What is Health Insurance?
A health insurance is a worthy wealth besides money. In a simple form, health insurance is a product which gives you a sense of security from the incurring expenses of hospital bills at the time of emergency. It covers the medical and surgical expenses of an ensured person. It can either done upfront (in the form of cashless treatment) or post treatment (in the form of reimbursement) by the insurer (the insurance company).
Health insurance has now become an essential for individual of all the age group in today’s life of ever-soaring medical expenses. Moreover, following a rise in lifestyle diseases and double digit medical inflation in India every year, you must have a health insurance plan that fulfils your requirement. Though private and public-sector employers provide group health insurance, but such do not provide all benefits to your family. Therefore, you always need a separate health insurance that covers you and your family. Going by medical expenditures of an individual a Health Insurance is extremely essential as uninsured people receive less medical care. Life is very uncertain, especially when we are living an imbalanced one in between stress and unhealthy habits. In such scenario, the main priority of every individual is to protect themselves from the expenses incurred due to any unforeseen medical issues. To cover that risk of medical expenses and to save the pocket from the huge bills of hospitals, we all need to cover ourselves with a health insurance. Don’t let your health problems to become a financial breakdown for your household. Buy a family health insurance to ensures your family and get total peace of mind. This way, you can focus to look after the hospitalised family member rather than running around gathering funds for the treatment or more disastrously, foregoing treatment altogether due to lack of funds.
Though, health insurance in India is a growing segment of India's economy but a survey carried out in the year 2014 found out that, more than 80% of Indians are not covered under any health insurance plan, and only 18% of the urban population and 14% of rural population was covered under any form of health insurance.
Why should you have Health Insurance?
Fall sick or get hurt is not in anybody’s to-do list. It is always unplanned as well as uncertain. Nobody wants to get hurt or fall sick, but still we all need a medical care like doctor’s visit, prescribed drugs, lab tests, and so on at some point of time. As the advanced technology has taken place of those old ways in health care segment, the cost of health facilities has also increased. At that point of time, a health insurance solves the purpose by providing us the financial aids either in the form of cashless or reimbursement. In addition to the hospitalization, health insurance also provides us the facilities like outpatient care, medication, laboratory tests cost when needed.
So, having a health insurance is beneficial for one or the other reasons. We all know the importance of health insurance, but the fact is that it is still considered as a tax saving tool only and taken by people only for the sake of getting exempted from the tax slab. But the fact is that other than a tax exemption, health insurance covers essential health benefits critical to maintaining your health and treating illness, accidents and high medical costs and gives us a free preventive care. In India the medical costs are surging at the rate of 15% to 20% every year.
Advantages & Features of Health Insurance
There are many private players in the market offering wide range of health insurance plans. It is now possible for all Indians to receive good quality, comprehensive health coverage.
Advantages of health insurance
Ill health, disease and sickness come without announcement. Though no one wants to be hospitalized, this becomes necessary from time to time. It can happen to anyone at any age or stage of life. At such time, the family's resources can become severely stressed and savings may be completely depleted because of surgery, extended hospital stays, specialists’ consultation and prolonged medication protocols. Since health care is costly, buying the right health insurance plans can help mitigate the problem. Health insurance acts as a safety net for the entire family: for the payment of a fixed premium, the policyholder is assured of protection in case of illness or disease.
Statistics show that people who do not have health insurance policy tend to have worse health outcomes. They may not get adequate or timely care and the chances of complications could increase. It may not be possible for an individual to arrange sufficient finances for a health emergency particularly when large sums are required at short notice. However, with health insurance, one is assured of getting timely medical attention and appropriate treatment.
Other advantages of health insurance plans are that insurance company also reimburse expenses incurred up to 30 days before and up to 90 days after hospitalization. Critical illness insurance, outpatient procedures, prosthetic costs, dental treatments, daily cash allowance, maternity coverage and dental treatments may also be covered depending upon the type of policy and the riders that a policyholder opts for. Policyholders can also opt for coverage of domiciliary treatments and/or attendant expenses. Some health insurance companies also offer attractive additional features such as free annual health checkups.
