Health insurance is a vital safety net providing financial protection against unforeseen medical emergencies. However, it is essential to understand the waiting period associated with health insurance policies. The waiting period is when the insured person cannot claim insurance benefits after purchasing the policy. This article will define the waiting period and its different types. Let's shed light on frequently raised queries to gain a comprehensive understanding.

Waiting period definition

The popularly known term waiting period in health insurance refers to the duration an insured person must wait before being eligible for insurance benefits. This period begins from the policy commencement date and varies between insurance companies. For instance, maternity coverage usually has a waiting period of two to four years. Waiting periods help to avoid unethical practices by policyholders. This includes purchasing a policy after being diagnosed with an illness and immediately making a claim. The waiting period helps prevent deceptive behaviour and ensures that insurance benefits get provided to only those who genuinely need them.

Types of waiting periods in health insurance

Here are the key points regarding the different waiting periods in health insurance policies:

● Initial waiting period in health insurance:

This is essentially the phase after purchasing your healthcare plan, during which you cannot claim any benefits for hospitalisation, planned or emergency. The minimum initial waiting period in health insurance is usually at least 30 days. Some insurance providers offer zero waiting period health insurance as well.

● Waiting period for pre-existing diseases:

This is a waiting period for those diagnosed with a specific pre-existing disease listed in the policy document. The insurer can impose a waiting period of up to 2 years.

● Waiting period related to specific diseases:

Health insurance plans may encompass separate waiting periods for diverse ailments, which can vary from one to two years, according to the insurer’s policy. This waiting period applies to illnesses that require long-term care.

● Maternity waiting period:

The period during which you cannot claim maternity benefits typically varies from 9 months to 6 years. The health insurance no waiting period may not be applicable here.

● Waiting period for accidental hospitalisation:

No waiting period applies in the case of immediate hospitalisation resulting from an unfortunate accident.

● Waiting period for health check-ups:

Insurers who offer complimentary health check-ups keep the waiting period to at least one year. It essentially means you can actively avail of this benefit only after completing the one-year waiting period in health insurance. You can avail of this benefit from the second year of your policy.

● Waiting period for COVID-19 coverage:

The waiting period in health insurance plans that fully cover COVID-19 disease is 15 days.

Thoroughly reviewing the policy documents is crucial to comprehend the waiting periods embedded in health insurance policies. Some insurance service providers may provide health insurance without waiting periods too. Waiting period insurance protects the insurer from the risk of high claims immediately after the policy’s purchase.

It is an undeniable truth that good health is synonymous with wealth. In today’s fast-paced life, health often gets neglected, and it is not until a medical emergency strikes that we realise the importance of being healthy. Medical expenses are skyrocketing, and paying for them can be financially draining. That is where health insurance comes in. Health insurance ensures you are not burdened with hefty medical bills and keeps you financially covered. The government encourages citizens to invest in medical policies by providing tax benefits under Income Tax Act’s Section 80D. In this article, we will delve into this Section’s provisions and comprehend the benefits it offers.

What is section 80D of the income tax act?

Section 80D of the Income Tax Act is a provision that allows taxpayers to claim a deduction on the amount paid towards health insurance premiums and medical expenses for themselves, their spouse, and dependent children or parents. The deduction limit varies based on the individual’s age and the type of policy purchased. This Section provides an additional deduction under the name of preventive health check-ups.

Deduction available under section 80D of the income tax act

• If you are under 60 years of age and have paid health insurance premiums for yourself, the eligible limit for tax exemption is Rs 25,000.

• If you have paid health insurance premiums for yourself, your spouse, and dependent children who are all under the age of 60, the eligible limit is Rs 25,000.

• If you have paid health insurance premiums for yourself and your parents, and all of you are below 60 years of age, the eligible deduction will be Rs 50,000 (Rs 25,000 for your parents and the same amount for yourself).

• If you have purchased health insurance premiums for yourself, and you are below 60 years of age and also bought insurance for your parents who are above 60 years of age, the eligible limit is Rs 75,000 (Rs 25,000 for yourself and Rs 50,000 for your parents).

• If you have purchased a policy for both yourself and your parents, and all of you are above 60, the eligible limit is Rs 1,00,000.

Deduction under section 80D for health insurance premium paid for parents

The deduction available under Section 80D for health insurance premiums paid for parents depends on the age of the parents and the premium paid. The table below provides the details of the deduction:

Mr X is 35 years old, and during the financial year 2022-23, he paid a health insurance premium of Rs 60,000 for his 60-year-old father. He also incurred expenses of Rs 35,000 for a premium for himself during the same period. The maximum deduction he could claim in this case would be:

Deduction on preventive healthcare check-ups under section 80D

• Under Section 80D of the Income Tax Act, individuals can claim deductions on preventive health check-ups up to a maximum limit of Rs 5,000 per year. This benefit is for all, irrespective of their age.

• Preventive health check-ups refer to medical tests and examinations carried out to identify any health issues before they become severe. Such tests include routine blood tests, urine tests, X-rays, and other scans.

• It is essential to note that the maximum deduction limit available under this Section is Rs 5,000, and any amount exceeding this limit is not eligible for tax benefits.

For example, if an individual incurs an expense of Rs 4,000 on a preventive health check-up for himself/herself or his/her family members, the person can claim a deduction of Rs 4,000 under Section 80D. However, if a person incurs an expense higher than Rs 5,000, he/she would not be able to avail of any benefit for the amount that exceeds Rs 5,000.

Health insurance has become a crucial part of financial planning for individuals in today’s world. It assists people during any unpredictable medical crisis without worrying about the financial burden. However, despite having a health insurance policy, individuals may still face the issue of exhausting their sum insured due to unforeseen medical expenses. That is where the restoration benefit in health insurance meaning comes into play.

What is restoration benefit?

Restoration benefit is an add-on feature in health insurance policies that provides an additional sum insured amount after the primary sum insured is exhausted in a policy year. This feature may be handy for policyholders likely to use their original sum insured due to recurring illnesses or hospitalisations.

How does sum insured restoration benefit you?

When your base sum insured is used up due to medical expenses, the restoration benefit replenishes it, allowing you to continue availing of healthcare services without financial strain. This feature is particularly beneficial for individuals with chronic ailments or those with a high risk of hospitalisation. For instance, the policyholder has a sum insured of Rs 5,00,000 and has utilised the entire amount in a policy year. The restoration benefit will automatically restore the sum insured amount for the same policy year, allowing the policyholder to avail of further medical treatment without incurring additional expenses.

Types of restoration benefit

There are usually two types of restoration in health insurance available in the market:

• Fixed restoration benefit:

It is a type of benefit in which the insurer offers a fixed restoration amount benefit equivalent to the sum insured amount. Let's say the policyholder has an insurance policy with a coverage amount of Rs 5,00,000. Suppose the policyholder has undergone surgery and used up the entire amount. But later in the same policy year, he gets sick and again needs hospitalisation. His insurer will restore his coverage amount to Rs 5,00,000. That means he will have a total coverage amount of Rs 10,00,000 for that policy year. But the restoration benefit will be applicable after you exhaust the total sum insured.

• Partial restoration benefit:

This kind of restoration has a slight edge over the fixed restoration benefit as one does not have to exhaust the entire sum insured to avail of it. For example, let’s say a policyholder has a health insurance policy with a sum insured amount of Rs 5,00,000 and a partial restoration benefit of Rs 2,00,000. In a policy year, the policyholder incurs medical expenses of Rs 5,00,000, exhausting the entire sum insured amount. Under partial restoration benefit, the insurer will restore only a part of the sum insured amount, which in this case is Rs 2,00,000. So, the policyholder will have a total sum insured amount of Rs. 7,00,000 for the same policy year.

Features of restoration benefits in health insurance

You must understand the restoration of cover in a health insurance plan meaning to make an informed choice. Some of the most common features of restoration benefits are:

• It is important to note that the restored sum insured does not get carried forward to the next policy year. It is applicable only for the remaining policy term.
• You can buy the restoration benefit as an add-on feature along with your insurance policy at a nominal extra cost.
• It is worth noting that restoration benefits are only available for future claims, not current or ongoing claims.
• The restoration benefit is not limited to policies with a higher sum insured. One can purchase it in conjunction with any given sum insured based on the policyholder’s needs.

How to buy a restoration benefit plan?

The process of purchasing a restoration benefit plan is quite simple:

• Find a health insurance plan offering restoration benefits after due research.
• Check policy details regarding the conditions for the sum insured restoration.
• Understand whether the benefit applies to related or unrelated illnesses.
• Opt for a plan that aligns with your medical history and coverage requirements.

Benefits of buying a health insurance policy with restoration benefit

If you are planning to buy a medical insurance plan, considering a policy with restoration benefits can be helpful in numerous ways. Here are some of the advantages of purchasing a health insurance policy with restoration benefits:

• Increased financial protection:

The additional sum insured after the exhaustion of primary coverage provides a financial cushion and protects you from unexpected medical expenses that might arise during the policy year.

• Multiple claims:

Restoration benefits can enable you to make several claims during the policy year. Its advantages are more apparent to policyholders with various ailments or those requiring frequent doctor visits.

• Cost-effective:

Health insurance policies with restoration benefits might be slightly more expensive than standard policies. However, they can be cost-effective in the long run as they provide additional financial protection without requiring the purchase of another plan.

• Peace of mind:

Knowing you have a health insurance policy with restoration benefits can give you peace of mind. You can be confident that you have additional financial security and can cover any unexpected medical expenses.

Importance of restoration benefit in health insurance

A restoration benefit enhances your health coverage, making sure that unexpected medical emergencies do not lead to financial burdens. For people suffering from chronic illnesses or individuals reaching an advanced age, as well as families who require broader coverage for all the members, it is a useful benefit to have

Who should opt for a restoration benefit?

The restoration add-on may not be for everyone. But this cover makes sense if you belong to one of the categories like being an individual with a history of multiple illnesses, require frequent medical attention, need additional financial protection in your health insurance policy, seek flexibility in making claims, or wish to avoid the hassle of purchasing another policy. It would also be beneficial for individuals worried about unexpected medical expenses that might arise during the policy year. Policyholders with family floater plans will also find it advantageous as the sum insured gets shared among everyone covered under such policies.

Things to consider while opting for restoration benefits in health insurance

If you are considering opting for restoration benefits in your health insurance policy, here are a few things to keep in mind:

• Claim Process:

Understand the claim process for restoration benefit and ensure it is hassle-free. Check whether the restoration benefit claim process is the same as the regular claim process.

• Exclusions:

Restoration benefits may come with certain exclusions, such as pre-existing illnesses or specific treatments. Make sure to read the policy documents carefully to understand the exclusions.

• Waiting Period:

Restoration benefits may come with a waiting period, which means that you may only be able to avail of the benefit after buying the policy. Check the waiting period before opting for this rider.

• Restorations permissible:

Determine how often you can use the restoration benefit in a policy year. Most policies restore the sum insured only once a year.

• No carry forward:

Restoration benefits in health insurance do not get carried forward to the next policy year. You can use it only within the same policy year.

FAQs

1. What is the restoration period in health insurance?

The restoration period refers to the time frame within which the sum insured is replenished after it has been fully utilised due to medical claims. This benefit is usually activated immediately once the insured amount is exhausted and remains valid for the rest of the policy term.

2. What does an extended restoration period mean?

An extended restoration period allows for the reinstatement of the sum insured beyond the policy's expiration date in certain scenarios, such as when a claim is made near the policy's renewal period. This ensures continued coverage for a specified additional period, as outlined by the insurer.

