Health Insurance – One kind of insurance that pays for medical costs resulting from a disease is health insurance. These expenditures may be associated with hospital stays, medication prices, or physician consultation fees. Health insurance is a type of financial plan that helps people and families pay for medical expenses. It is a contract in which an individual pays monthly premiums to an insurance company, and the insurance company pays for the policyholder’s medical needs. In this article, we are going to discuss health insurance, its types, benefits, and all other important facts.
Types of Health Insurance in India
Healthcare costs are rapidly increasing along with the growth of health-related issues. Furthermore, the demand for health insurance coverage is increasing. Because of this, there are several types of health insurance policies on the market that help to ease the financial burden. These insurance plans reduce financial burdens in addition to allowing you to receive the best treatment available for your medical conditions. Selecting the right insurance plan might be a bit difficult because there are so many different types of health insurance policies offered in India.
We have reviewed all the essential elements of health insurance coverage and listed all 11 plan types to make it easier for you to select the best plan.
| Health Insurance Plans | Suitable For |
| Individual Health Insurance | Individual |
| Family Health Insurance | Entire Family- Self, Spouse, Children, and Parents |
| Critical Illness Insurance | Used for funding expensive treatments |
| Senior Citizen Health Insurance | Citizens aged 65 and above |
| Top Up Health Insurance | This insurance plan is beneficial when the sum insured by the existing policy gets exhausted. |
| Hospital Daily Cash | Daily hospital expenses |
| Personal Accident Insurance | It can be used in case of any loss or damage to the owner or driver. |
| Med claim | In-patient expenses |
| Group Health Insurance | For a group of employees |
| Disease-Specific (M-Care, Corona Kavach, etc.) | Suitable for those who are suffering from pandemic-manifested conditions or prone to one. |
| ULIPs | The dual benefit of insurance and investment |
Different Types of Health Insurance in India
Now let’s discuss types of health insurance in detail
Individual Health Insurance
A single person is the target audience for an individual health insurance plan. It may be purchased by one person, as the name implies. The person who enrolls in this plan and obtains insurance is reimbursed for the costs associated with illness and medical bills. These kinds of health insurance plans pay for all hospital stays, surgeries, and pre-and post-medication costs up to the covered amount. The buyer’s age and medical history are taken into account when determining the plan premium.
Also, by paying an additional premium under the same plan, the insured person can cover his parents, spouse, and children. There is a two to three-year waiting time before you can receive payments if you are covered for an ailment that already exists.
Family Health Insurance
A family health insurance policy, often called a “Floater Plan,” provides coverage for every member of your family under one roof. Family health insurance policies provide coverage for your spouse, children, and elderly relatives. The whole family is covered by a single premium, which only has to be paid by one member of the family. If two family members are receiving treatment at the same time, you can file an insurance claim for each of them until the time the limit is met. The age of the oldest person to be covered by the plan determines the premium.
Critical Illness Insurance
The Critical Illness Insurance plan provides insurance coverage for life-threatening illnesses by providing a lump sum payment. The pre-selected health issues are covered at the time of purchase, and you are eligible to make an insurance claim if you are impacted by any of the illnesses. Under this kind of insurance coverage, hospitalization is not necessary to submit a claim.
You are only eligible to get benefits from critical illness insurance if you have been diagnosed with the sickness. Regardless of the costs incurred before and during hospitalization, the amount to be paid is predetermined. The list of all the serious illnesses that are protected by serious Illness Insurance is provided below.
- Major organ transplant
- Cancer
- Aorta graft surgery
- Kidney failure
- Stroke
- Multiple sclerosis
- Paralysis
- First heart attack
- Coronary artery bypass surgery
- Primary pulmonary arterial hypertension
Senior Citizen Health Insurance
As the name suggests, those 65 years of age and above are covered by these kinds of health insurance in India. Thus, this is the finest insurance policy for you if you want to get one for your parents or grandparents. Whether your medical expenses are related to an accident or a health problem, the Senior Citizen Health Insurance will cover them.
Both hospitalization and post-treatment expenditures are covered. In addition, other services including psychiatric and ambulatory hospitalization are also covered. The maximum age has been set at 70 years old. A full physical examination may also be required by the insurer before selling Senior Citizen Health Insurance. Moreover, because elderly people are more likely to become ill, this plan has a relatively higher premium.
