Key goals and major guide for

Health Insurance

Health insurance is an agreement wherein an insurance company agrees to compensate the insured for the medical and surgical expenses incurred during the policy tenure. The medical expenses may incur if the insured falls ill, or meets an accident that leads to hospitalisation of the insured. To be eligible to avail coverage benefits under the policy, the policyholder is required to pay a specific amount periodically, known as premium. Health insurance premium is decided by an insurance company and policyholders are required to pay the same on a monthly, quarterly, half-yearly, or yearly basis, without any lapse, to avoid losing the renewal benefits.

Health Insurance Importance in India

Rising healthcare expenses, access to the required and quality medical treatment can be financially draining. So, to protect yourself and your family against these expenses, you must get everyone insured under a reliable health insurance plan in time. Here are top reasons why you should consider buying health insurance today:

1-To Protect Your Savings

2- To Deal with Medical Inflation

3-Lifestyle Changes

4- To Secure the Health of your family Members

5- Life Style Changes

Benefits of Health Insurance

Health insurance offers a wide array of benefits to the insured. Following are some of the key benefits of a health insurance plan –
a. Comprehensive Coverage: A health insurance policy keeps you covered for major healthcare expenses incurred in case of medical emergency. Usually, health insurance plans keep you protected for in-patient hospitalisation expenses pre- hospitalisation and post-hospitalisation expenses, ambulance expenses, domiciliary hospitalisation expenses, daycare procedures, organ donor expenses, treatments taken under AYUSH systems of medicines, etc.

b. Lifetime Renewability: As per the guidelines issued by Insurance Regulatory and Development Authority of India (IRDA), the insurance companies offering health insurance plans are supposed to offer lifetime renewability benefits to the policyholders. It allows you to renew your health insurance policy without any upper restriction on the maximum age limit. The feature is most beneficial for parents and senior citizens as they can renew their insurance plans without any pressure of looking for new health insurance plans in old age.

c. Cashless Treatment: Insurance companies have tie-ups with certain hospitals, known as network hospitals, where the insured can avail cashless treatment. If you avail treatment at these hospitals, the insurance company will directly settle the bills at the hospital, and you will not be required to pay anything for the treatment availed, except for non-medical expenses incurred. 

d. Portability: Health insurance portability allows the policyholders to switch from their existing health insurance company to another, in case they are not satisfied with their existing health insurance plan, or find a more suitable plan. Portability feature saves the policyholders from being taken for granted and offers them flexibility to switch in case of dissatisfaction.

e. Tax Benefits Under Section 80D of the Income Tax Act, 1961: The government of India promotes health insurance by offering tax exemptions of up to Rs. 1.5 Lakh on the premium paid for health insurance plans, under Section 80D of the Income Tax Act, 1961. An individual can also claim a deduction of up to Rs. 25,000 for insurance cover for self, spouse, and dependent children. You can also avail a tax deduction of up to Rs. 25,000/Rs. 50,000 for health insurance plans purchased for parents aged 60 years/ more than 60 years.

Type of Health Insurance

Health Insurance Coverage

1- InPatient Hospitalisation Expenses
2- Pre and Post Hospitalisation Expenses
3- Daycare Procedures
4- Organ Donor Expenses
5- Domiciliary Hospitalisation Expenses
6- Road Ambulance Expenses

Health Insurance Riders

1- Critical Illness Cover
2- Maternity Cover
3-Hospital cash
4-Room rent Waiver
5-OPD cover
6-Personal Accident Cover
7-Air Ambulance Cover
8-Reduction in Waiting Period for Existing Cover

How To File A Health Insurance Claim?

Claim under a health insurance policy can be made in two ways – in a cashless manner and in a reimbursement manner. A cashless claim is when you receive treatment at a network hospital of the insurance provider who is servicing your policy. If the claim request is accepted, the insurance company directly settles the bills at the hospital. Whereas in reimbursement claims, you are required to pay for the hospital bill from your own pocket first, and make a claim request with the insurance company later. The insurance company will process your claim and reimburse you for the same after accepting the claim. You can make a health insurance claim by following the simple steps given below:
  • Step 1: Visit the network hospital or the hospital of your choice and inform the insurance company about the hospitalisation.
  • Step 2: Fill the pre-authorization form at the hospital’s TPA (third-party administrator) desk.
  • Step 3: You will receive an approval letter by the claim management team.
  • Step 4: Respond to the query raised by the claim management team, if any.
  • Step 5: Avail the required medical treatment.
  • Step 6: The insurance company will directly settle the bills at the network hospital as per the terms and conditions mentioned in your policy.