Basic features of Health Insurance Plans
- A basic health insurance plan offers protection for hospitalization expenses including room rent, medicines, nursing expenses, surgery, OT, anesthesia and so on.
- Basic policies typically assure sums between Rs.3 and 10 lakhs; though many companies offer higher value policies as well. The insurance company would pay or reimburse valid, covered expenses up to or less than the total policy amount.
- The policyholder can make a cashless claim at any of the network hospitals or diagnostic centers specified by the insurance company.
- Health insurance plans also cover expenses incurred 30 days before hospitalization and 60 days after discharge.
- Family floater plans cover all members of the family including the policyholder, spouse, children and elderly parents. This obviates the need to buy separate health insurance for senior citizens.
- The policyholder can avail no claims benefit or cumulative bonus if they made no claim under the policy during the preceding term of the policy.
- A mediclaim policy may be issued for anyone from the age of 5. Most policies offer the insured members renewal benefits for lifetime. According to IRDA guidelines, insurance companies are bound to issue health insurance for senior citizens as well and the insurance provider cannot refuse to issue such a policy to anyone until the age of 75.
- Usually health insurance plans do not cover newborn babies, maternity expenses and neonatal medical expenses.
- There is usually a waiting period of between 30 to 90 days after policy purchase, before a valid claim can be made. Some policies may waive this waiting period however.
- Health insurance plans will not cover critical illnesses (as specified by the policy document or the IRDA guidelines) and preexisting illnesses
Optional or Additional Features/Riders of Health Insurance Plans
It is possible to customize mediclaim and other health policies to the requirements of the policyholder. Depending upon a person's income, lifestyle, family size & average age, occupation (certain occupations carry higher health or accident risks), family health history and overall health of insured family members, a policyholder can decide what optional add-on/riders to opt for. By choosing riders below, a policyholder can secure themselves and their family better with the help of a comprehensive policy:
- Critical illness Cover offers coverage for medical conditions such as heart attack, stroke, organ failure and/or transplant, cancer and several other conditions which are excluded from basic health insurance. This becomes very important when buying health insurance for senior citizens who have greater likelihood of certain medical conditions. Examining family medical history and genetic risk factors will also help decide whether to opt for this rider.
- A hospital cash rider covers day to day expenses during hospitalization of up to 7 days in terms of cash.
- Basic policies do not pay for childbirth related expenses, however opting for maternity riders will help defray these expenses. This rider will pay for delivery, pre and post-natal expenses, and newborn baby cover as well as for complications if any.
- Personal accident riders will offer lump sum payment in case of accidental death and help compensate for temporary or permanent disability arising from accidents.
- Room rent waiver is another rider commonly opted for. It removes any capping on room rent under a policy, so that the policyholder can opt for a private room of a room with better facilities as required.
There may be other riders offered along with health insurance plans, depending upon the type of policy you buy, the total amount of coverage and from which company you buy. By choosing a policy that suits your requirements and then adding applicable riders, you can enjoy the peace of mind that comes from knowing that you have done all you need to protect your family's health.
Importance of Health Insurance
Today, the medical healthcare ecosystem is characterized by a steep rise in costs of medicines. It is not uncommon to see people selling off assets or taking loans to finance the costs of hospitalization and treatment. This phenomenon is more pronounced in semi-urban and rural areas. Typically, any major health ailment can be financially draining for you.
This is why taking a health insurance policy can be a good financial move.
Getting health insurance will offer coverage against
1. Diagnostic tests and doctor fees
2. Room charges, rental charges for equipment used in the treatment
3. Ambulance costs
4. Pre and post hospitalization costs
Some Benefits of Taking Health Insurance Include
1. Family coverage - You can opt for an umbrella cover in the form of a family health plan. It takes care of the health and treatment needs of multiple people in your family. If you opt for a floater plan, you can use the same policy for treatment of more than one relative in the same tenure.