Top Up Health Insurance
The Top Up Health Insurance plan is available for purchase by an individual who wants greater coverage quantities. Nevertheless, this insurance now includes a “Deductible Clause.” As a result, when the claim is submitted, the amount paid exceeds the pre-established cap specified in the policy. Additionally, the person has access to a Super Top-Up package. It boosts the sum covered by offering more coverage than the standard insurance. Only once the standard policy’s insured amount is depleted may the Super Top-up plan be utilized.
Hospital Daily Cash
Hospital Daily Cash is an inventive solution offered by several health insurance policies, which is covered in another section. You should follow through on this approach and educate yourself on the workings of these health insurance policies if you are hesitant to get an insurance policy.
Having this strategy in place might help shield you from unforeseen costs while you’re in the hospital. Routine hospital costs are not set once a patient is in; instead, they vary depending on the patient’s health. The Hospital Daily Cash is very useful for an individual in this kind of circumstance.
The daily cash reward under this plan ranges from Rs. 500 to Rs. 10,000, depending on the coverage amount chosen at the time of insurance. Certain plans additionally provide convalescence benefits if the patient stays in the hospital for more than seven days. Parental accommodations and wellness coaches are additional add-ons.
Personal Accident Insurance
Because there are now more road accident cases than ever before, India’s residents are protected by specialized health insurance plans. As a result, some individuals pass away or become incapacitated, and having to pay for their medical care can be emotionally taxing. Therefore, it makes sense to get personal accident insurance. The victim or his or her family receives help in the form of a lump sum payment under this insurance.
Additionally, some of the plans include orphan benefits and education benefits to help with the children’s expenditures. Additionally, Bajaj Allianz offers personal accident insurance with add-on coverage for temporary total disablement, support services, international emergency, and accident in-patient hospitalization. In addition, the insurance company will take care of the insured if they have an accident and need to pay back any loans.
Mediclaim
Accidents and illnesses are not subject to warning. The costs incurred once a person is admitted to the hospital for any of these also apply. As a result, purchasing a Mediclaim Policy is advised. The Mediclaim Policy guarantees payment for your medical bills in the event of a sickness or accident. It covers the costs associated with being an inpatient, including anesthesia, oxygen, doctor’s fees, and nursing charges.
The Mediclaim Policy is marketed as group mediclaim, personal medical insurance, international medical insurance, and so on.
Group Health Insurance
One of the newest and most popular categories of health insurance policies available today is group health. Employees at many big and medium-sized businesses can purchase this insurance package. The company’s employer purchases this kind of health insurance for its staff members. This coverage has a significantly cheaper premium than Individual Health Insurance coverage. It is provided to the staff to address the company’s financial problem and prudential practices.
Disease-Specific (M-Care, Corona Kavach, etc.)
People are more likely to get a variety of diseases these days, including Covid-19. Therefore, the cost of treating these infections may be rather high. Therefore, Bajaj Allianz has launched various disease-specific insurance coverage to make it easier for customers to get treatment.
You should thus consider purchasing health insurance coverage that will assist you in dealing with such serious health issues. Disease-specific medical insurance policies are situation-specific and offer coverage for particular disorders. One insurance policy is Corona Kavach, which gives the policyholder a sum ranging from Rs. 50,000 to Rs. 5,00,000.
The age range for this restriction is 18 to 65. This kind of policy is called a family floater. When it comes to the M-Care Health Insurance Policy, protects the insured against illnesses spread by mosquitoes. Numerous illnesses may be contracted by mosquitoes, such as Zika virus, malaria, dengue fever, and chikungunya. As a result, M-Care provides coverage for certain illnesses.
ULIPs – Unit Linked Insurance Plans are an extension of ULIPs. Under these plans, you invest a portion of your premium and utilize the leftover funds to get health insurance. As a result, in addition to offering you security, this plan helps you generate income. Your funds may not last long due to the escalating expense of healthcare facilities.
Consequently, having more money available to you is always preferable. You cannot guarantee a certain sum with ULIPs because they are based on market risk. Additionally, after the insurance term, the buyer receives the returns generated from ULIPs.
Indemnity & Fixed Benefit Plans of Insurance
Indemnity – policies that let the policyholder claim medical expenditures up to a certain amount are known as indemnity policies. The policyholder is limited to filing claims over the maximum amount. You can get your medical expenditures from your insurance provider in one of two ways:
Reimbursement Facility: You pay the costs first, and the insurance company reimburses you for those expenses.
