HEALTH INSURANCE

Health Insurance policy cover hospitalisation expenses on account of an illnesses or injuries. A comprehensive health insurance covers the cost of hospitalisation, day-care procedures, medical care at home (domiciliary hospitalisation), ambulance charges etc. The expenses are paid directly to the healthcare provider or reimbursed. The Income Tax Act of India allows tax benefit u/s 80D for premiums paid for health insurance plans.

Kinds of Health Insurance

Individual Health Insurance Policy

Individual Health Insurance plans cover a single individual. The insured individual is compensated for the medical expenses to the extent of sum insured. The premium of the plan is decided based on the buyer’s age and medical history. There may be a waiting period to claim benefits in case of a pre-existing health condition.

Family Health Insurance Plans

Family Health Insurance plans protect an entire family under a single cover. The spouse, children and parents are covered under Family plans wherein only one member pays premium for all. The extent of coverage is limited to the sum insured.

Critical Illness Insurance Plans

Such plans insure the person against specific critical / life-threatening illnesses. Such illnesses may require multiple visits to the hospital over a long period. In addition to the hospitalisation expenses, there will be other costs like consultation fees, investigations etc. At the time of buying the insurance, the chosen health problems are included and insurance lumpsum can be claimed in case the insured is affected by any of the pre-selected conditions. The diagnosis and not hospitalisation is enough to avail the benefits of such plans. The critical illnesses specified for coverage under this type of plans are:

Major Organ Transplant

Cancer

Aorta graft surgery

Kidney failure

Stroke

Multiple sclerosis

Paralysis

First heart attack

Coronary artery bypass surgery

Primary pulmonary arterial hypertension

Personal Accident Insurance Plans

Such plans cover the insured against financial liabilities arising from injuries, disabilities or even death due to accidents. They cover medical and hospitalisation expenses, children’s education and a lumpsum in case of disabilities. Common inclusions for such plans are as follows:

Coverage for hospitalisation and other medical expenses

Coverage for Expenses (with daily limit basis)

Coverage for Partial or Permanent disability due to accidents

Coverage for Death due to accidents

Coverage for Children’s education

Senior Citizen Health Insurance Plans

Such types of Health Insurance plans provide coverage to people who are 65 years and above. They offer coverage for the cost of hospitalisation and medicines, whether it arises from a health issue or any accident. It covers hospitalisation expenses and post-treatment costs too. On top of this, some other benefits like Domiciliary Hospitalization and Psychiatric benefits are also being covered. There are clauses however like upper-age limits, medical check-ups etc. The premium for this plan is comparatively higher when compared to individual or family health insurance plans.

Top Up Health Insurance Plans

An individual can opt to buy Top Up Health Insurance plans to seek higher coverage amount at a very affordable premium. When the claim is made, the payment done is over and above the pre-defined limit (Deductible) that is mentioned in the policy. Moreover, there is also a Super Top-Up plan available for the individuals and family. It provides additional coverage over the deductible whether the person has a regular policy or not. The Super Top-up plan can only be used once the hospitalization expenses cross the deductible amount.

Group Health Insurance Plans

Such plans are offered by Employers to their Employees. Since such plans are designed for a group of people, the premiums are usually lower than Individual plans. Apart from the pricing, group plans may also offer more benefits.