We live in uncertain times. It’s good to sound optimistic, but the fact is none of us can be really sure of what tomorrow may bring. And that in one line is just why you need health insurance!
Before we dive headfirst into the types of Health Insurance, it is important to know the benefits of Health insurance. This, in turn, is important, simply since once you are convinced, it is that much easier to take those concrete steps towards getting yourself insured.
Benefits of Health Insurance
Given below are at least 10 benefits of Health Insurance Policies.
1. Recovery Benefit
There is this common assumption that Health Insurance pays only for hospitalization expenses. Yet the fact is, many benefits of health insurance policies remain unutilized, simply due to ignorance. A health cover is not only about its features but is also about just how prudently one is able to extract its many benefits. One such benefit is the ‘Convalescence Benefit’.
As part of this benefit, the insurer compensates collateral damages that may occur due to hospitalization. This includes a loss of pay. In such a case, the insurer steps up to compensate anywhere between 1 week to 10 days of the policyholder. In certain cases, costs involved for a caretaker and visits from family members, are also covered by the Insurance policy.
2. Alternative Healing
With the advent of Natural Healing methods like Yoga and Ayurveda, many Insurance companies are coming forward to cover an unconventional method of healing. The insurance policy offered by TATA covers alternative treatment up to Rs. 25,000. The only condition in such a case being, that the treatment is carried out by a reputable institute.
3. Organ Donation
Health Insurance typically covers expenses with regard to even organ donation. For instance, the cost of a kidney transplant can be anywhere between 3 to 5 lakhs. Having a Health Insurance ensures that during a crucial time like an organ transplant, the monetary aspect is taken care of.
Yet it must be kept in mind, that in the case of an organ transplant, some companies reimburse all the expenses, while others offer compensation to a large extent. This is mostly because an organ donation involves harvesting the organ, post-surgical complications and other miscellaneous expenses.
4. Treatment at Home
Domiciliary Treatment basically denotes medical treatment that is conducted at home. Yet the one rider, in this case, is that the insurance covers only a set number of days.
5. Care Taker’s Allowance
An attendant or a caretaker allowance is permitted, especially in the case where the beneficiary is a child. Yet, here again, the insurance company pays for the attendant, only for a fixed number of days.
6. Cash Allowance in the Hospital
A Hospital stay invariably involves expenses and hence in some case daily allowance up to a sum of Rs. 2000 is permitted by some insurance companies. In the case where a person is in a critical condition like being in an ICU, this allotted amount to meet expenses is doubled.
7. Health Check Up – Free of Cost
One of the really good benefits of taking up a health Insurance policy is that Health Checkups are conducted and can be availed free of cost.
Facility for a free health checkup is conducted in designated hospitals which might have a tie-up with the said Insurance company.
8. Health Insurance covers Teeth trouble!
Dental treatment is quite often covered by health insurance. Outpatient dental treatments in some cases, come within the ambit of insurance cover.
9. Weight Loss Surgeries
Bariatric or Gastric Bypass Surgeries are no longer considered mere cosmetic surgeries since they can be lifesaving in certain cases. Obesity is a widespread problem these days and keeping this in mind, Health Insurance has begun to be provided for such cases, especially if it has been certified by a doctor as absolutely essential.
10. Maternity Benefits
A Health Insurance especially when taken for the family includes maternity coverage. In fact, the medication involved in the months preceding childbirth and the subsequent doctor visits, can all be covered by a good Health insurance policy.
Different Kinds of Health Insurance Plans:
Health Insurance, is essentially about paying a fixed amount of premium every year, in return for a certain assurance during a medical emergency. Health is the one area which requires a contingency fund and this can be achieved with the help of a good insurance cover. We can now proceed to look at the different kinds of Health Insurance Policies in India. There are essentially three types of Health Insurance in India.
1. Hospitalization Plans
This plan entails that the medical costs incurred during the course of a hospital stay will be borne by the Insurance Company.
Beneath this umbrella term of ‘Hospitalization Plan,’ there are two subheads.
Individual Health Policies
Family Health Policies
To understand this further, we can take the case of a family of three, where each member is individually insured for a sum of Rs. 1 lakh. On the other hand, a ‘Family Health Plan’ of Rs. 3 lakhs would mean that any member can avail of medical insurance more than 1 lakh, as long as the total sum does not exceed Rs. 3 lakhs.
2. Hospital Daily Cash Benefit Plan
Under this scheme, the Health Insurance Policy legitimately pays a fixed amount daily, as part of the hospital expenses. If the stipulated amount to be paid by the insurance company is 1000 bucks per day and the accrued expense is only 500 rupees, even then 1000 rupees will be paid to the insurer in the hospital.