3. How long is the restoration benefit valid?

The restoration benefit is typically valid only within the ongoing policy year. It cannot be carried forward to the next renewal period, meaning it can only be utilised for fresh claims within the current coverage term.

4. How do restoration and recharge benefits differ in health insurance?

While both provide additional financial protection, restoration benefits replenish the entire sum insured once fully depleted, whereas recharge benefits add a partial amount when the sum insured is reduced due to claims. Their applicability varies based on claim conditions and policy terms.

5. Is the recharge benefit useful in health insurance?

Yes, the recharge benefit is highly beneficial as it helps reinstate a portion of the sum insured, allowing policyholders to make additional claims without facing out-of-pocket medical expenses.

6. Can I carry forward the unused restored sum insured to the next policy year?

No, the restored sum insured is only applicable for the current policy year. Any unused amount does not roll over to the following year, as restoration benefits are designed to provide coverage for unforeseen medical needs during the active policy term.

7. Does restoration benefit apply to pre-existing medical conditions?

Restoration benefits generally do not cover pre-existing medical conditions unless explicitly stated in the policy. It is advisable to review the policy terms or consult the insurance provider to confirm whether pre-existing conditions are included under this feature.

8. Can you avail of restoration benefits in health insurance in the same claim?

No, you cannot avail of restoration benefits in health insurance in the same claim. Restoration benefit restores the sum insured amount for future claims after the current sum insured has been exhausted during a policy year.

Suppose you have a health insurance policy with a sum insured of Rs 4,00,000, but your hospitalisation costs amount to Rs 7,00,000. In such a case, you must pay the additional Rs 3,00,000 from your wallet. However, if you require hospitalisation again soon, your sum insured will be reinstated to Rs 5,00,000.

9. Can two members of the family suffering from the same disease claim restoration benefits?

Restoration benefit in health insurance is available only for future claims, and only one covered individual can raise a claim for this at a time. To claim restoration benefits, the trigger point for the medical condition must occur at different time intervals. However, restoration benefits may apply to multiple covered members in a family floater plan in some exceptional cases. For example, in the event of an accident resulting in multiple injuries and hospitalisations, different members are eligible to receive the restoration benefit. It is vital to read and understand the terms and conditions of the health insurance policy to determine eligibility for restoration benefits in different scenarios.

10. Does restoration benefit increase the policy premium?

Restoration benefits are typically offered as a add-on, which means that any additional coverage beyond the standard plan will increase the premium to some extent. However, it is important to focus on how the add-on will benefit you in the long run rather than just the increased premium.

Consider the following scenario: a 28-year-old policyholder with no illnesses chooses a standard plan, which costs around Rs 5,000. If he decides to include the restoration add-on, the extra premium would be around Rs 1,000-1,500.

Insurers consider factors such as age, medical history, sum insured, and type of plan when determining the premium for restoration benefit add-on.

Conclusion

Restoration benefit is a crucial feature in a health insurance plan, ensuring uninterrupted medical coverage even after the exhaustion of the sum insured. It is especially useful in critical illness insurance, where it enhances coverage by refilling the sum insured, ensuring that policyholders remain covered even after an initial claim. When selecting a policy, it’s essential to understand the terms of restoration benefits to maximise coverage and financial security. By opting for a plan with this feature, you can safeguard your health and finances effectively.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis, or treatment. Please consult your general physician or another certified medical professional for any questions regarding a medical condition. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.

Blood pressure is a critical indicator of an individual's overall health, and maintaining it within the normal range is essential for a healthy lifestyle. Blood pressure readings are classified based on various components. Understanding the recommended ranges can help individuals take appropriate measures to maintain their blood pressure within a healthy range and seek medical attention when necessary. In case you are in a dangerous blood pressure range, you can seek the right treatment through health insurance.

What is the normal blood pressure range for different age groups?

Normal blood pressure range fluctuates throughout the day depending on various activities, but sustained high blood pressure can lead to serious health problems.

Blood pressure measurement comprises two factors: systolic blood pressure, measured during the heart's contraction phase, and diastolic blood pressure, measured during the relaxation phase between heartbeats.

Various experts may employ distinct standards, wherein some may identify hypertension when the blood pressure readings constantly remain at 140/90 mmHg or higher. In contrast, others may consider 130/80 mmHg as the cut-off point.

How is blood pressure measured?

A blood pressure cuff, known as a sphygmomanometer, is used to measure blood pressure in humans. You can tightly wrap the cuff around your arm (left or right). While the cuff is wrapped tightly on your upper arm, you can inflate it till the blood flow stops. Again, the cuff is gradually deflated until it returns to its original position. Your doctor will check your pulse with a stethoscope throughout this process to observe any abnormalities.

Today, you can find advanced sphygmomanometers in the market. These will display your blood pressure levels and pulse rate on the monitor. You don’t need to use a stethoscope for the same.

Normal blood pressure range for men

Here is an approximate value chart for the blood pressure normal range by age for men.

Normal blood pressure range for women

Here is an approximate value chart for the normal blood pressure range for females.

This guide includes the benefits of porting to a new insurer and the steps involved in porting your policy online. Health insurance port allows insured individuals to switch to a different insurance company or policy without losing accumulated benefits. The process of health insurance porting can vary slightly depending on the policies offered by the insurer. Therefore, it is essential to consider all factors before deciding to port a health insurance policy.

What is health insurance portability?

Health insurance portability offers a convenient option for insured individuals to switch to a different insurer or policy while retaining accumulated benefits. By renewing your existing policy without a break, you can transfer your coverage to a new provider during the renewal period. Introduced in 2011, portability rules protect policyholders’ interests by allowing them to switch insurance providers without losing any benefits. This includes waiting periods and No-Claim Bonuses. While purchasing a suitable health insurance policy involves careful planning, various factors like increased premiums, location changes, or dissatisfaction with services may prompt a policyholder to switch to a new insurance provider.

Health policy portability rules - Rights & conditions set by IRDAI

The IRDAI has established the following rules for medical insurance portability:

• The IRDA portability rules ensure fair and transparent health insurance policies for both insurers and insured parties.
• One such rule is that if a policyholder renews their health insurance policy without any lapses or gaps, the policy may not have an exit age.
• In addition, insurance companies must inform policyholders about the terms and conditions of their policies regarding healthcare facilities across the country.
• As per health insurance portability rules IRDA, insurance companies need to provide clear reasons in writing if an application for a health insurance policy gets denied.
• The 2020 IRDA guidelines focus on aspects such as claim settlement and the inclusion of telemedicine in coverage.
• The new rules prohibit claim rejection based on misrepresentation or non-disclosure and require payment of interest by insurance companies in case of a delay in claim settlement.

How to apply for health insurance portability?

For porting of health insurance policy, here are the steps to follow:

• To initiate the process to port health insurance policy online, find an insurance company that offers better benefits and suits your needs. You can research online or seek advice from a professional for better results.
• Fill out the request or application form for the new insurance policy online.
• The new insurance company will send you the portability and proposal forms, which you must fill out with your personal details and the particulars of your previous policy.
• Your details get verified, and your medical history gets reviewed to ensure you qualify for the new policy. Any false information can lead to the refusal of your portability request.
• The two insurance companies exchange the necessary details.
• The final step is when the new insurance company sends you the proposal. It may take some time to reach you, but you can rest assured that you will soon receive your new health insurance plan.

List of documents required for porting a health insurance policy

The process of medical insurance porting can vary slightly depending on the policies of the insurance company.

• To begin to port medical insurance, it’s important to contact your current and previous insurers to understand the specific documents required for porting.
• You may need to submit various documents, including identity proof, address proof, proposal form, IRDAI portability form, medical history documents, and insurance policy.
• If applicable, claim history and a declaration of no claims may also be required. Understanding the specific requirements and providing accurate information can simplify the process and ensure you have a successful porting experience.

What is the benefit of porting a health insurance policy?

Porting your health insurance policy can bring several benefits if you’re dissatisfied with your current plan:

• You won’t lose any of the benefits from your existing policy as they will remain in force with the new insurer.
• The accrued bonus from your previous policy is added to the new sum insured value, resulting in better benefits and increased policy value.
• Switching to a new insurer can lower policy premiums since many discounts and benefits are available.
• You can customise your new policy as per your needs, such as focusing on health issues or changing nominees.
• Porting to a new insurer can provide a more transparent system without hidden clauses or conditions and a better claim settlement ratio.
• Porting your policy can help you choose an overall better service provider, especially if you’re unhappy with the services of your existing insurer.

Consider these benefits when deciding whether to port your health insurance policy.

Health insurance portability rules

Apart from IRDAI guidelines, here are additional portability rules:

• The portability process must be completed within 15 days of application.
• If the new insurer does not accept the request within this timeframe, the policyholder can renew with the existing insurer.
• Policyholders must disclose all medical conditions accurately, as non-disclosure may lead to rejection.

Rejection of health insurance portability requests

Though portability is a right, insurers have the discretion to accept or reject applications based on certain factors. Let us understand some of the most prominent reasons why applications get rejected.

Top reasons for rejection of health insurance portability requests

• Pre-existing Medical Conditions: High-risk health conditions like cancer or chronic illnesses.
• Frequent Claims: Multiple claims in the past may indicate a high-risk profile.
• Lapsed Policy: If the current policy has expired, portability may be denied.
• Incorrect Information: False or misleading information in the application form.

Common reasons to opt for health insurance portability

Policyholders consider portability for various reasons, such as:

• Dissatisfaction with Current Insurer: Poor claim settlement experience.
• Higher Premiums: Finding a more affordable critical illness insurance
• Limited Coverage: Upgrading to a plan with additional benefits.
• Better Hospital Network: Access to a wider network of cashless hospitals.

Things to consider before porting health insurance provider

When considering porting your medical insurance policy, there are several important factors to keep in mind:

• Look for a policy offering hospitalisation and daycare procedures without sub-limits.
• Remember that insurance policies can vary widely and get regulated by their respective underwriters.
• Be aware of waiting periods for new policies, which can range from 30 days to four years for pre-existing conditions.
• If you are porting to a new insurer to save on premiums, carefully review the new policy’s coverage to avoid later surprises.
• You can also request a higher sum insured, although this is at the discretion of the underwriter and may not always be approved.
• Consider the network of medical facilities covered by the policy and the reimbursement process for medical costs. Look for a policy that offers a hassle-free payment and billing process to ease your mind during a medical emergency.
• Carefully analysing these factors can help you make an informed choice when porting health insurance policy.

Why should you opt for health insurance portability with ICICI Lombard?

ICICI Lombard offers the following advantages:

• Comprehensive coverage with a wide hospital network.
• Fast claim settlements with minimal paperwork.
• Customizable health plans to suit individual needs.
• No-claim bonus retention and seamless portability process.

FAQs

1. What is the waiting period before we can port health insurance?

When your current health insurance policy is up for renewal, you have the option to switch to a different insurer while retaining your accumulated benefits. To do so, you can apply for portability of your health insurance policy at least 45 days before the renewal date. This means you can start the process of transferring your policy to a different insurance provider approximately two months prior to the expiration of your current policy. It is vital to keep this timeframe in mind to avoid delays or complications in the porting process. By applying for portability promptly, you can ensure a smooth transition to your new health insurance provider while continuing to enjoy the benefits of your existing policy.

2. How many times is porting health insurance allowed?

Health insurance portability allows policyholders to switch their insurance provider without losing the benefits of their existing plan. However, it is essential to note that you can port your medical insurance plan only at the time of policy renewal and not during the policy period. To be eligible for portability, policyholders must renew their policies without any breaks. Any gaps or lapses in policy renewal can make a policyholder ineligible for portability. Therefore, it is always essential to renew the policy on time to ensure continuity of coverage and the ability to switch to a new insurance provider at the time of renewal.

