From speaking to singing and from breathing to swallowing-the throat plays an incredibly important role in how we engage with the world around us. Everyone, regardless of their age, gender or lifestyle, relies on the health of their throat for a range of activities. Taking good care of your throat should be near the top of everyone’s list when considering their overall wellness. Understanding the signs and symptoms of a more serious condition like throat cancer can help ensure that any issue you may have with such a delicate area gets addressed quickly and appropriately. With this in mind, it’s essential that you understand just what impacts your throat’s health and take actionable steps towards looking after it on a daily basis.

What is Throat Cancer?

Throat cancer, in everyday language, refers to cancer that begins in your throat. However, doctors and medical experts prefer to use more precise terms because the throat area can be affected by various types of cancers. When you have medical appointments, your healthcare provider will explain the exact type of cancer you're dealing with using the correct medical terms.

For instance, cancer that starts in the thyroid gland at the front of your neck is called thyroid cancer. Cancer that begins in the tube that typically carries food to your stomach is known as esophageal cancer. Similarly, cancer that originates in the windpipe, also called the trachea, is called tracheal cancer.

Types of Throat Cancer 

The following are some of the most commonly known types of neck cancer.

• Oropharyngeal cancer: This type typically impacts the area situated just behind your mouth. Nasopharyngeal cancer: This typically emerges in the area behind your nose.
• Laryngeal cancer: This cancer refers to tumours forming within your vocal cords. The origin of the cancer can be from different parts of your voice box.
• Glottic cancer: If you encounter glottic cancer, it affects your vocal cords located in the middle of your larynx. Notably, more than half of all laryngeal cancer cases begin in this region.
• Subglottic cancer: This cancer starts beneath your vocal cords, in the lower portion of your voice box. Supraglottic cancer originates in the upper part of your larynx and might typically include the epiglottis; it is the cartilage that prevents food from entering your windpipe.

Symptoms of Throat Cancer

Listed below are some of the most commonly known throat cancer symptoms:

• Keep an eye out for recurring nosebleeds.
• The tumour's presence can affect your voice, making it quieter, huskier, or resembling a perpetual cold.
• Throat cancer can make eating and swallowing painful and difficult, leading to weight loss, a common symptom in various cancer types.
• You might encounter pain or a burning sensation when chewing or swallowing, as the tumour interferes with these actions.

Causes of Throat Cancer

The following are some of the popular risk factors that can potentially become one of the throat cancer reasons.

• If you are a man, you have a 4 to 5 times greater likelihood of developing throat cancer compared to women.
• If you have been exposed to human papillomavirus (HPV) through sexual activity with an infected partner, you are at risk of laryngeal and hypopharyngeal cancer.
• While those over 55 years of age face a higher risk, it's crucial to note that even younger individuals can also be affected by these types of cancer.
• If you use tobacco products like cigarettes, cigars, pipes, chewing tobacco, or snuff, you need to be aware that these increase your risk of cancer. An astonishing 85% of cancer cases are linked to tobacco use. In addition to direct smoking, exposure to second hand smoke and smoking marijuana can further raise this risk.
• If you have difficulty swallowing and are iron deficient, be aware that you are at a higher risk of throat cancer due to this condition.
• If you happen to frequently consume alcohol in excessive amounts, you are significantly increasing your chances of developing cancer. Combining alcohol with tobacco usage intensifies this risk more.
• If your occupation exposes you to harmful substances like asbestos, wood dust, paint fumes, or specific chemicals, your risk of developing cancer significantly increases.

Your tongue possesses remarkable versatility, carrying out a wide range of tasks. Its impressive mobility allows coordinated functions like speaking, sucking, and swallowing. Not only that, this skilled organ acts as a sensory powerhouse, governing your sense of taste and displaying remarkable sensitivity to touch. In addition, it houses numerous immune cells, actively contributing to your body's defence mechanisms. Understandably, any condition that affects your tongue, such as tongue cancer, can lead to distress and discomfort. However, by promptly identifying and addressing such issues, you can be secured financially and mentally.

What is Tongue Cancer?

Tongue cancer typically arises from abnormal cell growth on your tongue and falls into the category of head and neck cancers. There are various types of tongue-related cancers, but the most common type starts from the flat, slim cells that cover the surface of your tongue, known as squamous cells. This type of cancer is commonly called squamous cell carcinoma.

Your tongue is divided into two distinct parts, namely, the oral tongue and the base of the tongue, both of which can be susceptible to cancer. The oral tongue makes up the first two portions you see when you stick your tongue out. On the other hand, the base of your tongue is located at the back and is very close to your throat.

Symptoms of Tongue Cancer

The following are some of the most common tongue cancer symptoms.

You might notice early stage tongue cancer symptoms such as an unhealed ulcer, sore, or lump on your tongue that tends to bleed easily. This condition can lead to sensations of pain or a lingering burning feeling within your tongue. 

