What is a Health Insurance Policy?

Health insurance is a contract between an insurance company and a policyholder in which the insurance company provides financial protection for medical expenses incurred by the insured. Health policies provide the benefit of substituting medical expenses or non-monetary treatment specified in the health policy. More than the health insurance, health insurance plans also offer the tax benefits which is under section 80D of the Income Tax Act 1961. Healthcare costs are soaring that one hospitalization is enough to get rid of your lifelong savings. With cashless devices, keep your savings untouched by the best health insurance plans from various insurance providers.

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Health Insurance Plans in India

Why Do You Need Health Insurance?

Health insurance will help you whenever you need medical treatment. If you become ill or ill, you have an accident and the like, health insurance provides coverage for expenses incurred and also provides other benefits. A health insurance plan basically protects you from any health risks. Provide if there is a high cost of health care. Anxiety can happen anywhere, anytime and easily make you depressed and take you financially and emotionally. In today's era of life and lifestyle, it is important that every individual is insured in health insurance. In addition to the increase in the number of diseases and the price of health care in our country, it is also necessary to have health insurance, as it provides financial deposits in the event of a medical emergency. Unfortunately, only 20% of the total population in India has health insurance. In addition, only 18% of the total population living in urban areas and 14% of the total population living in rural areas have any form of health insurance. Everyone must buy good health insurance, which includes benefits such as hospital expense cover, cost of medications and laboratory tests, including critical illness, and more. Some health plans cover OPD expenses up to a certain amount.

Types of Health Insurance Plans in India

Must be ensure that the health insurance plan which you purchase should meets your insurance needs, it is very important to know the different types of health insurance plans and after knowing you will able to purchase right policy. Here are the different types of health insurance programs that you can choose according to your insurance needs:

Individual health insurance plans

Individual health insurance plans offer insurance coverage with benefits such as cashless hospital admission, reimbursement of expenses, reimbursement of expenses incurred before and after hospitalization, home treatment coverage and more. Individual health plans come with additional coverage that enhances basic health insurance with a minimum premium.

Family health insurance plan

Family health insurance offers single family insurance for the whole family. Under this health plan, the sum insured is evenly distributed among the members of the insurance contract, which can be used by one or all family members in one or more events insured during the term of the insurance contract. With a family health plan, almost all family members can be added to one health insurance premium.

Health insurance plans for senior citizens

The health insurance plan for the elderly offers insurance for the age group of 60 years. The health insurance program covers the cost of hospital admission, including expenses for hospital treatment, expenses for OPD, day care services, pre-hospital and post-hospital expenses, along with 80 D tax reduction benefits.

Sickness insurance plans

A critical illness health insurance plan offers a large amount if the insured person has been diagnosed with a critical illness, such as kidney failure, paralysis, cancer, heart attack, etc. insurance.

Maternity health insurance plan

Maternity health insurance plans provide coverage for maternity expenses incurred during prenatal and postpartum care, during childbirth (normal or caesarean section). Some providers also include the cost of newborn vaccination in maternity health insurance plans. The coverage list also includes the fee to take the mother to the hospital of the nearest network of her choice.

Personal accident insurance

Personal accident insurance is insurance coverage for drivers who offer insurance coverage in the event of an accident that causes disability or death. This insurance covers hospitalization and bears medical costs in the event of an accident. Fixed cash benefits are provided in the event of an accident resulting in loss of income.

Group health insurance plans

More than 80% of employers now provide health insurance to their employees. The health insurance offered by the employer covers the cost of admission to the hospital of the employee and his or her family, including spouse, children or parents. It is a sensible decision to choose a medical card offered by your company, as you do not have to pay insurance premiums. These are administered by group health insurance and premiums are paid by the employer based on the group measurements and benefits offered.

Unit Linked Health Insurance Plans

The Health Insurance Investment Plan (ULHP) is a newly introduced health plan. This unit's health insurance plan offers a unique combination of health insurance and investment. In addition to health coverage, ULHP also contributes to developing a corpus that can be used to cover expenses not covered by health insurance plans.