3. When should porting health insurance be considered?

When you plan to port your health insurance policy, it is essential to keep track of timelines. To ensure a seamless transition to a new insurer, make sure to submit your portability request at least 45 days prior to your current policy's renewal date. This will give the new insurer ample time to process your request and ensure a seamless transfer of your policy. Additionally, you must inform your current insurer in writing about your intention to port your policy by mentioning the name of the new insurer. This ensures that your existing insurer is aware of your plan and can provide you with all the necessary documents required for the portability process.

4. What is the difference between health insurance migration and porting?

Migration and portability are two different processes for changing your health insurance policy. Migration refers to moving your current policy to a similar plan with the same insurance company. On the other hand, portability essentially allows you to transfer your existing medical insurance policy to a plan with another insurer. While migration involves sticking to the same insurance company, portability gives you the flexibility to choose the best insurance plan that perfectly suits your needs. Whether you opt for migration or portability, making an informed decision that considers your current and future health needs is essential.

Conclusion

Health insurance portability ensures policyholders can switch insurers without losing accumulated benefits. Whether you seek critical illness insurance, better service, or lower premiums, choosing the right insurer is key. It is crucial to carefully compare policies, evaluate the terms and conditions, and select an insurer that best aligns with your needs. This process ensures seamless, uninterrupted medical coverage and helps you maintain a high standard of healthcare, even when transitioning to a new provider.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis, or treatment. Please consult your general physician or another certified medical professional for any questions regarding a medical condition. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.

The blog will highlight the advantages of having a vaccination certificate. Additionally, we’ll address common queries related to the certificate, such as who is responsible for issuing it, if registering with an Aadhaar card is obligatory, and if a booster dose certificate is required. You will have a proper understanding of the significance of possessing a COVID-19 vaccination certificate, as well as various methods for acquiring it.

What is a CoWIN Vaccine Certificate?

Before knowing how you can download your Co-WIN certificate, let us tell you what this certificate means. It is valid proof that you have been vaccinated against COVID-19. It contains the date of your vaccination. Even today, in some places, you must show your CoWIN vaccination certificate to gain entry.

Download the COVID-19 vaccine certificate by Aadhar

Downloading your vaccination certificate is a convenient way to verify your vaccination status, especially when travelling. To complete the process of vaccine certificate download by Aadhaar number, you must follow some simple steps.

You can choose to download your Covid-19 vaccination certificate using the CoWIN, DigiLocker, Umang, or Aarogya Setu app. You can also download the certificate by visiting the portals of these four apps.

Aadhaar is linked to individual biometrics, preventing duplicate numbers and identifying fake identities. This ensures no one else can utilise your vaccination information via your Aadhar card. Thus, your information is always confidential, which is particularly crucial when considering your overall health security, including having adequate health insurance coverage.

Download Covid certificate using CoWin app/website

CoWIN is an all-in-one platform for universal vaccination, including registration, scheduling, verification, and certification. To acquire a Covid-19 vaccination certificate through the portal, you must strictly follow the subsequent set of instructions:

• Go to the official website.
• Provide your registered mobile number to log in or sign up.
• To verify your identity, a unique password will be sent to the mobile number you have registered at the portal. Please note that you should keep your Aadhar details handy to download the CoWIN certificate using Aadhar card.
• Once you log in and verify your details, you can view the dates of your first and second vaccination.
• Find the certificate tab link under your name and click on it.
• Finally, click on the “Download” button to save a PDF file of your Corona Vaccine Certificate.

This is a popular alternative to download vaccination certificate by Aadhar card safely.

How to get Aarogya Setu certificate using the app?

The Aarogya Setu app records time and GPS location when two registered users exchange unique Digital IDs via Bluetooth. The collected information is securely stored on the other user’s mobile device and later uploaded to the server if the user tests positive for COVID-19. This helps with contact tracing to identify individuals who may have been essentially in close contact with the infected person. This is another frequently favoured option to download vaccination certificate using Aadhar card.

If your aim is to obtain the Aarogya Setu certificate via the app, you will be required to adhere to the following set of guidelines:

• Begin by installing the Aarogya Setu app on your mobile phone.
• Navigate to the CoWIN tab and click on “Register Now.”
• Please enter your registered mobile number and verify it using the OTP sent to your number.
• Select the Vaccine Certificate option and provide your reference ID comprising 13 digits.

Click the “Download Covid Certificate” option to obtain your Aarogya Setu certificate.

Cancer health insurance policies typically cover hospitalisation, chemotherapy, radiation therapy, surgery, and medication costs. The coverage can also include expenses related to pre-and-post-hospitalisation, doctor consultations, and diagnostic tests.

What is cancer health insurance?

Cancer is a life-threatening disease requiring extensive medical treatment, including chemotherapy, radiation therapy, and surgery. The financial cost of cancer treatment can be significant, and cancer insurance helps to ease the financial burden by covering some or all of the medical expenses related to cancer treatment.

Cancer health insurance policies typically cover hospitalisation, chemotherapy, radiation therapy, surgery, and medication costs.

How does cancer insurance work?

When the policyholder purchases a cancer insurance plan , he/she pays a premium to the insurance company. In return, the insurance company provides coverage for the expenses related to cancer treatment up to a predefined limit. The amount of coverage and premium depends on the cover chosen.

Let's consider an example to understand how cancer policy works. Mr A, a 30-year-old working professional, purchases a cancer insurance policy for a 20-year term with a sum insured of Rs 10,00,000. At 40 years of age, he gets diagnosed with the first cancer stage. In this scenario, the insurer will pay 25% of the sum insured, which amounts to Rs 2,50,000. As a result, the coverage under the policy will reduce to Rs 7,50,000.

After seven years, Mr A's cancer progresses to a severe stage. At this point, the insurer will pay the remaining sum insured amount of Rs 7,50,000, and the policy will terminate. It's important to note that the payout from the plan is made based on the stage of cancer diagnosed.

Once the policyholder receives the lump sum payment, the person can use it to cover any expenses related to the cancer diagnosis, including medical bills and treatment expenses, and to replace lost income. The payment is typically tax-free, and one can use it as one sees fit.

Types of cancer covered by cancer insurance plans in India

Types list of the types of cancer that insurance companies cover is quite extensive. The most common types are listed below:

• Bladder cancer:

The malignancy in this cancer begins in the bladder lining, commonly causing blood in the urine. 

• Colorectal cancer:

This type of carcinoma affects the colon or rectum, often causing changes in bowel habits or rectal bleeding. 

• Breast cancer:

A malignant tumour that develops in breast tissue, usually detected through a breast lump or mammogram. 

• Lung cancer:

Carcinoma that forms in lung tissue, commonly caused by tobacco and smoke exposure. 

• Kidney cancer:

It is a cancer that develops in the kidney cells, often resulting in flank pain or blood in the urine.  

• Lymphoma:

It begins in cells of the immune system, causing swelling in the lymph nodes, spleen, or other immune tissues. 

• Oropharyngeal:

Also known as oral cancer, these are cancers that develop in the tissues of the throat or mouth, often causing persistent sores or difficulty swallowing.

• Prostate cancer:

This forms in the prostate gland, commonly leading to urinary problems or discomfort in the pelvic region. 

• Pancreatic cancer:

This type of cancer forms in the pancreas cells, often causing abdominal pain and unintended weight loss. 

• Uterine cancer:

It is cancer that develops in the uterine tissues, causing abnormal vaginal bleeding or discharge.

• Thyroid cancer:

This kind of cancer forms in the thyroid gland, often leading to lump development or swelling in the neck.

Benefits of a cancer insurance plan

• Covers multiple stages:

The health insurance for cancer policy covers various stages of cancer and provides a lump sum amount to the insured upon a cancer diagnosis. 

• Premium waiver:

Medical insurance for cancer patients may include premium waiver benefits. The waiving of premium payment happens in certain circumstances, such as a cancer diagnosis in its early stages.

• Increase in sum insured:

If the policyholder does not make any claims during the year, the sum insured can increase by a percentage mentioned in the policy wording.

• Tax benefits:

The premiums paid towards the cancer insurance policy are eligible for tax benefits under Section 80D of the Income Tax Act.

• Continuing benefits:

The major benefit of a cancer cover policy lies in its coverage continuity. Even if the policyholder is diagnosed with cancer several times, the policy will continue offering coverage without interruption.

Why do you need a cancer insurance plan?

Cancer can be an emotionally and financially draining health condition that often requires frequent medical visits, chemotherapy sessions, and hospital stays. As the treatment procedure is an ongoing process that can last for years, the costs can quickly pile up, making it difficult to manage them.

Furthermore, as cancer progresses, working and earning an income becomes impossible or difficult, making it even more challenging to manage treatment costs. However, with the help of a cancer insurance plan, one can avoid all these challenges. Cancer cover provides financial assistance in the form of a lump sum pay-out to cover the high costs of cancer treatment. It ensures one can access the best medical care without worrying about the financial burden.

Who is eligible to buy health insurance for cancer treatment?

• To purchase this policy, an individual must be at least 18 years old. However, parents can buy the policy for their newborn child as soon as they turn 91 days old.
• The policy is available for a five-year period and offered on an individual basis.
• The maximum age to purchase this insurance is 50 years old.
• There is no medical assessment required to buy this plan.

How to buy cancer insurance online?

• Step 1: Research and compare cancer insurance policies from reputable insurance providers.

• Step 2: Visit the insurance company’s website. Next, fill out the online application form for quote generation.

• Step 3: Provide accurate and complete personal and medical information, including your age, gender, medical history, and any pre-existing conditions.

• Step 4: Choose the coverage amount and duration and review the policy details, including exclusions and limitations.

• Step 5: Pay the policy premium through a secure online payment gateway.

• Step 6: Once the payment is processed, you will receive an email with the policy document and a confirmation of the coverage.

Inclusions of cancer insurance

• Comprehensive coverage:

Irrespective of whether it is in the early or advanced stages, the policy provides comprehensive coverage against most types of cancers.

• In-patient hospitalisation:

Cancer treatment often necessitates extended hospitalisation. Given this, cancer insurance covers a wide range of expenses associated with the treatment, including charges for oxygen, room rent, prescription fees, and other related costs.

• Annual check-ups:

Early detection of cancer greatly improves the chances of survival. Many insurers offer annual check-ups to their policyholders.

• Pre-and-post-hospitalisation:

The doctor may require several regular visits before admitting a cancer patient. Furthermore, as the treatment process can be lengthy, healthcare providers may need to administer medication and counsel patients even after discharging them from the hospital. This plan’s lump-sum payout covers both pre-and-post-hospitalisation expenses.

Exclusions of cancer insurance

• Health insurance with cancer cover does not provide coverage if the policyholder has pre-existing cancer ailments.

• Health insurance for cancer patients typically excludes coverage for carcinoma-in-situ and cancers caused by sexually-transmitted diseases, primarily HIV or AIDS.

• A congenital disease that progresses to form cancer would generally result in the policyholder being ineligible for coverage.

• Regardless of the stage, cancer insurance policies do not provide coverage for cancers resulting from the unlicenced use of drugs or heavy use of alcohol.

• These health insurance policies typically exclude coverage for cancer caused directly or indirectly by chemical, nuclear, or biological sources of pollution.

To lead a healthy lifestyle, it is important to eat a balanced diet every day. Your meal should contain enough proteins, fats, carbohydrates, and essential vitamins and minerals. One essential water-soluble vitamin you should regularly consume is vitamin B12.

Vitamin B12 is important for the overall health of your nerves. It supports the formation of DNA and red blood corpuscles. However, your body cannot make vitamin B12 on its own. Hence, ingesting it through your food is the only way to get it. According to experts, you have to consume about 2.4 micrograms of vitamin B12 every day for a healthy life.