Pay attention to tongue cancer symptoms such as discovering a lump in your neck, experiencing a persistent sore throat, or feeling like something is obstructing your throat over time. This condition might even impact your ability to speak clearly and lead to the development of bad breath, unintentional weight loss, and persistent fatigue.

Causes of Tongue Cancer

The following are some of the most popularly known tongue cancer causes.

Tongue tumour is strongly linked to the excessive use of tobacco and alcohol, as well as exposure to the human papillomavirus (HPV). While it used to mainly affect older men, this disease in recent years has started affecting women and younger individuals more frequently. This change is partly due to the rise in HPV infections. HPV, a widely spread sexually transmitted infection, affects nearly everyone who is sexually active.

There are other aspects that contribute to the risk of tongue tumour. These include getting older, with those over 45 years of age being more susceptible. Not having enough fruits, vegetables, and sources of vitamin A in your diet also increases your risk. 

As we age, the risk of developing critical illnesses increases, making planning for unexpected healthcare expenses essential. Critical illness insurance for senior citizens provides financial protection against life-threatening ailments and lifestyle diseases that are expensive to treat. We will discuss the advantages of acquiring critical illness insurance for those aged over 60. Such policies provide coverage for exclusive therapies, medicines, and domestic medical services not included in standard health insurance plans. Furthermore, we will delve into how this supplementary coverage can safeguard retirement funds and offer reassurance for senior citizens and their loved ones.

What Is Critical Illness Insurance For Senior Citizens

The fast-paced and stressful lifestyle of modern times has resulted in a rise in lifestyle diseases, such as hypertension, diabetes, and others, leading to serious health complications later in life. However, one can live a healthy life with proper management and treatment. Critical illness insurance policies help you deal with the expenses related to critical conditions and lifestyle-related diseases. It’s imperative to invest in a top-tier health insurance plan that safeguards you financially from these ailments since the treatment for these critical illnesses is exorbitant, and the resultant financial burden is unsettling.

Before purchasing a senior citizen critical illness policy, it is crucial to consider various factors, such as present age, number of dependents, and health status. For example, suppose you have certain family members who are senior citizens and dependents. In such circumstances, you may want additional coverage for sudden healthcare emergencies, such as heart attacks. Thus, it is always advisable to opt for a critical illness cover for senior citizens with sufficient financial support. Additionally, people who smoke regularly, have high-stress jobs or are more at risk of developing health problems with advancing age should start to plan early to overcome hurdles while purchasing insurance.

Your present financial position is also crucial to consider as the cost of quality healthcare continuously increases, and inflation is bound to happen. Consequently, it is essential to think about all these issues while deciding on the adequate sum insured.

Why Should You Buy Critical Illness Insurance For Senior Citizens

While traditional health insurance coverage can help with medical expenses, it may not cover all the costs associated with a critical illness. For this reason, senior citizens must consider obtaining a separate critical illness insurance plan.

• A critical illness policy for senior citizens can provide additional financial coverage in the event of a severe medical condition. This type of insurance can cover specialised treatments, medications, and domiciliary treatment, which do not typically get covered by regular health insurance policies. This additional coverage gives those aged over 60 the financial resources they need to cover the costs associated with a critical illness.
• A critical illness’s potential impact can have severe repercussions on the retirement savings of senior citizens. In the event of a severe medical condition, senior citizens may have to withdraw funds from their retirement savings to cover expenses not covered by their standard medical insurance plan. This could significantly impact their retirement plans and leave them with a shortage of funds in their twilight years. Investing in a separate critical illness insurance policy can help alleviate these concerns.
• Critical illness insurance provides a safety net to senior citizens and their family members, as they have additional financial coverage in the event of a severe medical condition.

In conclusion, senior citizens should consider obtaining a separate critical illness insurance plan in addition to their regular health insurance coverage. One can also opt for it as an add-on coverage to widen the scope of coverage of their primary healthcare policy. This can ensure they have the requisite financial resources to meet the extra expenses related to a critical illness and protect their retirement savings.

Health insurance has become crucial in safeguarding our finances with continually rising medical cost. However, navigating the complex claim processes and expenses involved in your time of need can sometimes be overwhelming. To cater to these challenges faced by our customers, ICICI Lombard has introduced an innovative solution called 'Anywhere Cashless.' This feature revolutionises health insurance, offering our policyholders a hassle-free and convenient experience at the time of claim.

Let's delve into the benefits of Anywhere Cashless and discover how it can make managing and using your health insurance easier.

Freedom from network hospital limitations:

Anywhere Cashless allows you to choose any hospital you want without worrying if it's a network hospital or not. This service lets you decide which hospital is best for you, whether near your home or a specialised facility you trust. You can get cashless treatment even if your preferred hospital is not in our network. This is available pan-India, so if you're in your hometown or travelling to another city, you can still get cashless treatment if the hospital you prefer accepts it.

Treatment without worries:

One of the most significant advantages of Anywhere Cashless is that it allows you to receive treatment without worrying about upfront payments. Unlike traditional health insurance plans that require you to pay a deposit or make payments during discharge, Anywhere Cashless eliminates these out-of-pocket expenses. This means you can focus solely on your & your family's well-being, knowing that your insurance will cover the costs directly.