2. Peace of mind - You don’t need to worry about your financial situation at the time of unplanned medical contingencies. You can dedicate your energies to getting the best medical care your loved ones deserve and leave the financial worries to a health insurance policy.
3. Tax benefits - Under section 80D, you can claim income tax exemptions on premiums for a health insurance policy. This is an additional reason why you need to check out health insurance as a viable financial instrument.
4. Longevity - With proper access to timely medical care, you can ensure the longevity of your loved ones. No longer will superior quality health care need to be a barrier due to lack of funds. Give total care by opting for the appropriate health insurance plan.
In order to avail these benefits, you need to consider some important points when buying a health insurance policy for your family:
1. Talk to an insurance expert to know your precise requirement
2. Don’t wait till you fall sick to get a health insurance. It may happen that the premium would be steep then
3. Different policies from different providers come with different inclusions and exclusions. You need to be aware of what you are going for
4. Rather than going for verbal commitment, you need to have a close look at the written terms and conditions before signing up for a new policy
5. Check out the credibility of the insurer by looking at the claim settlement ratio for health insurance (amount paid vs the total claims made)
6. Check out the co-pay option applicable. It is basically the percentage of the claims you will have to bear from your pocket (the remaining will be borne by the insurance company). The one with a lower co-pay will be beneficial for you.
Types of Health Insurance Plans
With more companies issuing health insurance products to suit various lifestyles and personal requirements, it can become rather confusing to decide which is the best mediclaim policy and what purpose they serve. To choose the best health insurance plan for your requirements, it is important to know about different types of health insurance policies, coverage extent, features, and customization options:
Individual Plans – This is the best mediclaim policy for single people or those who live by themselves. It covers hospital and surgical expenses to the extent of the sum assured under the policy. The coverage is subject to the maximum amount specified by the policy.
Family Floater Plan or Mediclaim Policy for Family – This type of health insurance covers the entire family under one single plan for the payment of a single premium. The policyholder will specify who all are to be covered, including themselves, spouse, children and parents as required. Such policies cover simultaneous medical events of more than one member of the family as well; subject to the claim limit of the maximum sum assured by the insurance company. Such health insurance plans for family tend to be much more economical than buying individual plans for every member separately.
Hospitalization Plans – Also known as basic plans, these policies will offer cashless settlement of claims arising from hospitalization due to disease or illness. Comprehensive planscover a wider range of ailments and medical conditions and offer better protection. A basic mediclaim policy for family will typically cover room rent (which could be subject to a sublimit), surgical, nursing, specialist, anesthetist, diagnostic expenses and medications. Such policies also normally cover medical expenses incurred 30 days prior to hospitalization and 60 days after discharge. A policyholder can also opt for various riders to create a more comprehensive policy offering more protection, such as maternity cover, domiciliary hospitalization benefits (home care when hospitalization is unadvisable or impossible), daily cash allowance and so on. Basic plans usually include day care procedures – surgical or other interventions that do not need a person to be admitted to hospital overnight or for extended periods.
Top Up and Super Top Up Plans – This is the best mediclaim policy for those who already have some amount of medical insurance cover available with them from their employer. This type of policy usually has a deductible amount that will be the threshold limit above which the Top up or Super top up plan will be activated. However, it can be a good way to supplement an existing policy, whether self-purchased or offered by an individual's employer. Such a top up plan also acts as mediclaim policy for family when employee health insurance is inadequate or where it covers only one member of the family. In addition, there is also the option of super top up or health booster plans that offers additional coverage of a higher sum against an aggregate deductible. The other benefit is that premiums are more affordable in this case.