In this blog, we will discuss some of the important facts about vitamin B12 and the foods you can consume to maintain your daily intake.

What is vitamin B12?

Vitamin B12 is a water-soluble vitamin found primarily in animal products. It can also be added to foods to fortify them, and vitamin B12 supplements are available.

The suggested intake for vitamin B12 varies with age; it is also different for women and men. Depending on the doctor's suggestions, pregnant women may require different amounts of vitamin B12.

There is currently no established toxic level for vitamin B12. However, high doses of supplements may essentially increase the risk of bone fractures. Vitamin B12 is part of the B complex vitamins, which help the body convert food into energy and support the nervous system, liver, and healthy skin, hair, and eyes.

It essentially works with other B vitamins to regulate homocysteine levels in the blood, which may be associated with heart disease.

Why Vitamin B12 is Important?

• Healthy hair growth depends on the strength and activity of hair follicles. Our hair follicles can produce about six inches of hair per year. Vitamin B12 is essential for promoting healthy hair growth.
• Vitamin b12 sources help in the manufacturing of red blood cells that are abundant in oxygen, which feed hair follicles.
• Hair is made of a protein called keratin, while hair follicles are alive and contain the fastest-growing cells in the human body. The papilla at the base of the hair follicle contains blood vessels that deliver oxygen and nutrients necessary for hair growth. The human body does not produce vitamin B12, and getting it from our diet is important.
• Animal-based vitamin b12 food such as fish, poultry, meat, dairy, and eggs are sources of B12. Vegans and vegetarians need to add B12 supplements or B12-fortified foods to their diet. B12 deficiency can cause anaemia, heart palpitations, shortness of breath, nerve problems, and depression.
• Several factors can cause difficulty in absorbing B12 and lead to a deficiency. Some factors responsible for vitamin B12 deficiency are advancing age, immune system disorders, Crohn's or celiac disease, excessive alcohol consumption, and undergoing weight loss surgery.

A blood test and consultation with a medical professional can help determine the need for a B12 supplement. In such a situation, having a health insurance plan can be of great help.

Papaya contains essential nutrients like folate, fibre, and vitamins A, B, and C that can benefit both the mother and baby. Eating papaya in pregnancy in unripe or semi-ripe conditions is strongly not recommended due to the high concentration of latex. This can cause uterine contractions and potentially lead to a miscarriage. You should avoid overconsumption of ripe papaya as it can lead to digestive discomfort. However, no evidence suggests that ripe papaya can induce a miscarriage or harm the mother or baby. It is essential to consume ripe papaya in moderation and follow your doctor’s guidelines to avoid any adverse effects. If you have any concerns about consuming papaya during pregnancy, it is best to consult with your obstetrician.

Can We Eat Papaya During Pregnancy?

If you’re wondering, “can pregnant women eat papaya,” you can keep a few factors in mind.

Papaya is a safe and nutritious fruit to eat during pregnancy as long as it is ripe. Pregnant women should avoid eating unripe papayas as they contain a high concentration of latex, which can cause uterine contractions and potentially lead to a miscarriage. However, no substantial evidence suggests that ripe papayas can induce a miscarriage. In fact, papayas contain essential nutrients beneficial for expectant mothers.

There are several myths surrounding the consumption of papaya during pregnancy, including that it can induce excessive body heat, lead to bleeding and detachment of the placenta, and cause miscarriage. However, there is no scientific evidence to support these claims, and they are likely old wives' tales or irrational beliefs.

While you should avoid unripe and semi-ripe papayas during pregnancy, ripe papayas are safe to eat and offer numerous health benefits. They are commonly found in tropical countries and are known for their sweet, juicy, orange flesh.

It is essential to prioritise the nutrition and health of the expecting mother during pregnancy, and this includes being mindful of what foods to eat and avoid. Hence when you search online for “papaya eat during pregnancy,” remember it is a nutritious choice as long as it is ripe.

Working women in India face numerous challenges. Maternity leave plays a vital role in ensuring the overall well-being of the mother and newborn child and allows women to adjust to their new role as mothers.

Maternity benefits are necessary to protect women’s economic rights, ensure job security, and support their social function of childbearing and rearing. The Indian Maternity Benefit Act of 1961 provides comprehensive maternity benefits, including paid leave, medical bonuses, and nursing breaks. Additionally, having adequate health insurance coverage is crucial for working women to address any medical expenses related to maternity.

Let’s learn more about the eligibility criteria, why it is essential for women, the rules of the Leave Policy, HR’s role in granting you leave, and more.

Maternity Leave Benefits in India

1. The Maternity Benefit Act in India provides maternity benefits such as paid leave for women employees who need to fulfil their maternal obligations and duties.
2. For first and second-time mothers, the leave is for 6 months or 26 weeks, while every subsequent child entitles the mother to 3 months or 12 weeks of paid maternity leave.
3. Many companies offer maternity health insurance to their employees under their group health insurance policies. However, that depends on the insurance provider that the company is buying from.
4. The Act also ensures the holistic well-being of mothers and their babies by providing childcare provisions.
5. Employers cannot fire or dismiss women employees solely because they are pregnant, in labour, or recuperating post-childbirth
6. The Act mandates that pregnant women have access to amenities, such as hygienic restrooms, comfortable seating, and safe drinking water in their workplace.
7. The Act entitles pregnant women to additional leave days if they are unable to return to work after the maternity leave period.
8. The payment for maternity leave is at the rate of the average daily wage for the period of absence, with an additional medical bonus of Rs 3500 and a benefit of a minimum amount of Rs 6000 under the National Food Security Act 2013
9. Employers must not give pregnant employees difficult tasks or long working hours ten weeks before delivery to ensure the health and safety of both the mother and child.
10. HR departments can incorporate measures to support pregnant employees, including:

• flexible working arrangements
• counselling services
• wellness programs

Important Rules of Maternity Leave Policy in India

1. The Maternity Benefit (Amended) Act 2017 in India provides full compensation to women employees during their maternity leave
2. Compensation via the maternity leave policy is calculated based on their salary or daily wages in the three months before their maternity leave request
3. A minimum of 80 days of work at their workplace in the 12 months before their delivery or adoption date is required
4. Depending on whether the woman is expecting her first or subsequent child, she can take up to a maximum of 26 weeks off for her maternity leave, with up to 8 weeks off before delivery
5. Maternity leave is payable, and the amount payable to the mother is equal to the rate of average daily wage for the period of her actual absence
6. Various statutes as the following prescribe different procedures and compliances for employers while dealing with the maternity health of their employees, such as:

• Employer State Insurance Act, 1948
• the Maternity Benefit (Mines and Circus) Rules, 1963
• the Central Civil Service Rules, 1972
• the Mines Act, 1952

Sugarcane has been a part of human life for thousands of years, celebrated for its sweet taste and versatility in culinary and medicinal applications. Its juice, extracted through a process of pressing and filtering, has been consumed as a refreshing drink in many cultures around the world.

From the bustling streets of India to the tropical beaches of Brazil, the sight of vendors selling freshly squeezed sugarcane juice is common. And with good reason — this humble drink offers a myriad of potential health benefits, making it not just a tasty treat but a possible elixir of vitality. 

Nutrition Value of Sugarcane Juice

It is important to note that the nutritional content of sugarcane juice may vary depending on factors such as the variety of sugarcane, the plant's maturity, and the extraction method. Additionally, the nutritional content may be affected by any added ingredients or processing methods used in the preparation of the juice. 

10 Health Benefits of Sugarcane Juice

Following are the top 10 health benefits of drinking sugarcane juice-

• Blood sugar regulation:

The low glycaemic index of sugarcane juice means that it slowly gets absorbed by the body, preventing a sudden increase in blood sugar levels.

Moreover, the high fibre content in sugarcane juice regulates blood sugar levels by slowing down glucose absorption into the bloodstream.

• Antioxidant properties:

Sugarcane juice contains antioxidants, such as flavonoids and phenolic compounds, which protect against oxidative stress and inflammation. These compounds may help prevent chronic diseases, such as cancer, cardiovascular disease, and neurodegenerative disorders.

• Anti-inflammatory effects:

Sugarcane juice has anti-inflammatory effects, which may help reduce inflammation in the body and prevent chronic diseases. The anti-inflammatory effects of sugarcane juice may be due to its high antioxidant content.

• Digestive health:

The high fibre content of sugarcane juice may promote digestive health by preventing constipation, promoting regular bowel movements, and reducing the risk of gastrointestinal diseases. Additionally, sugarcane juice may boost the growth of beneficial gut bacteria as it has prebiotic effects.

• Immune system boost:

Sugarcane juice contains vitamin C, essential for maintaining a healthy immune system. Vitamin C may also help reduce the duration and severity of colds and other viral infections. Additionally, sugarcane juice with lemon and ginger benefits may have immunomodulatory effects. This tangy drink helps regulate the immune system.

• Hydration:

Sugarcane juice is a natural source of hydration and can help prevent dehydration, especially in hot and humid climates. Additionally, sugarcane juice may have a diuretic effect, which promotes urine production and helps remove toxins from the body.

• Kidney health:

Researchers have found that sugarcane juice protects the kidneys by lowering the risk of kidney stones and other renal diseases. The high antioxidant content of the juice helps to prevent oxidative stress and inflammation in the kidneys.

In a world where traditional hospital stays can be financially and emotionally draining, many people are opting for alternative solutions to receive quality medical care. One option gaining popularity is the idea of bringing the hospital to the patient, creating a seamless and personalised healthcare experience in the comfort of one’s own home. Patients can recover in familiar surroundings, surrounded by loved ones, with access to top-notch medical equipment and personnel. This concept transforms healthcare and brings hope and comfort to patients worldwide. However, seeking medical care at home can sometimes be costly if insurers refuse to cover the expenses, which is where the concept of domiciliary hospitalisation cover comes into play.

What is domiciliary hospitalization?

Domiciliary hospitalisation cover refers to the medical treatment provided to a patient in their home, which otherwise would have been provided in a hospital. This type of cover aims to provide financial protection to patients who are unable to get admitted to a hospital or prefer to receive medical care at home.

For instance, let's consider a patient who is bedridden due to a chronic illness and needs constant medical attention. If this patient requires admission to a hospital, the expenses would be astronomical. However, with domiciliary hospitalisation cover, the patient can receive the necessary medical treatment at home without needing hospitalisation. This type of cover is especially beneficial for patients who need long-term medical care and for whom hospitalisation is not convenient.

Domiciliary hospitalisation cover includes medical expenses, such as nursing care, medical equipment, and prescription drugs required for the treatment of the patient at home.

When is domiciliary hospitalization covered in health insurance?

Most health insurance plans cover domiciliary hospitalisation under specific conditions, such as:

• The patient is critically ill and cannot be moved to a hospital.
• The required treatment is available but hospital admission is not possible due to the unavailability of beds.
• The treatment is for a condition that requires hospital-level care but can be effectively managed at home.

However, coverage terms may vary depending on the medical insurance provider.

How does domiciliary hospitalization work?