Key Benefits of Health Insurance Plans in India

Here are the main benefits a health insurance company can consider:

Every health insurance company has relationships with various hospitals and hospitals across the country, called "empaneled hospitals." If you are accepted as one of them, you do not have to pay anything. All you have to do is state your insurance number and everything else will be taken care of by your hospital and insurance company. This type of health insurance plan is preferred because there is no pressure in paying claims and documentation. However, if your expenses exceed the sub-limit set by the insurance cover or are marked as not covered by the provider, you must pay it directly at the hospital. Another important thing to keep in mind is that cashless medical treatment is not available if hospitalized, which is not part of the insurance company's network of hospitals.

This health insurance feature manages the costs associated with hospital admission before and after hospitalization. It considers the costs incurred for several days before and after hospitalization as part of the claim, provided the expenses are related to the illness / disease covered.

Rescue Payment
After being admitted to the hospital, the person is exempted from transportation costs as borne by the insurance company.

NCB (or bonus without right to compensation) is a bonus given to the insured if no treatment rights have been filed in the previous year of insurance. Rewards can be offered either as an increase in the guaranteed amount or as a premium discount. You can take advantage of this to renew your policy.

The health plan entitles the insured to a regular medical examination. Some insurance companies provide free tours or you can get them as an added benefit.

There may be different sub-limits related to health insurance; Room rental is one of these sub-limits. The general insurance company gives you maximum coverage up to the guaranteed amount. However, they may deliberately reduce their responsibilities by introducing a sub-threshold clause to cover hospital room rentals. Once the insured is admitted to the hospital, there is a partial limit to cover the daily room rent. For example, if your health insurance contract covers your daily room rent up to a maximum of Rs. 3,000 and the cost of your room is Rs. 5,000 a day, then you have to pay the balance of R. 2,000 from your own pocket. In addition, room fees are directly related to the type of hospital room you are using, ie. A. With one room or jointly. Everything else is calculated accordingly. If the total cost of treatment in the hospital is Rs. 5,00,000, the table below illustrates the expenses that may be borne by the insurance company or you.

In this case, your total cost is Rs. 1 16,000 of the total expenditure incurred, t. J. Rs. 5 00 000. Therefore, make sure that you have made a reasonable decision if you want to limit such a limit in your health insurance.

Co-Payment

With this feature, your health insurance plan can reduce the cost. The health insurance plan offers a joint participation option that determines in advance the voluntary deductions that must be paid by the policyholder. So in the event of a medical emergency, a sum of money will be paid by the policyholder and the rest by the provider. Joint participation is a condition of cost sharing in the context of health policy, which stipulates that the organization or person will bear a certain share (as a percentage) of the total costs that are eligible to be incurred. However, the possibility of mutual financing does not affect the amount secured. This allows you to reduce premiums to a certain extent (depending on the insurance company and the insurance contract).

Tax benefits of health insurance programs

Disease insurance entitles you to tax benefits under Section 80D of the Income Tax Act 1961. The premium you pay for health insurance for yourself or a family member gives you tax relief, whether it depends on you or not. no. The tax deduction offered in relation to the premium depends on the age insured and the maximum amount of tax deduction available. You can save a maximum of Rs. 25,000 in the fiscal year if you are under 60 years old. If your age exceeds 60 years, the maximum tax benefit will increase to Rs 50,000. If you pay health insurance premiums for parents and yourself, you are entitled to a tax exemption of up to 55,000 R. per annum under section 80D if your parents retire.

Third Party Administrators
The concept of landfill is the main idea of the Insurance and Development Board of India (IRDA), which assists insurance and insurance agents. While this is beneficial for insurance companies as it reduces overhead or administrative costs, false damage and insurance ratios, policyholders also use better and faster insurance services. TPA is an important player in the health insurance sector. They have the ability to deal with all or part of the damage associated with a health insurance plan. They have links to their own health or insurance companies that manage services such as premium collection, registration, claims settlement and other administrative services. Hospitals and health insurance companies often issue health insurance responsibilities to reduce their burden.

Coverage of existing diseases
Two to 4 years after policy making, different policies will begin to take into account existing diseases, e.g. diabetes, high blood pressure, etc. Coverage is provided for available illnesses for certain illnesses owned by policyholders before purchasing insurance.

Preventive Health Care
Health care is undoubtedly very expensive and no one wants to be hospitalized. We now have a preventive medical examination that will take care of you before you get sick. This principle provides preventive treatment, such as regular medical examinations, reduction of X-ray fees, consultation fees, etc. The goal of this plan is to give you various health measures to take care of your health. Preventive care is medical treatment given not based on specific complaints, but for the purpose of prevention and early detection of difficulties.