Health Insurance
The health insurance policy is also popularly known as Mediclaim Policy covers cost of medical treatments.
It involves expenditure incurred on unforeseen diseases, accidents, Critical Illness, etc and covers services like Hospitalization, Day-care, Domiciliary treatment, operation charges, Ambulance charges, etc.
Individual Plan
In this plan, an individual is covered. This plan is suited for unmarried individuals.
Family Floter Plan
In this plan, the entire family is covered. The family consists of husband, wife, and two children. Total sum assured will be available to the family collectively or individually.
Family Floter With Parents
In this plan, the parents of either of the spouse are also covered along with the family.
It protects the medical expenses towards Hospitalization, Day-care, Domiciliary treatments, Surgical treatments, etc.
Insurance companies are also protecting against critical illness by charging an extra premium. They cover life-threatening diseases like Cancer, Kidney failure, Strokes, etc.
Insurance Companies provide cashless treatments through their network hospitals. The claim is settled between hospital and insurance companies. Hospitals take pre-authorization of expenses from the insurance companies. Policyholders need not worry about the expenditure aspect.
Premium paid towards the health policy is eligible for tax deductions under Section 80D of the Income Tax Act. In the case of an individual and his family premium up to Rs 25000 is allowed. Whereas in the case of Senior Citizen an amount up to Rs 50000 is allowed as deduction. A deduction of Rs 5000 is also allowed towards preventive health check-up.
Buying Insurance Plan Basics
What to consider while selecting a Health Insurance Policy/Plan.
Amount of coverage or sum assured is to be selected basing the income and need for the coverage for the self and family.
Health Insurance plan is needed to protect from the exorbitant medical expenses to be incurred on unforeseen diseases or accidents.
Premium on the policy also differs from company to company. It is advisable to check the premium charged by the other insurance companies. This can be done by visiting their respective websites.
Minimum waiting period for pre-existing illness to be checked. It is also different in different companies. Normally it is 24-36 months.
Claim settlement ratio is to be verified. A higher claim settlement ratio indicates the intention of the company to settle the claims.
Maximum age for renewal of the policy to be checked. It differs from company to company. Normally, renewal for life long is assured.
Sub-limits of various expenses concerning Room Rent, Major or Minor operation charges, the cap on certain diseases like Hernia, Cataracts, etc. Sub-limits for all these expenses also different for each company.
Additional Features of Health Insurance Policies
No Claim Bonus
Insurance companies offer to increase the sum assured by 5 to 10% p.a. in case of no claim during the year as No claim Bonus. This amount is added to the sum assured.
Free Health Check Up
Insurance companies are offering free health check-ups after completion of a certain period of the policy, say 2 years. Either they arrange health check through their network hospitals or reimburse the amount ranging from Rs 1000 to Rs 5000 pa depending on the Sum assured.
Restoration of Sum Assured
In case during the year sum assured amount is exhausted toward the claim. Some Insurance Companies re-instate the sum assured.
HEALTH POLICY for SENIOR CITIZENS
Insurance Regulatory and Development Authority (IRDAI) is the regulatory authority for the Insurance sector in India. As per the instructions of the IRDAI a Specialised policy for Senior Citizens has been introduced by Insurance companies. The aim of the policy to reduce the hardship faced by senior citizens due to increased medical expenses.
The main features of the policy areas are as follows:
- The entry age is 60 to 80 years and allows renewal for life long. Normally policy is not renewed after 90 years.
- Certain pre-existing diseases and critical diseases are also covered in the policy on certain terms and conditions.
- Since the rate of settlement of claims in the case of senior citizens is higher, Insurance companies insist on a certain percentage of claim amount as Co-payment by the policyholder. This amount differs from company to company.
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