Here are the steps that typically take place in the domiciliary hospitalisation process:

• <h3>Diagnosis: The patient visits a doctor and receives a diagnosis that requires medical treatment. The doctor will determine if the patient is eligible for domiciliary hospitalisation based on the nature and severity of the condition.
• <h3>Treatment plan: Once the patient is deemed eligible for domiciliary hospitalisation, the doctor will prepare a treatment plan that outlines the necessary medical interventions and the required duration of treatment.
• <h3>Insurance coverage: The policyholder or his/her family member will notify the insurer that the insured is planning to undergo domiciliary treatment. The insurance company will then provide the patient with the necessary forms and documents.
• <h3>Medical equipment: If required, the patient will be provided with the necessary medical equipment, such as oxygen cylinders, nebulisers, etc., to facilitate the treatment process.
• <h3>Healthcare provider: The patient will choose a healthcare provider specialising in domiciliary hospitalisation. The healthcare provider will assign a nurse or caregiver who will visit the patient's home and provide the necessary medical care.
• <h3>Treatment at home: The assigned nurse or caregiver will provide medical treatment to the patient at home following the treatment plan, monitoring the patient's progress, and reporting it to the doctor.
• <h3>Follow-up: After treatment completion, the patient visits the doctor for a follow-up to determine the success and need for further treatment.

Why should you choose domiciliary hospitalization cover in health insurance?

Opting for domiciliary hospitalisation coverage in your health insurance policy provides:

• Financial assistance for hospital-like treatment at home.
• Uninterrupted medical care when hospitalisation is not possible.
• Coverage for essential medical expenses, reducing out-of-pocket costs.
• Additional benefits in critical illness insurance plans that cater to long-term illnesses requiring extended care.

What is covered under domiciliary hospitalization?

Domiciliary hospitalisation offers several benefits and inclusions. It is typically less expensive than traditional hospitalization. This is due to the fact that it eliminates the need for hospitalisation expenses like room charges and medical equipment rental. Patients can receive medical care in the comfort of their own homes, which is especially beneficial for those with mobility issues or chronic illnesses.

Patients receive one-on-one attention from their assigned nurse or caregiver, allowing for personalised medical care.
 The inclusions of domiciliary hospitalisation may vary based on the insurance policy. However, inclusions may include doctor consultation fees, nursing charges, the cost of medical equipment, and medication costs.

What is not covered under domiciliary hospitalization?

The domiciliary hospitalisation coverage may not cover any medical condition that existed before obtaining the insurance policy. Experimental or unproven medical treatment may be subject to exclusions under domiciliary hospitalisation coverage. Several medical procedures or treatments, such as cosmetic surgery, infertility treatments, and weight loss surgery, are usually not covered. The domiciliary hospitalisation cover excludes any medical treatment received outside of the country.

Several medications, such as prescription drugs not approved by regulatory authorities, are excluded from this coverage. A domiciliary hospitalisation policy does not cover injuries caused intentionally by the policyholder.

A domiciliary hospitalisation plan may not provide coverage for substance abuse or addiction treatment. Treatment for mental illness is also not covered under domiciliary hospitalisation coverage. Injuries sustained during hazardous activities, such as extreme sports or actions involving weapons, may not be covered under domiciliary hospitalisation cover. One cannot make a claim for treatment expenses incurred for alternative therapies, such as acupuncture or chiropractic treatments.

Difference between home care treatment and domiciliary treatment

How to claim domiciliary hospitalisation in health insurance?

To claim domiciliary hospitalisation benefits under your health insurance policy, follow these steps:

1. Notify Your Insurer: Inform the insurance provider about needing domiciliary treatment.
2. Obtain a Doctor's Prescription: Ensure the treatment is medically justified and documented.
3. Keep Medical Records: Maintain prescriptions, diagnostic reports, and bills.
4. Submit a Claim: Provide the required documents for reimbursement or cashless treatment.
5. Await Approval: The insurer will verify the claim and process payments accordingly.

7 things to know about domiciliary hospitalization cover

In order to claim the domiciliary hospitalisation expenses, you must keep the following things in mind.

• When evaluating the domiciliary hospitalisation benefit, you should consider the medical conditions covered and the specific services provided.
• It is also crucial to assess the eligibility criteria for the benefit, such as the patient's medical condition, the availability of a suitable home environment, and the requirement for frequent monitoring or specialised equipment.
• When evaluating the domiciliary hospitalisation benefit, you must consider the duration of the benefit and any limitations or restrictions on the number of visits or treatments it covers.
• The cost of the domiciliary hospitalisation benefit should also be evaluated, including any co-payments or out-of-pocket expenses that may be necessary.
• Domiciliary hospitalisation is possible if the policyholder can demonstrate to his/her insurer that the person was unable to obtain a bed in a hospital where the treatment is available.
• When claiming such expenses, keep all necessary treatment bills and doctor's prescriptions in one place so that you can easily provide them if your insurer wants documentary evidence.
• Not all health insurance policy offers domiciliary hospitalisation; check your insurance policy details for more insights.

All treatments must be doctor-approved and meet the insurer's guidelines to be claimed under domiciliary hospitalisation cover.

FAQs

1. Can I avail domiciliary hospitalisation for any illness?

No, domiciliary hospitalisation only applies to conditions requiring hospital-like care and continuous medical supervision. Minor ailments such as fever, cold, or flu are generally not covered.

2. Does domiciliary hospitalisation cover post-surgical care?

Some medical insurance policies cover post-surgical care under domiciliary hospitalisation if a doctor prescribes home-based treatment instead of hospitalisation.

3. Is domiciliary hospitalisation covered under all health insurance policies?

No, not all health insurance policies offer domiciliary hospitalisation benefits. It is essential to check the policy details before purchasing a plan.

4. What type of expenses are covered under domiciliary hospitalisation?

Expenses such as doctor visits, medications, nursing care, oxygen therapy, and medical equipment like IV drips and ventilators are typically covered.

5. Can I get domiciliary hospitalisation coverage under critical health insurance?

Yes, many critical illness insurance plans include domiciliary hospitalisation, especially for chronic illnesses that require long-term home-based care.

6. How long can I avail of domiciliary hospitalisation benefits?

The duration depends on medical necessity and policy limits. Some insurers set a maximum limit, such as 10-15 days per hospitalisation instance.

7. Do I need prior approval from my insurance company for domiciliary hospitalisation?

In most cases, prior approval is required for cashless treatment, while reimbursement claims require proper documentation after the treatment is completed.

Conclusion

When a patient cannot get hospitalised because of a medical condition or a doctor suggests that a policyholder receive treatment at home, this is known as "domiciliary hospitalisation." It is a valuable option for patients who require medical treatment but prefer to receive it in the comfort of their own homes. This type of care offers several benefits, including reduced costs, personalised attention, and improved emotional support from family members. Additionally, domiciliary hospitalisation eliminates the risk of acquiring infections commonly found in hospitals, making it a safer option for patients with compromised immune systems. While the inclusions of domiciliary hospitalisation may vary depending on the insurance policy, it typically covers medical treatment, necessary medical equipment, and the services of a trained nurse or caregiver.

There are numerous comprehensive health insurance policies offering domiciliary hospitalisation coverage. If you invest in a policy where domiciliary hospitalisation is covered, you may claim reimbursement for domiciliary care. However, not all health insurance policies cover at-home care, so you must be careful when shopping for a policy that meets your needs. When an insured person has a medical emergency, the option of receiving care in the comfort of his/her home may be a lifesaver. It is a feature that allows access to proper medical assistance when essential medical facilities are absent.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis, or treatment. Please consult your general physician or another certified medical professional for any questions regarding a medical condition. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.

While the excitement of parenthood may require some time to subside, if you have adequate maternity insurance, you won't have to stress about the associated costs. Couples should consider several other things before and after the baby is delivered. The best insurance plan for pregnancy will also cover the newborn child up to a specific time. Financial protection during pregnancy, pre- and post-natal care, pre- and post-hospitalisation costs, ambulance fees, and delivery costs, regardless of whether you have a normal delivery or a caesarean section, are all advantages of maternity insurance. Therefore, one of the best ways to deal with such costs is to purchase maternity insurance, which many health insurance companies provide.

What is maternity insurance?

Maternity insurance is a specialised health insurance plan that is designed to cover expenses related to pregnancy and childbirth. This includes costs associated with both normal and caesarean deliveries, prenatal and postnatal care, and sometimes extends to cover the newborn's medical needs for a specified period.

What is pregnancy insurance so important?

The following list includes maternity insurance benefits in India:

• Acting as a Financial Backup:

Maternity insurance is a safety net for the family’s finances by covering the expenses related to normal and caesarean birth. You need not worry regarding the payment of treatment. Some plans include pre- and post-hospitalisation expenses, paying all associated costs up to 30 days before admission and related expenses up to 60 days after admission.

• Expensive delivery in an intimate setting:

People today prefer private clinics because they want high-quality healthcare. Caesarean delivery may cost an additional Rs 50,000 to Rs 1 lakh in a private hospital, while a normal birth may cost Rs 50,000 to Rs 70,000. Your insurer provides all these costs.

• Coverage for the newborn from Day 1:

Typically, health insurance begins to cover infants once they’re at least 90 days old. A maternity insurance policy, however, starts to pay benefits as soon as the child is delivered. In addition, some plans will pay for the newborn's immunisations until the end of the policy year.

• Prepares the couple for complications:

A newborn requires an incubator for a specified time for complications like premature birth. The price of such treatment can reach Rs 10,000 per day. However, if you have a good maternity insurance plan covering most expenses, you can find respite from the financial pressure.

Features of maternity health insurance

The benefits of purchasing pregnancy insurance online include the following:

• Cashless hospitalisation:

Leading insurance companies offer maternity plans to provide cashless hospitalisation services at hospitals nationwide. At network clinics, you can access medical services without paying for them.

• Claim-free Bonus:

If you do not make a claim during a policy year, some insurance companies will reduce the insurance payment for the following year or increase the amount covered at the same premium. Moreover, insurance companies provide an online application facility to make the process straightforward for policyholders.

• Choice of the covered amount:

Policyholders can choose the insured amount. When purchasing a maternity insurance policy, they can select the desired amount insured.

• Tax benefit:

Section 80D of the Income Tax Act of 1961 allows policyholders to receive tax benefits for insurance premiums paid for pregnancy coverage.

When you are ready to become a parent, maternity insurance coverage is an excellent addition to your healthcare plan. Growing medical inflation and the possibility of unpredictably high hospitalisation costs typically make it challenging to pay for medical expenses and can interfere with parenting pleasure. Therefore, buying maternity insurance is advised for an economically secure pregnancy. You can purchase these insurance policies online, as the process is seamless and easy.

Key benefits of maternity health insurance

The key benefits of maternity health insurance are-

• Financial Security: Reduces the financial burden of maternity-related medical expenses.
• Quality Healthcare: Facilitates access to better medical facilities and services.
• Comprehensive Coverage: Encompasses a wide range of maternity-related expenses, ensuring holistic care.

What is covered under a maternity insurance plan?

Inclusions are circumstances in which an insurer will accept a maternity benefit claim. The coverage extends to both the woman and the newborn child's related costs and those associated with delivery and childbirth. The following are the standard benefits of maternity health insurance:

1. Support for both pre- and post-hospitalisation

• Delivery and Labour Costs:

The maternity add-on insurance covers all birth-related expenses. However, the insurance may only cover a certain number of pregnancies due to the coverage limit.

• C-Section:

Your insurer will cover all costs if the doctor recommends a C-section for the mother's or the child's health.

• Hospitalisation and Room Rent:

All hospitalisation costs and room rent incurred while receiving medical care are covered by your health insurance policy with maternity benefits. This also includes the cost of natural and c-section births and pregnancy termination in a life-threatening, medically essential scenario.

• Newborn baby coverage:

Up to 90 days after birth, a newborn will receive coverage at no extra expense. The infant must be added to the basic plan as an insured individual after 90 days.