3. Critical Illness Plans
In this case, a certain lump sum amount is paid on the diagnosis of certain critical illnesses. This is mostly since critical illnesses like Cancer, for instance, entail exorbitant expenses beginning with Chemotherapy and Radiation. Hence an insurance cover, in these cases is rather reassuring.
Points to be kept in mind before choosing a Health Insurance Plan:
It’s important to keep these 4 points in mind while deciding on which Health Insurance to adopt
The amount you plan to pay a premium
The Hospital and Health Care providers that your Insurance Company has an agreement with
The kind of doctors that your Insurance plan would be able to afford
Certain plans even include the cost of prescription medicines
There are certainly other things to keep in mind before one takes that big step towards getting Health Insurance.
Do you or your family constantly require medical care?
If you envisage higher medical costs, it would automatically mean a higher monthly premium.
Do you anticipate any surgeries that might need an Insurance cover?
Is there any particular doctor that you regularly visit and can these doctor visits get covered beneath insurance?
While considering what Health Insurance cover one ought to sign up for, it is important to keep in mind these little things one might otherwise overlook. This is essential since, at no extra cost, they save you time and money and a lot of stress. These little things include checking to see if your Health Insurance plan is available on
A Mobile App
If they have a good website with helpful customer service executives
A separate phone number dedicated to answering Medical queries
Incentives in the form of discounts and vouchers that can be availed on fitness and health products
We now proceed to look at certain Frequently Asked Questions when someone is about to take that big step towards getting a Health Insurance Cover.
It goes without saying, that Online Research goes a long way in helping one make an informed choice. Making an astute comparison between the different health policies available will ensure that you pick the health insurance coverage that will suit your budget the most. All this is essential so that one does not fall prey to the pushy salesmanship from one particular brand. A little research at the right time goes a long way in ensuring that your health Insurance stands by you, at the time you need it most. Given below are a list of questions that you can ask, before settling on buying a particular health insurance cover.
1. Is the ‘network hospitals’ in your comfort zone?
Perhaps the most important thing to keep in mind while signing up for a Health insurance cover is to know whether the hospitals that are in partnership with your Health Insurance provider are well within your comfort zone. In the sense, there are hospitals where one instinctively feels safe and where one can readily admit oneself during any unforeseen eventuality. In the case of cashless settlement, it is imperative that your Insurance provider has a tie-up with a hospital that is ideally in your vicinity and where you would feel comfortable.
2. Is my Health Insurance valid across India?
This is a truly pertinent question to ask, simply since there are certain policies that are valid even on foreign shores. Hence it is wise to find out about the geographical scope of your policy since one can prevent any rude shocks later.
3. Does the Health policy I sign up for cover already existing illnesses?
It is common practice, that a Health Insurance policy quite often excludes coverage on preexisting illnesses. In such a case, it is prudent to find out just what is the waiting period, before one can be covered for preexisting illnesses. Alternately, if such an illness is being completely ignored by your Health insurance.
4. During a medical emergency, how can one reach out to their Insurance Provider?
A medical emergency is stressful on its own, without having the prospect of formidable paperwork looming large before one gets any help from a Health Insurance provider. A seemingly small thing like efficient customer care goes a long way in ensuring that you made the right choice while picking your health insurance plan.
5. What can be done in case one is admitted in a Hospital that does not have any tie up with the Insurance provider?
In such a case, the medical bills are mostly on a reimbursement basis and until then the expenses have to be borne by the insurer himself. Also, it’s important to know if there is lengthy paperwork involved and in such a case one can rethink the whole idea of signing up with a certain service provider.
6. What kind of documents are needed to make a Health Insurance claim?
This is perhaps the most common of all queries and knowing this process makes the claims process that much easier. A Health Insurance Company basically asks for identity proof and hospital bills, at the time of a claim and a pre-authorization form in the case of a cashless claim. Knowing these details can help with the smooth claiming of health insurance.
7. The Methodology as followed by the Company with regard to Insurance Claims?
It is indeed true that the whole process of the settlement of the claim is where the integrity of the Insurance Provider can be tested. It is important to know that many a time when it actually comes to settling a claim an Insurance provider can try to absolve themselves of the responsibility and hence honesty is very important. It helps to analyze the previous track record of the said company and a Cashless facility is indeed a wise option to deal with huge medical bills.
In that sense, associating with Health Insurance Providers with tie-ups with Big hospitals can be a first step towards securing the healthy future of your family.
In the final analysis, it can be said that in today’s stressful times, a Health Insurance Plan is not just an added benefit but a necessity.
Once you have had your basic queries cleared, it is indeed wise to think of enrolling oneself in a Health Plan which might come in handy when one least expects it! When it comes to the health of one’s loved ones one can never be too sure and hence a good insurance plan is like a safety net, that can allow you the simple luxury called… Peace of Mind!