Group Insurance Plans – Many insurance companies offer group plans to specific groups of people, such as the employees of a company, members of club or social group and so on. A policyholder can buy this type of insurance in addition to an existing policy or such insurance may be provided by their employer. Group insurance can be an economical option since insurance companies would typically be able to offer a bulk discount in respect of such policies.
Pre-Existing Disease Plan – For elderly people or for those with specific medical ailments, the best health insurance plan with the highest coverage limit may be inadequate if there is a pre-existing disease exclusion clause. A pre-existing disease is defined as “any condition, ailment, injury or related condition(s) for which you had signs or symptoms, and/or were diagnosed, and/or received medical advice/treatment, within 48 months before taking your first policy”. This means that the insurance company will not pay for claims made with regard to conditions that already exist at the time of policy purchase. It is further important to note that even with the best mediclaim policy there is typically a waiting period of between 12 and 36 months from the initiation of the policy before the policyholder can make a claim for a preexisting illness. The policyholder can obviate this problem by buying a policy that covers preexisting conditions and has no waiting period for making a claim.
Unit Linked Health Plans (ULHPs) – You may want to consider ULHPs when you are buying a mediclaim policy for family, if you wish to combine insurance with investment. Similar to other investment-based insurance plans, some health insurance service providers offer health plans with ULIP features and returns are paid out at the end of the policy term. The returns are not fixed since they are subject to market performance.
1.Disease specific plans – Sometimes, there is an outbreak of certain diseases, particularly viral or vector borne diseases such as dengue which may result in significant complications leading to high expenses. Policyholders can opt for such health insurance plans for family based or lifestyle factors, epidemic patterns, occupational and other factors.
2. Optional plans/ riders – Rather than types of health plans, these are optional addendums that you can choose to add to your basic health plan. You can create the best mediclaim policy for your needs. Rather than choosing insurance products from one or another insurance services provider or selecting one or another specific plan, the best health insurance plan is the one that you create for yourself. Choose the coverage limit that best suits your health needs and lifestyle. To this you can choose to add the optional coverage or the riders you need based on the age and health condition of individuals covered by the policy, occupational and other risk factors such as family history.
Indemnity plans seek to bring about zero changes to the financial condition of the policyholder. This is done by reimbursing the actual hospitalization costs borne by him/her. The extent of the amount borne will be equal to or less than the sum insured amount associated with a given policy. Consider the two scenarios for an indemnity health plan of Rs. 1 lakh–
- Total costs of hospitalization and medicines = Rs. 76,000. Amount disbursed by company = Rs. 76,000
- Total costs of hospitalization and medicines = Rs. 2,10,000. Amount disbursed by company = Rs. 1 lakh (maximum SI amount allowed)
What Is Covered in Your Health Insurance?
Though health insurance plans do offer protection and peace of mind, still they have several terms and conditions, inclusions and exclusions (a basic policy does not offer critical illness insurance for instance) that determine the circumstances and medical procedures for the insurance company to pay under a policy. We look at what health insurance covers:
Health Insurance Plans typically cover the following:
- Health insurance covers hospitalization expenses arising from specified illness or disease up to the maximum limit or value of the policy. This includes room rent, surgical and operation theatre expenses, nursing, anesthetist charges, prescription medications and relevant diagnostic procedures. Most policies require overnight hospital stays for a successful claim.
- Mediclaim policies also pay for related expenses that a policyholder incurs 30 days before hospitalization as well as up to 60 days after discharge from hospital. Under Mediclaim policies, the company will pay the expenses incurred by a policyholder, 30 days prior to hospitalization and up to 90 days after discharge Tests, consultations with specialists and prescribed medicines may some of the expenses covered.
- Whereas individual plans are designed for single people, families can opt for family floater plans. This type of health insurance plan gives coverage to you and your whole family under one policy in a single premium. These types of health insurance plans cover the entire family under one policy, for the payment of a single premium. Even if more than one person in the family needs treatment concurrently, the insurance company will pay for both claims so long as they are valid claims covered by the policy; subject to the maximum amount payable under the policy.