• Vaccination coverage:

A newborn infant needs to receive vaccinations frequently. The maternity advantages of a medical insurance policy cover the expenses of routine vaccinations, such as:

• Measles
• BCG
• Tetanus Toxoid
• OPV+IPV-B1/OPV
• Hib
• Hepatitis B-1
• MMR-1
• Typhoid
• DTPw booster-1 or DTPa booster-1
• HPV (female child)
• Meningococcal

What is not covered under maternity insurance plan?

Maternity insurance has several exclusions too. First, one should increase the coverage or amount insured under the plan to pay maternity expenses. The typical range of coverage offered by health insurance plans with maternity benefits is between Rs 20,000 and Rs 70,000, which needs to be revised to cover delivery expenses.

Second, there may be circumstances where the insurance company chooses not to settle the claim even though you think the policy covers all expenses. For example, an insurer may reject a claim in the event of a delayed pregnancy (for women aged 35 and more). Let’s have a look over the critical exclusions that apply to maternity insurance policies:

• Spending on vitamins and tonics listed in the plan as well as other dietary supplements
• During the pregnancy, costs associated with diagnostic procedures and medical visits.
• Costs associated with treating infertility
• Price of collecting and preserving stem cells, including the possibility of doing so as a preventative step.

The list above includes some factors; additional exclusions may be relevant depending on your selected maternity health insurance plan. Maternity insurance coverage plans vary, and it would be wise to read the terms and conditions related to the exclusions before you decide on one.

Is there an option to buy maternity health insurance while you are pregnant?

Typically, insurers do not provide maternity coverage as a part of your standard healthcare plan. Insurance companies consider pregnancy and it-s related expenses as a pre-existing condition. However, you can still buy maternity coverage as an add-on with your regular healthcare insurance policy. You might be wondering why you should buy maternity insurance. You might have to wait between 9 months and six years to make a claim for expenses related to becoming a mother. Therefore, purchasing pregnancy insurance after getting pregnant is not a good plan. Instead, consider buying it much ahead in preparation to avoid having to wait.

Unfortunately, inflation has increased the expense of healthcare and will probably continue to do so in the future. This includes maternity-related costs too. Women must buy pregnancy insurance as quickly as they can afford it. By doing this, you can enjoy the arrival of your kid without worrying about expensive medical bills. You can leave that in the care of your insurance provider.

Waiting until the very last minute when attempting to conceive will only lead to unnecessary worry. So, we suggest that you invest in a comprehensive maternity insurance policy well in anticipation. This will also help you complete the waiting period and help you to receive coverage when you start planning for a family.

One can have a medical emergency at any time, irrespective of age. Additionally, the stress associated with finding a work-life balance and our lifestyles is taking a toll on most of us. While medical services constantly improve, newer diseases like COVID-19 are becoming more prevalent. The exorbitant cost of medical services such as hospitalisation or treatment procedures adds to our woes. There is no right age for health insurance; investing in one as early as possible ensures coverage and lets you avail of the best treatment, particularly in medical emergencies.

Therefore, purchasing a comprehensive health insurance policy and ensuring your peace of mind is the best way to combat the rising cost of healthcare.

When is the Right Age to Buy Health Insurance?

In India, one can buy an individual health insurance policy as soon as he/she turns 18. Anyone who invests early in a healthcare plan will be better prepared for medical emergencies as well as enjoy financial security. Buying health insurance at the age of 26 or in your 30s could be a sensible decision with an eye on your future as well as your loved ones.

When your age falls in the bracket of 20 to 30 years, you can plan ahead and purchase maternity coverage if you want to start a family soon. If you are in your 40s or 50s, you could opt for a family health insurance policy. But you will need more add-on coverage as you could be at risk for diabetes, high blood pressure, and other hereditary health concerns or lifestyle-related issues.

Purchasing a health insurance policy post-retirement can be expensive as senior citizens are prone to severe health issues and may require hospitalisation and prolonged therapy. Moreover, one might need to purchase more add-ons like critical illness coverage.

Whether you are considering purchasing health insurance for students under 26 or looking at plans customised for senior citizens, the earlier you invest in one, the more benefits you can enjoy. Investing in a healthcare plan in your 20s is prudent as the premium is lower. You can easily cover the waiting period that comes with purchasing a new healthcare policy. If you don’t make a claim, you can enjoy the benefit of cumulative bonuses. You can opt for a family floater plan at a later age with a low premium, but it's still more expensive than a policy bought at a younger age.

Reasons Why Health Insurance is Important Irrespective of Your Age

Let's look at some reasons why we should invest in getting a health insurance plan as soon as possible:

• Creating a compelling claim history:

The best moment to purchase a health insurance policy is when one is physically healthy. Young and healthy people pay cheaper premiums and are less likely to make a claim.

• Earning Bonus:

One benefits from the no-claim bonus (NCB) incentive if there isn't a claim in any given year. A policyholder receives supplemental coverage each year without a claim at no additional expense. The extent of coverage continues to expand over time.

• Coverage for pre-existing conditions:

The most significant benefit of purchasing earlier in life is completing the waiting period associated with pre-existing conditions. There are waiting periods in health insurance policies before some or all of the policyholder’s pre-existing diseases will be covered. While some health issues have a waiting period of 12 to 24 months, typically, insurers cover pre-existing conditions after 48 months.

• Tax benefit:

There is an additional advantage to purchasing a health insurance plan if you are young and employed. The 1961 Income Tax Act states that if you pay a premium for health insurance, you are eligible for tax advantages up to Rs 25,000 in a financial year. Additionally, the tax benefit for the premium paid for a health insurance plan bought for your parents can increase to Rs 50,000 if they are dependent on you.

Benefits of Buying Health Insurance at A Younger Age

Health insurance is there for us when we require it the most. It is sensible to purchase a health insurance policy as early as feasible, although there is no set age for health insurance for investing in a healthcare plan. Let's examine the benefits of buying health insurance online at a young age:

• Lower quotations & premiums:

The likelihood of developing a medical problem is lower if an individual is young. For instance, you can purchase a policy with INR 5 lakh as the sum assured for INR 5000 if one purchases health insurance coverage before age 30. The premium becomes costlier as you get older. The same coverage may cost between INR 6000 and INR 8000 when you are in your 40s.

• Financial alignment:

Buying a healthcare plan earlier in life ensures that a person has coverage for multiple illnesses, including diabetes, renal failure, cancer, and heart disease. These ailments begin to affect individuals as they turn older. You will be left dealing with significant financial woes if you purchase health insurance benefits at a later age when diagnosed with an ailment or hereditary illness. The premium for a policy will be much higher, or you may even have to purchase add-on covers for an additional premium.

• Renewability:

According to the Insurance Regulatory and Development Authority of India (IRDAI), one can always renew a health insurance plan. However, 65 to 70 is typically the upper age limit for health insurance coverage extension. Lifetime renewability is available if you purchase a policy earlier.

Health insurance is becoming increasingly important in India, with rising medical costs. Every health insurance policy carries a premium, which you need to pay to avail of the benefits of the healthcare plan. And this premium is determined by various factors. The amount one needs to shell out is a major concern, particularly if you are considering a senior citizen insurance premium.

The amount of the premium you must pay for this coverage is a crucial factor to consider, as it can act as a financial safety net in the event of unanticipated medical problems. Your health insurance premium will be determined based on numerous variables and specific situations. Knowing the variables that will affect the cost of your premiums will empower you to make the most of your insurance plan.

What is senior citizen health insurance?

Senior citizen health insurance is a specialised policy created for people aged 60 years and above. It provides coverage for medical expenses incurred due to illnesses or injuries, ensuring that healthcare costs do not become a financial burden during the golden years.

How do senior citizen health insurance plans work?

These plans function by offering coverage for hospitalisation expenses, pre-existing conditions (after a waiting period) and sometimes even domiciliary treatments. Policyholders pay a premium, which is decided at the beginning, and in return, the insurance company covers eligible medical expenses up to the sum insured.

Key features of medical insurance for senior citizens

The main features of a health insurance policy for senior citizens are:

• Hospitalisation Coverage: This covers expenses related to hospital stays, including room rent, doctor's fees and medical procedures.
• Pre and Post-Hospitalisation: Expenses incurred before and after hospitalisation, such as diagnostic tests and follow-up consultations, are covered.
• Daycare Procedures: These cover treatments that do not require prolonged hospital stays.
• Pre-existing disease Coverage: After a specified waiting period, pre-existing conditions are covered.
• Cashless Treatment: Access to a network of hospitals where treatments can be availed without upfront payments.
• Domiciliary Treatment: Some policies cover treatments taken at home under medical supervision.

Benefits of senior citizen health insurance

The key benefits of buying a senior citizen health insurance policy are: 

• Financial Security: Protects savings from being depleted by high medical costs.
• Access to Quality Healthcare: Ensures timely medical attention without financial constraints.
• Tax Benefits: Premiums paid are eligible for deductions under Section 80D of the Income Tax Act, offering health insurance tax benefits.
• Peace of Mind: Reduces stress related to potential healthcare expenses.

How to calculate the premium for senior citizen health insurance?

Premium calculation considers factors like the insured's age, medical history, chosen sum insured, policy tenure and any add-on covers. Utilising online premium calculators provided by insurers can offer a quick estimate, aiding in budget planning and policy comparison.

Things to consider when buying a medical policy for senior citizens

Your health insurance premium will depend on the type of healthcare plan you choose. A family floater plan, for instance, is usually less expensive than an individual health insurance policy. But remember that the age of the oldest family member will determine the cost of the premium for a family floater plan.

• Coverage Scope: The scope of coverage and the sum insured will also impact your health insurance premium. A lesser insured sum can lead to the lowest premium health insurance for senior citizens, while a higher premium will ensure a greater sum insured. Your insurance will only pay you up to the amounts insured in reimbursement for medical costs. However, you will be responsible for covering additional expenses if your total medical bills exceed the amount specified as the sum insured in your healthcare policy.
• Renewability: Remember to choose a plan that offers lifetime renewability and not just the lowest premium health insurance for senior citizens. Look for a plan that covers pre-existing diseases, adequate pre- and post-hospitalisation expenditures, a minimal waiting period after which one can avail of coverage for pre-existing disorders, add-ons, top-ups, family floater policies and benefits and other discounts. Also, opt for a plan that provides adequate coverage for critical illnesses, as with age, there can be a higher risk of senior citizens being diagnosed with such ailments.
• Waiting Period: When you search for a healthcare plan, look for one that provides coverage for a maximum number of pre-existing diseases. Check the waiting period and select one with the least time so that you can easily complete it. Sometimes insurers waive the waiting period for an additional fee. Consider this option if you are aged over 60 or purchasing a policy for your senior citizen parents. You can calculate the premium with a senior citizen health insurance premium calculator and get an idea of the plan’s cost.
• Policy Requirements: Many people think that skipping the tests or not disclosing any pre-existing medical conditions will let them get a healthcare policy for a lower premium. It is sensible to opt for a policy requiring medical tests so that the insurer can customise the right plan for you. It is better to pay a slightly higher senior citizen insurance premium than be denied a claim in times of need.
• Payment Options: Understand the available payment options for the health insurance you are planning to choose. Although opting for co-payment is optional for people aged less than 60, it is mandatory for senior citizens. Anyone can find the co-payment value with the help of a senior citizen health insurance calculator.
• Network Hospitals: It is also important to consider the network hospitals, especially in case of critical illness or senior citizen health care plans, to see if they are located in an area that can be easily reached in case of emergency.

Key factors affecting senior citizen health insurance premium

Some significant factors that affect a senior citizen’s health insurance premium include pre-existing diseases or health issues, add-on covers, co-payment, habits and lifestyle and family medical history. Moreover, if you live in an area where there is a high level of pollution or severe climatic conditions, you might have to pay a high premium. Environmental issues play a crucial role in determining the premium of healthcare policies, as senior citizens are prone to health issues arising from living in such regions.

