cover heart ailments without financial worries.
Critical Illness Mediclaim Policy
Medical expenses arising out of critical illnesses are high and the Critical Illness Mediclaim policy offers to cover illnesses such as cancer, kidney failure, cardiovascular-related illnesses, etc.
Enter List here for all critical illness as per your organization document:
Student insurance
This is a best plan for students studying far away from their home in another country. This plan covers expensive medical care such as hospital accommodation, surgery and other in-patient treatments. It includes benefits like rehabilitation treatment, out-patient surgery and medical evacuation, just in case of few insurers.