- Cashless service is one of the attractive features of health insurance. Getting admitted to a network hospital has the advantage of not having to pay cash up front. The insurance company undertakes to pay the hospital directly for treatment, surgery and other covered medical expenses directly. Each health insurance company has a network of hospitals and diagnostic centers where covered individuals can receive cashless treatment.
- Like other types of insurance, mediclaim policies also offer no claims bonus. This means that if the policyholder makes no claim during the previous insurance term, the company may offer discounts or additional features on subsequent policy purchases.
- Health insurance policy portability is another feature that insurance companies are bound to offer. This allows the policyholder to port their policy from one to another company for seamless protection without loss of accrued benefits on the plan. The policyholder is free to switch service providers if he or she feels that another company offers a better deal or additional features at a better price. Insurance companies cannot disallow this.
- Health insurance policies also offer tax benefits to the policyholder. Under section 80D of the income tax act, policyholders could save Rs 25,000 in taxes and up to Rs 55,000/- if senior citizens are also covered under the policy.
Other features of Health Insurance Plans
While the above are features of a basic health policy, it is possible to add coverage to a policy by adding riders or by buying a more comprehensive plan. For instance, critical illness insurance daycare procedures, domiciliary treatment, maternity expenses and disability insurance are not usually covered. However, some comprehensive policies do offer these features. Failing this, the policyholder is free to opt for riders to buy more protection for their family. Depending upon the service provider or company, some policies include these additional features:
- Free annual or bi-annual medical checkups that include basic tests and consultations for all the individuals covered by the policy
- Some health insurance plans have no capping on room rent. This means that the policyholder can choose the type/ grade of hospital room without being constrained limited by the room rent sub limit and can opt for a private room or one with better facilities.
- Some mediclaim also cover organ donor expenses in the event of organ failure up to the sum assured
- Similarly, health insurance plans from some companies also cover day care or outpatient procedures that do not require hospital stays
- Some health insurance policies also provide reimbursement for ambulance charges subject to a specified limit.
- In some cases, health insurance plans may waive the waiting period required to make a claim after policy purchase. There may also be variations in the waiting period for coverage of preexisting diseases; depending upon the service provider and specific policy terms.
- Dedicated claims handler(s) may be another attractive feature that some companies /policies may offer. It can greatly ease the claims process when there is a team of dedicated, knowledgeable customer care professionals to offer information and guidance and to ensure quick and trouble-free processing of a claim under the policy.
When there is an illness in the family, this can be a time of great stress and uncertainty. At such juncture, the policyholder wants to rest assured that they will be able to avail cashless claims for any eventuality. The right health insurance plans will help ensure that you can avail convenient and speedy cashless services for a variety of ailments and diseases. Hence it is important to ascertain the market reputation of an insurance company and examine aspects such as the claims settlement ratio. Then choose the right policy, with the assured sum commensurate with your medical needs, lifestyle and family size to get the peace of mind you deserve!
What Is Not Covered in Your Health Insurance?
It is vital for a policyholder to understand the exclusions of health insurance and eventualities that health policies do not cover. Typically, even a product that claims to be the best health insurance plan may not cover the following:
Critical illness – A typical mediclaim policy does not pay for critical illnesses such as stroke, cancer, heart attacks, coma, organ failure requiring regular dialysis, major organ or bone marrow transplant, permanent paralysis of the limbs, motor neuron disease, Multiple Sclerosis and other conditions. These are listed in the definitions set out in the IRDA circular covering Guidelines on Standardization in Health Insurance. However, a policyholder can buy a separate critical illness policy or opt for a rider that adds protection to a basic plan. It is important to find out exactly what expenses are covered and whether there are set sub-limits within the overall coverage limit.