Age of the Insurer

A comprehensive health insurance policy for people aged over 60 years is a must-have as it provides financial security as well as peace of mind. Age is one of the most significant factors that affect senior citizens’ health insurance premiums. The reasons behind this are listed below:

• As we age, the risks for increased hospitalisations, hereditary illnesses and the need for medical supervision increase.
• As it gets harder to anticipate risk factors and medical expenditures as people age, some insurance companies do not reimburse pre- and post-hospitalisation expenses.
• Several health insurance plans include the option of lifetime renewals, but some insurers only permit renewal until age 80.

Pre-Existing Illness

Let’s look at how pre-existing diseases affect the premiums for health insurance plans, particularly for senior citizens.

• If a person has a history of medical conditions which affect his/her health in the long run, he/she is more likely to spend more money on consulting doctors and specialists, hospital care and other healthcare services.
• You cannot avail of any benefits until you complete the waiting period for pre-existing conditions as stated in your policy documentation.
• The amount of your premium will increase depending on the severity of the pre-existing health condition, as evaluated by a professional.
• If your close family members have a medical history of a pre-existing condition like heart disease, diabetes, hypertension, etc., you are more likely to have a risk of acquiring it at a later stage in life.

Medical Test Results

Medical tests enable the insurance company to learn as much as possible about an individual's health. The insurer may tailor a term policy just for you, down to the details like the length of coverage you need, the cost of premiums and other perks. The findings of the examinations that your insurance provider requests will decide the inclusions and exclusions of your healthcare plan, especially if you're applying for senior citizens' health insurance. The factors listed below may change based on the outcomes of a medical exam for a health insurance policy:

• The insurance company’s main objective is determining the premium you'll have to pay for your healthcare plan. Based on an applicant's perceived level of risk, the insurer will provide a quote for the plan's premium. Your premium will be minimal if you are in excellent health. If you have any pre-existing problems revealed in the test results, the insurer will consider you a greater risk and you might need to pay a higher premium. But it will reduce the chances of your claim being denied or rejected.
• If your medical tests come out reasonably healthy, you may be eligible for a larger sum assured.

Co-Payment Option

The part of the sum insured you'll be obliged to pay for your medical insurance is a co-payment. In other words, you and your insurer share the expense of your healthcare. Health insurance coverage for those aged over 60 or senior citizens includes a compulsory co-pay clause due to the exorbitantly greater medical care costs faced by the elderly compared to younger individuals.

• Some insurers let you choose the size of your co-payment. Opting for a co-payment reduces the amount you pay as a premium for your healthcare policy. It's important to remember that a larger co-pay will result in a lower overall premium, but you will still be responsible for paying a higher amount for claims.
• The insurer will pay the majority of the claim, but the insured will be responsible for paying a certain amount. Co-insurance varies in proportion based on the kind of medical care received.
• Typically, a co-pay clause mandated the policyholder to pay 50 per cent of the cost for a claim due to a pre-existing condition and 25 per cent for hospitalisation.

Why should senior citizens buy a health insurance policy?

It has become crucial for every person to purchase suitable health insurance coverage for their loved ones, especially for parents who are senior citizens. Even if you have an employer-sponsored group health insurance plan that covers your parents, a separate health insurance policy customised to meet the needs of senior citizens is a sensible investment. The premium for senior citizen health insurance can offer your parents the appropriate coverage.

Senior citizens are more vulnerable to various diseases and hereditary medical conditions with age and may even require hospitalisation and domiciliary care. A majority of insurers provide annual health check-ups at no cost to the policyholder. This could help diagnose any ailment that a senior citizen may have developed in its early stages and help the person seek timely medical intervention. As healthcare policies for senior citizens are customised, keeping their needs in focus, they provide adequate coverage. Spending a little more on a senior citizen’s health insurance premium could provide add-ons that could help the person in cases of chronic diseases or critical illnesses.

When one obtains health insurance, particularly for senior citizens, he/she may relax knowing that in the event of a medical emergency, most of the financial commitments will be taken care of by the insurer.

FAQs

1. Can pre-existing conditions be covered under senior citizen health insurance?

Yes, but typically after a specified waiting period as defined by the policy.

2. Are there tax benefits associated with paying premiums for senior citizen health insurance?

Yes, premiums paid can be claimed as deductions under Section 80D of the Income Tax Act.

3. Is there an age limit for purchasing senior citizen health insurance?

While policies are designed for those aged 60 and above, the maximum entry age varies among insurers.

4. What is a co-payment clause?

It is a provision where the policyholder agrees to pay a certain percentage of the claim amount, with the insurer covering the rest.

5. Can I avail cashless treatment with senior citizen health insurance?

Yes, if the treatment is taken at a network hospital associated with the insurer, you can choose for cashless claim settlement.

Conclusion

Timely purchasing a comprehensive health insurance policy for senior citizens is one of the most important steps for ensuring a healthy and stress-free time for the person insured as well as their family. By understanding the factors that have an impact on policy premiums and evaluating policy features, you can select a plan that best suits your needs or the needs of their loved ones.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis or treatment. Please consult a certified medical and/or nutrition professional for any questions. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.

Over time, alcohol has become more prevalent in people's lives, especially among younger generations. Consuming it in moderation is not an issue, but if it becomes a habit, that is cause for concern. It can lead to various illnesses, including liver cirrhosis and cardiac disease. Many people today are unsure of insurance for alcohol consumers and the benefits of a policy that provides coverage to such people. Also, many believe their insurance providers will reject their claims because of their consumption of alcohol.

If your insurance provider learns you regularly consume alcohol, the insurer might deny or reject your claim. This is because greater alcohol use may result in health risks that your insurer may not be willing to pay for. The catch is that your insurance provider might ask you to shell out a higher premium because your chance of contracting diseases may increase. As a result, drinking alcohol affects your insurance cost in many ways.

Are Alcohol Consumers Eligible to Buy Health Insurance?

A person can apply for a health insurance plan if he/she infrequently drinks or consumes alcohol moderately without adverse effects on the person’s health. Therefore, those who consume alcohol can buy health insurance.

• The insurer might request an examination when someone starts drinking after obtaining health insurance. To avoid paying a higher premium, you must always drink alcohol cautiously.
• You must inform your insurer even if the insurance provider does not evaluate you on this count. If you hide the fact that you consume alcohol regularly and subsequently experience health issues, the insurer might reject your health insurance claim.
• Insurance companies can request the medical case file to analyse the alcohol consumption problem of a policyholder. If that happens, you could be obligated to pay for the therapy. Many people hide this to avail of a policy at a lower premium. However, if the insurer finds out, the monetary consequences of a denied claim are much worse.
• Significant health problems brought on by a high level of alcohol consumption result in a higher premium as it increases the insurance company's liability to provide coverage. If you drink, choose “alcoholic” when getting health insurance estimates. Try ticking off non-alcoholic beverages to see the difference in the premium.

The premium will also depend on you, and your drinking practises if you are the oldest family member considering a family floater health insurance plan.

Is It Important to Declare if You Are an Alcohol Consumer to an Insurance Company?

It's important to understand that your drinking practices may affect the perks of any health insurance plans you buy or already have. So, this may not severely impact those who drink alcohol infrequently; it might significantly affect extreme drinkers and could even lead to insurers denying or rejecting their claims.

When buying a life insurance policy, you must fill out a declaration form so that the insurer is aware of any existing medical conditions. Furthermore, one must reveal whether or not they consume alcohol because failing to do so could result in the life insurance policy being affected by pre-existing medical problems like cirrhosis of the liver.

Drinking too much alcohol can cause several illnesses, such as liver disease, cancer, stroke, diabetes, and pancreatitis, which generally shorten a person’s expected lifespan. The insurance companies see it as a risk and request an advance declaration from the prospective policyholder. Your insurance provider may raise your premium if your blood alcohol level exceeds the permissible limit.

Your risk of denied claims increases manifold if you withhold facts when buying a health insurance policy. As a result, it is wise to be completely truthful about your health status when applying for an insurance policy.

Why Is Insurance Premium High for Alcohol Consumers?

Moderate alcohol consumption is acceptable, but excessive drinking may raise red flags for prospective insurers.

• Excessive alcohol consumption may lead to illnesses like high blood pressure and liver, kidney, and coronary diseases. In addition, it may cause problems with a person’s mental health and issues related to substance abuse. Therefore, your alcohol intake significantly impacts your premiums when determining your suitability for the finest term insurance policies.
• Your medical documents may also show that your routine alcohol consumption is above a threshold. Additionally, becoming a higher risk for prospective insurers will directly raise the cost of your insurance premium.
• You will probably be eligible for a standard rate if your binge drinking happened in the past and you have refrained for 5-7 years, for instance. On the other hand, if you've been sober for one to five years, you probably count on rated insurance, which has higher rates. But the insurer will limit the scope of coverage. However, your application has a high chance of being rejected if you sought therapy, relapsed, or remained sober for less than a year.
• Purchasing life insurance coverage may be extremely harder if you have a criminal record for driving while intoxicated (DUI).

Suppose the insurance provider determines that the policyholder died in an accident due to intoxication and the person's blood alcohol level was higher than the legal limit. In that case, the insurer has no obligation to provide coverage to the policyholder's family. You must be mindful of these factors when you think in terms of insurance for alcoholics. You must be aware of these factors when you think in terms of insurance for alcoholics.

Importance of Buying Health Insurance for Alcoholics

While it might be challenging for an alcoholic to obtain health insurance, it's not unattainable. An insurance company might issue a policy, but the payment might be higher; a medical test can reveal whether an individual drinks heavily or moderately. A person may be eligible for a basic health insurance plan if he/she has only been a moderate drinker for a brief period. Below is a list of factors that show the significance of purchasing health insurance for alcoholics.

• Hospitalisation as an inpatient: Medical expenses accrued while receiving treatment in the hospital will be covered. However, the co-pay provision or clause may require the policyholder to foot a portion of the bill.
• Co-payment and deductibles: Health insurance providers may have a co-payment provision requiring the insured to pay a portion of the expenses incurred. In most instances, the policyholder can choose the percentage of the co-payment. One of the elements affecting the cost of health insurance is the co-payment proportion selected. Similarly, a person who chooses a high deductible can get the benefit of a relatively cheap premium.
• Cashless facility: If a person decides to get treatment in a network hospital, he/she can get the advantage of cashless transactions. The insurer will pay for the expenses incurred at the point of discharge.
• Lifetime renewability: This is a standard feature of health insurance plans. The policyholder must renew the insurance plan on time to continue receiving the benefits.

Many reputable insurance companies require you to undergo certain medical tests when you seek health insurance coverage. These pre-medical exams are necessary for obtaining health insurance because they play a significant role in establishing your eligibility for coverage. However, it does not entail that you cannot get health insurance without a medical test. 'Insurance providers that require you to take a health insurance test are the most accommodating when filing a claim.

However, it is crucial to remember that even if the insurance company has not requested that you undergo these tests, this does not suggest that you conceal a pre-existing medical condition. Fraud is intentionally misrepresenting facts, resulting in the insurer denying or rejecting your claim. Therefore, before your insurance provider determines your premium amount, you must declare any pre-existing medical condition to avoid the chances of your claim being denied or rejected in the future.

What are the Pre-Medical Tests?

Pre-medical inspections, or pre-medical tests, are a set of medical assessments performed by licenced medical professionals to determine the applicant's current health status. Before issuing a healthcare policy, most insurers insist on pre-medical tests as they want to assess the prospective policyholder’s medical condition. Also, the premium for a policy depends on the results of the pre-medical tests that you have to undergo.