Cashless Facility: This type of facility does not need you to pay bills because the insurance company pays the hospitals directly.
The following medical insurance plan types are included in the category of indemnity plans:
- Individual Health Insurance
- Family Floater Plan
- Group Health Insurance
- ULIPs
Fixed Benefits
With fixed benefits, you might get a set sum of money for certain medical conditions brought on by diseases or accidents. It provides coverage for the medical conditions specified when the insurance was purchased. The following is a list of well-liked health insurance plans that are covered by fixed benefits;
- Personal Accident Plan
- Critical Illness Plan
- Hospital Cash Plan
Why is Health Insurance Important?
Financial Support – In the event of a medical emergency, insured persons are provided with financial support by their health insurance policies.
Tax Benefits: Since health insurance is covered by Section 80D of the Income Tax, purchasing one would let you deduct some expenses from your taxes.
Investment plus savings – When you get a health insurance policy, you may stop worrying about the cost of medical care. This is so that the insurance company will pay for the costs.
Annual health examinations: Bajaj Allianz offers you the benefits of annual health examination coverage. As a result, the insurer covers the costs of the covered person’s yearly physicals.
Handle Medical Inflation: Purchasing health insurance policies will enable you to handle medical inflation better, more easily, and without having to pay more out of cash.
Covers difficult operations: Benefits for coverage of complex treatments, such as bariatric surgery, are provided by health insurance policies.
Benefits for organ donors: Purchasing health insurance will cover you if you choose to donate an organ. It provides coverage up to the insured amount.
Coverage for alternative therapies: When you buy a health insurance policy, you get coverage for therapies like yoga, homeopathy, and Ayurveda.
Things to Consider While Buying Health Insurance
Deductibles: It’s important to research the deductibles associated with any form of health insurance coverage before purchasing it. A deductible is the portion of a claim that must be paid by the insured if one occurs; the insurance company will cover the remaining balance.
Your Age – When purchasing health insurance for oneself or a family member, the buyer must be aware of the significance of the age element. A buyer’s age determines the plan they choose, and other factors like premiums, waiting periods, and renewability also come into play.
Medical History of Family Members: When purchasing a health insurance policy, it is important to take the family members’ medical histories into account as they may influence the policy’s price. A family member’s likelihood of filing an insurance claim increases if they already have a medical condition.
Exclusions: A clause in a policy that forbids coverage for a particular kind of risk is called an exclusion. Pre-existing conditions, pregnancy, cosmetic procedures, hospitalization costs, alternative therapies, lifestyle-related disorders, diagnostic test limits, and medical charges for treating accidents are just a few of the usual exclusions included in the majority of health insurance policies. Thus, before purchasing any health insurance, the customer must go over these restrictions with the insurance company.
Sum Assured/Insured: The amount of money that the insured person will receive after the insurance term is known as the sum assured. The amount paid to the insured in the case of an unanticipated circumstance, such as a medical emergency, theft, car damage, etc., is known as the sum insured.
Waiting Period: When referring to health insurance coverage, the waiting period is the time you must wait before receiving benefits. Plans differ in terms of how long they have to wait.
Lifetime Renewability: There are several possibilities for renewability offered by the various health insurance plans. Therefore, before purchasing one for yourself or a member of your family, exercise caution.
Network Hospitals: The insurance provider covering the largest network of hospitals on the buyer’s list must be selected when purchasing any insurance policy.
Claim Settlement Ratio: The person ought to choose an insurance provider that offers a quick ratio for settling claims.
Conclusion – People now have to get health insurance policies for themselves and their family members due to the ever-growing expenses of medical care. In India, Bajaj Allianz provides all-inclusive health insurance plans that cover any kind of illness, circumstance, or accident.
As a result, it takes time and effort on the part of the buyer to fully understand the meaning of health insurance and the many kinds of policies that are offered on the market. Comparing the terms and conditions offered by each insurance company becomes equally crucial.
Many people express dissatisfaction about paying exorbitant premiums and receiving subpar benefits. This occurs when someone neglects to compile the necessary data for every insurance plan and provider. To ensure that you select the plan that best suits your needs, you must be knowledgeable about the ins and outs of different forms of medical insurance.