Day care procedures – Daycare procedures are those that do not need overnight, or longer hospital stays, such as keyhole surgeries, endoscopies and minimally invasive procedures. Unless a mediclaim policy expressly covers daycare procedures, these are excluded as well. Even policies that claim to cover daycare procedures usually have a pre-defined list of day care treatments that will be covered. Any other day care procedures outside of this list won’t be covered. exclude specified list of such treatments. So be careful about the definitions set out in the terms and conditions of the health policy. The best health insurance plan is one that covers all daycare procedures rather than ones on a specified list.
Maternity and neonatal care – An individual plan or even health insurance plans for family will not usually cover expenses incurred for pregnancy, delivery, abortion, miscarriage and other obstetric expenses. If there are complications for mother or child after delivery such as neonatal ICU or emergency surgery these are also not covered. However, some group plans such as employee insurance do offer maternity coverage. A policyholder can also opt for a maternity and/or neonatal protection rider to acquire additional protection.
Preexisting conditions – A mediclaim policy will not cover ailments that already exist prior to commencement of a policy. Some types of preexisting diseases may be covered; but typically, there is a waiting period of between 12 and 36 months before a policyholder can make a claim for preexisting disease related expenses. It is important to make full disclosure of any preexisting medical conditions to the insurance company at the time of buying a policy, so the insurance company cannot raise a dispute or dishonor a claim at a later date.
Dental and eye care – Most mediclaim policies will not cover dental or eye care procedures, such as dental implants, braces and corrective surgery that is not medically indicated. Though some policies do have dental and eye care provisions, their scope may be limited. Here again, the policyholder must check the terms and conditions; particularly those relating to daycare procedures, since these could be considered daycare or outpatient treatments.
Cosmetic procedures – Even the most expensive and the best health insurance plan will not offer to pay for plastic surgery, beauty treatments or any treatment that has only cosmetic application (not medically necessary). However, if cosmetic surgery is required as a result of an accident, some policies do cover these expenses.
Sexually transmitted or lifestyle diseases – STDs such as HIV or AIDS and others or any conditions arising from STDs are not covered by a mediclaim policy, even if the policy provides critical illness insurance. The insurance company will also not pay for diseases or disorders that are the result of unhealthy lifestyles or habits such as excessive drinking, drug abuse or prescription medication abuse.
Self-harm or suicide attempt – Any hospitalization or treatment that arises from illegal acts, self-harm or an attempt to suicide is outside the purview of a mediclaim policy.
Alternative or complementary treatments –[VC1]
Acts and omissions – Some acts or omissions on the part of a policyholder may also void the terms and conditions of the contract between the insured and the insurance provider. It is important for the policyholder not to withhold any relevant information, medical or otherwise, or to make any false statements to the insurance company. Full and fair disclosure of all relevant details must be made before buying a policy. Not doing so could be construed as fraud and in such circumstances the insurance company is well within its right to refuse to pay for treatments or expenses.
At the time of buying a mediclaim policy or any type of health insurance it is important to do your due diligence by reading the policy document and understanding fully the implications of it. Read the fine print thoroughly to understand inclusions and exclusions. If you have any doubts, do not hesitate to ask for clarifications from the company representative or customer service personnel. As a policyholder this is your right; as someone who wants to look after the wellbeing of your family, this is your duty.
What should be the ideal health insurance cover?
Different requirements make it necessary for different health insurance plans to be opted for. We cover a few common scenarios and recommend the right kind of policy.
1 – Newly married family (no kids) - You can go for family floater plan for Rs. 4-5 lakhs. Since the health risk is lower you can get coverage at lower cost
2 – Small family with young kids (kids are around 4 years) - You can go for family floater plan for Rs. 6-7 lakhs. There is a lower risk of all member requiring treatments, and hence works well for this young family
3 – Older family with young kids (kids are around 15 years) - You can increase the coverage to Rs. 10 lakhs. While the risk may increase with age, the increased coverage will be adequate
4 – Mature family (kids are around 20-22 years) - While both parents may require individual plans, the floater plan can be continued but with a lower coverage of around Rs. 15 lakhs
Do note that this is just an illustrative indication. You need to carefully align the right plan after thorough research.