In most cases, the insurance provider's coverage and the number of tests doctors perform are correlated. Additionally, most testing is done based on the applicant's age and the plan's benefits. According to the general tendency, most people seek insurance without medical exams.

The age of a potential customer and the scope of the insurance coverage determines how many pre-policy medical examinations are required. For example, if the beneficiary is older than 45, most health insurance firms demand a pre-policy medical assessment, including several parameters.

The world has seen one of the most dreadful pandemics in human history. As a result, how people generally live their lives in the present has undergone a complete transformation due to COVID-19. In addition, many sectors, along with the health insurance sector, have been impacted by this pandemic. As a result, how the health insurance market works has undergone considerable change.

Nowadays, most insurers insist on a pre-medical investigation for prospective policyholders. Although it is not mandatory, pre-policy medical tests are gaining popularity.

Is Pre-Medical Examination Compulsory for Buying Health Insurance?

A prospective policyholder with a pre-existing condition views medical exams as a barrier as they can lead to higher premiums or even coverage denial. However, most individuals over 45 undergo regular medical examinations to be aware of any dormant health issues. Insurance providers advise them to give accurate information when applying for insurance to guarantee a smooth claims procedure. Furthermore, most policies have a waiting period for pre-existing conditions. Insurance providers usually reject claims related to pre-existing health issues made during this tenure.

Regular medical exams are always advisable because they give you an update on your health condition and act as a benchmark for medical professionals. Without medical exams, disputes over whether policyholders concealed or misrepresented their illnesses could arise when claims get settled. Your insurer can reject your claim if the insurance provider finds you have concealed information about a pre-existing illness.

The premiums for plans that cover pre-existing ailments are comparatively high than a standard policy. They also have more stringent restrictions than plans with standard coverage. However, you will still have to give detailed information even though buying a policy without a medical exam may seem simple.

A comprehensive medical evaluation will establish your actual degree of fitness. If there are any possible health problems, you will be in a position to opt for medical intervention and timely treatment.

Although it is not mandatory, you should go for a medical examination before buying health insurance coverage.

A cashless Mediclaim policy is a progressive new way to manage medical expenses. Traditionally, when someone falls ill or requires medical attention, they must pay for the costs upfront and then submit a claim to their insurance provider for reimbursement. However, with a cashless Mediclaim policy, the entire process is streamlined and simplified.

What is cashless health insurance?

A cashless Mediclaim policy allows you to walk into any of your insurance provider’s network hospitals and receive the necessary medical treatment. The payment for the treatment is then directly settled between the insurance provider and the hospital without the need for you to pay any money upfront. This arrangement eliminates the burden of arranging for funds in times of medical emergencies while also allowing for a seamless and hassle-free medical experience.

How does cashless mediclaim work?

Cashless Mediclaim insurance works in the following manner.

• Choose medical insurers that provide coverage for the majority of diseases.
• Provide information about your current and previous medical conditions and then pay the premium.
• Review the network hospitals in your area.

If you become ill, you can go to any accredited hospital listed on the insurer’s network and get treated without having to pay anything out of pocket.

Benefits of cashless health insurance

Here are the major advantages of opting for a cashless health insurance plan:

• Immediate access to medical care without upfront payment.
• Peace of mind during emergencies.
• No need for reimbursement paperwork.
• Wider network of hospitals ensures accessibility.
• Helps manage finances better, especially during high-cost treatments.

For families, opting for a health insurance policy for family with cashless benefits ensures that each member is protected without added financial pressure.

Types of cashless health insurance plans

Cashless mediclaim is available in various types of insurance plans to suit individual needs:

• Individual health insurance plans: Covers one person with cashless hospitalisation.
• Family floater plans: Offers shared coverage for the entire family under a single sum insured.
• Senior citizen plans: Tailored for older adults with specific health conditions.
• Critical illness plans: Offers cashless treatment for predefined life-threatening illnesses.
• Group health insurance: Common in corporate sectors; employees get cashless treatment benefits.

Inclusions and exclusions of cashless health insurance

Understanding what’s covered and what’s not is crucial when choosing any health insurance plan, including cashless Mediclaim-

Common inclusions:

• Hospitalisation expenses (pre and post)
• Daycare procedures
• ICU charges
• Ambulance fees
• Some diagnostic tests and medicines

Common exclusions:

• Cosmetic treatments
• Dental and vision not related to accidents
• Self-inflicted injuries
• Pre-existing diseases during the waiting period
• Non-network hospital treatments (unless reimbursed later)

Things to consider when buying cashless health insurance

Before purchasing a cashless health insurance plan, keep these points in mind:

• Hospital network: A wide hospital network increases accessibility.
• Claim settlement ratio: A higher ratio means better reliability.
• Pre- and post-hospitalisation coverage: Look for comprehensive benefits.
• Inclusions and exclusions: Read policy documents carefully.
• Waiting period for pre-existing diseases: Shorter waiting periods are better.
• Customer service support: Quick claim assistance is crucial during emergencies.
• Top-up options: Useful when you want to extend your coverage.

Especially for families, evaluate the health insurance policy for family based on the number of members, age, and existing health conditions.

FAQs

1. Is cashless health insurance available in all hospitals?

No, cashless benefits are available only at network hospitals listed by the insurer.

2. Can I convert a reimbursement claim into a cashless claim?

No, cashless claims must be pre-authorised. Reimbursement is a separate process.

3. What should I do if a cashless claim is rejected?

You can pay the hospital bill yourself and then file for reimbursement with valid documents.

4. Is cashless mediclaim available for pre-existing diseases?

Yes, but only after the waiting period as mentioned in your policy.

5. How can I check the list of network hospitals?

Visit your insurance provider’s website or app to check the latest network hospital list.

Conclusion

Cashless mediclaim insurance brings convenience and peace of mind when you need it most. Whether you’re buying an individual health insurance plan or a health insurance policy for family, ensuring it offers comprehensive cashless benefits can significantly ease the burden during medical emergencies. Do thorough research, compare policies, and choose what aligns best with your family’s healthcare needs.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis or treatment. Please consult a certified medical and/or nutrition professional for any questions. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.

Picture this: you wake up one morning feeling unwell, and the only thing on your mind is getting medical attention. But as you navigate the maze of healthcare options available, you are left wondering — what is the best choice for my health insurance needs? Choosing the right health insurance plan can be overwhelming in a place where healthcare is a top priority. And with multiple options available, it is easy to get confused about which plan to go with. One of the most common debates in the Indian insurance sector is whether a private health insurance plan can replace a government-run scheme. 

What is ESIC?

The Employees’ State Insurance Corporation (ESIC) is a statutory organisation responsible for the Employees’ State Insurance (ESI) management and administration. The scheme was introduced in India in 1948 under the Employees’ State Insurance Act to provide social security benefits to employees in the organised sector, such as medical perks that include benefits pertaining to sickness, maternity, disability as well as death.

The ESI is a self-financing social security and health insurance scheme for workers earning a monthly wage of up to Rs 21,000 and Rs 25,000 if a person has a disability. ESI is funded by employers and employees, with the employer contributing 4.75% of the employee’s salary and the employee contributing 1.75%.

The ESIC has a multifaceted role in managing and administering the ESI Scheme. Its responsibilities include collecting contributions, providing medical and cash benefits to employees and their dependents, and managing hospitals, dispensaries, and other medical facilities. Additionally, it serves as a regulatory body to ensure compliance with the ESI Act and other related laws. 

Difference Between ESIC and Mediclaim

Below are the primary distinctions between ESIC and Mediclaim.

ESIC:

• It is a government-run health insurance scheme for employees in the organised sector, earning up to a certain limit. 
• The ESIC sees contributions from both employers and employees.
• It provides a range of benefits; this includes medical, cash, disability, maternity and dependent benefits.
• ESIC also manages and runs its network of hospitals and dispensaries.

Mediclaim:

• It is a private health insurance policy that individuals can purchase from insurance companies.
• It is available to anyone willing to pay the premium, regardless of their employment status or income level.
• It provides coverage for hospitalisation expenses, including medical bills, room charges, surgery costs, and more, up to the sum insured.
• Mediclaim policies have broader coverage and more flexible options but come at a higher cost than ESIC.

Benefits of Switching to Mediclaim from ESIC

Switching from ESIC to Mediclaim can have several benefits, including:

• More comprehensive coverage: Mediclaim policies offer a broader range of benefits than ESIC, including coverage for pre-existing conditions, outpatient expenses, and non-allopathic treatments.

• Greater flexibility: Mediclaim policies offer more flexibility in terms of choosing the sum insured, adding riders or endorsements, and selecting hospitals and doctors.

• Higher coverage limits: Mediclaim policies have higher coverage limits than ESIC, which means that you can get higher coverage for hospitalisation expenses, including room rent, medical bills, and surgery costs.

• Tax benefits: Premiums paid towards Mediclaim policies are tax-deductible under Section 80D of the Income Tax Act, 1961, whereas ESIC contributions are not tax-deductible.

• No dependency on employment status: Unlike ESIC, which is only available to employees in the organised sector, Mediclaim policies are available to anyone willing to pay the premium, regardless of their employment status.

Mediclaim cannot replace ESIC as ESIC is a mandatory social security scheme for employees in the organised sector, whereas Mediclaim is a private health insurance policy. However, employees not covered under ESIC can opt for Mediclaim for health insurance coverage.

Today, where medical costs are skyrocketing and can drain one’s finances, a Mediclaim policy has become an essential shield to safeguard against unexpected medical expenses. It offers financial assistance during medical emergencies, ensuring you and your loved ones receive the best medical care without any economic burden. However, with various payment options available, people are often uncertain about the payment methods for their Mediclaim premiums. Let’s explore whether Mediclaim premiums can be paid in cash and understand the answer in detail.

Before delving into the topic, it is essential to understand the basics of Mediclaim. A Mediclaim policy covers the expenses incurred during medical treatment, consultation charges, and pharmacy bills. It provides financial assistance to you, ensuring you do not face any economic burden due to unexpected medical emergencies. To avail of these benefits, you must pay a premium to the insurance company at regular intervals, as specified in the policy document.

Can you make a cash payment for the Mediclaim premium?

Yes, most health insurance companies will accept cash payments for Mediclaim premiums. However, checking with the specific insurer about their preferred payment methods is always a good idea. You should make cash payments directly at the insurer’s branch office and remember to obtain a valid receipt for future reference. For added convenience and security, you should use electronic payment methods such as online transfers or debit/credit card payments.

No tax benefit when you pay cash for Mediclaim Premium

If you pay the premium for your Mediclaim insurance policy in cash, you will not be eligible for any tax benefits. Under Section 80D of the Income Tax Act, tax deductions are available only on premiums paid through digital modes of payment like Net Banking, credit cards, or debit cards. Therefore, choosing a suitable payment method to maximise your tax savings while purchasing a Mediclaim policy is essential.

• You are eligible for a tax break of up to Rs 25,000 for Mediclaim insurance premiums paid for yourself, your spouse, and your dependent children.
• An additional benefit of up to Rs 25,000 is available for Mediclaim insurance premiums paid for your parents.
• If you or your parents are senior citizens (age 60 years or above), the deduction limit increases to Rs 50,000.
• If you and your parents are both senior citizens, the deduction limit increases to Rs 1,00,000.
• It is important to note that the total deduction for Mediclaim insurance premiums, including those paid for parents, cannot exceed Rs 1,00,000.

However, you can still get a tax benefit if you spend money on preventive healthcare, such as routine health tests, and pay for it in cash. In this case, the maximum allowable deduction is Rs 5,000, and the benefits are limited to a cap of Rs 25,000.