Advantages of Buying Health Insurance Online
As already mentioned, different companies offer different types of insurance plans. However, you need to know what is available in order to select the best health insurance plan to protect your family. With online insurance purchase you can get the best quotes and that too for the specific overage you are looking for.
With online health insurance, the best thing is that you can do a side by side comparison of the different plans and then make a research-backed decision. You can check out various parameters like sum insured, add-ons, riders, and premium costs. This will let you take the right purchase decisions. With online insurance you don’t need to travel all the way to different insurance companies’ offices and pick their brochure and then make a decision. With the powerful comparison facility, you can align the right health insurance plans to protect your family.
Documents Required for Health Insurance Policy Claims Reimbursement
When you opt for a health insurance claim reimbursement you need to keep detailed records of all bills. Some documents of the hospitalization that you would be required to furnish include:
1 – Discharge card
2 – Pre-signed and filled up hospital bills
3 – Bills from the pharmacy and from in-hospital disposables
4 – Claim form filled up properly with the insured signature
5 – Patient reports and charts
6 – ID card of TPA (Third-Party Administrator)
7 – Insurance policy document copy
8 – Cancelled cheque and ECS authorization to allow the insurer to make the deposit in your bank account
9 – KYC documents for ID purpose
Process of Health Insurance Claims Settlement
1. Cashless Claim – for planned hospitalization
- Before hospitalization, check two essential things
- Is the ailment or illness covered under the insurance?
- Is the hospital a part of the insurer’s approved network?
- Before hospitalization, you will need to inform the company and fill up an authorization form available with the TPA sitting at a desk inside the hospital. The TPA is like a middleman between the policyholder and the hospital. He forwards the form to begin the approval process.
- Once you receive approval you can arrange for the hospitalization and cashless treatment
2. Reimbursement Claim – For unplanned hospitalization or treatment at non-network hospital
- Inform the company and submit a filled-up claims form to begin the reimbursement process. This needs to be done within 30 days of discharge
- Submit all necessary documents (as mentioned earlier) and doctor’s prognosis that led to the hospitalization
- Submit all post hospitalization documentation and prescription.
- Submit post hospitalization bills within 60/90/120 days as per your specific policy
If all goes well, you can expect the claim to be settled within 2-3 weeks of applying
Important Health Insurance Terms:
- Sum Assured - This is the amount you can expect to receive from the insurer for hospitalization expenses. If bills are more than the sum assured, then you need to bear the amount above the sum assured on your own
- Co-pay - Co-Pay is a certain percentage of the claim you need to bear. The insurer will offer to pay the remaining claim amount.
- Sub-Limits - Within the policy, you will find some sub limits i.e. the maximum you can get even if you aren’t exhausting your overall coverage. Room rent is one component that carries its sub-limit, beyond which you won’t be reimbursed by the insurer
- Comprehensive Cover - A comprehensive plan offers the widest coverage against every illness and thus provide your family with optimal protection
- Critical illness - A serious disease or a chronic condition like Cancer or Heart Attack. For such diseases, it is better to opt for critical illness cover that provides lump-sum amount upon being diagnosed with the illness.
- No claims bonus (NCB) - NCB is an incentive for not raising a claim in the previous year. The incentive can be in the form of reduced premium or enhanced coverage
- Waiting period - The policyholder needs to serve a fixed waiting period for any pre-existing ailments to prevent the policy’s misuse. He cannot apply for claims in this period.
Maternity - Maternity plans provide cover for pre and post-natal care, expenses towards delivery of baby, and post-delivery baby care.
You don’t need to worry about which policy to buy. With RenewBuy, you can purchase the best fit health insurance online. Now you can buy health insurance online after doing complete research as per the comprehensive information provided on the site.