Hassle-free cashless facility:

With Anywhere Cashless, you can bid farewell to the hassle of reimbursement processes and complex paperwork. This seamless cashless experience ensures you can concentrate on your recovery rather than worrying about insurance-related matters.

Peace of mind:

Lack of awareness about insurance coverage and reimbursement processes can be a source of stress during medical emergencies. Anywhere Cashless eliminates these concerns by simplifying the claims process. You no longer have to worry about understanding medical admissibility, sub-limits, or which expenses are covered. By opting for Anywhere Cashless, you can have peace of mind, knowing that your insurance will cover the costs, and you can focus solely on your recovery.

ICICI Lombard Health Insurance Cashless Network Hospital List in Buldhana, Maharashtra

Explore ICICI Lombard’s health insurance policies :

• Family Health Insurance
• Personal Accident Insurance 
• Top Up Health Insurance
• Arogya Sanjeevani Policy
• Corona Kavach Policy
• Senior Citizen Health Insurance
• Parents Health Insurance
• Children Health Insurance

which offers people much needed financial backup during any medical emergencies.

With the increasing costs of medical care and treatments, having a health insurance plan has become essential for everyone. Choosing the right health insurance plan for your family can be a confusing and overwhelming task, especially with the numerous options available in the market. This guide will help you understand the factors to consider while choosing a health insurance plan that best suits your family's needs.

Factors to focus in while deciding coverage

• Coverage

One of the most important aspects to consider while choosing a health insurance plan is the coverage it offers. The plan should cover all the essential medical treatments and procedures required by your family. It is also important to check if the plan covers pre-existing conditions, as it could have a significant impact on the overall cost of treatment.

• Premiums

The premium you pay for your health insurance plan is a monthly or annual fee that you need to pay to keep your policy active. It is important to choose a plan that fits within your budget and is affordable for you in the long run. Do not compromise on coverage for a lower premium, as it could result in out-of-pocket expenses in case of medical emergencies.

• Network Hospitals

Make sure to check the network of hospitals that are covered under the health insurance plan. This is important as it will help you determine the hospitals you can go to in case of a medical emergency. Also, check if the plan covers out-of-network hospitals, as it could have a significant impact on the cost of treatment.

• Deductibles

A deductible is the amount you need to pay out of pocket before your insurance kicks in. It is important to choose a plan with a deductible that you can afford in case of a medical emergency. High deductibles can lower your monthly premium but could result in higher out-of-pocket expenses.

• Co-payments

Co-payments is the amount you need to pay after your deductible has been met. It is important to choose a plan with co-payments that you can afford. A plan with higher co-payments could result in lower premiums but could result in higher out-of-pocket expenses in case of medical emergencies.

Conclusion

Choosing the right health insurance plan for your family is a crucial decision that should not be taken lightly. It is important to consider the coverage, premium, network of hospitals, deductible, co-payments, and co-insurance while making your decision. With the right health insurance plan, you can ensure the financial stability of your family in case of a medical emergency.

ICICI Lombard Health Insurance Cashless Network Hospital List in Amalner, Maharashtra

Explore ICICI Lombard’s health insurance plans :

• Family Health Insurance
• Personal Accident Insurance 
• Top Up Health Insurance
• Arogya Sanjeevani Policy
• Corona Kavach Policy
• Senior Citizen Health Insurance
• Parents Health Insurance
• Children Health Insurance

which offers people much needed financial backup during any medical emergencies.

Super top-up health insurance means a policy that provides additional protection beyond the existing medical insurance coverage. It acts as a supplementary policy that kicks in when the sum insured by the primary health insurance policy is exhausted. In other words, it provides an extra layer of protection against unexpected medical expenses that may exceed the coverage limit of your standard or primary health insurance policy. Increasing ailments, a sedentary lifestyle, and rising medical inflation make it necessary to consider medical coverage over and above your basic healthcare plans. Let us try to grasp the meaning of what is a super top up policy and how we can use it in medical emergencies.

Highlights of super top-up health insurance plans

To understand the ins and outs of a super top-up health insurance plan, one needs to know super top up health insurance meaning. A super top-up health insurance plan provides additional coverage if the existing cover of the primary health insurance policy is exhausted. It works on the principle of aggregate expense. The total hospitalisation and treatment expenses in a policy year get considered, not the per-claim expenditure. If the cumulative expenses in a year exceed the deductible limit, the super top-up policy comes into effect and covers the remaining expenses up to the sum insured.

Understanding what is super top-up in health insurance explains its need as well. Medical expenses, including hospitalisation charges, surgeries, and other treatments, can quickly escalate and surpass the coverage limit of a primary health insurance policy. In such cases, having a super top-up health insurance plan can provide an extra layer of financial protection, ensuring that individuals do not get burdened with excessive out-of-pocket expenses. Super top-up plans offer additional coverage beyond the primary policy at a lower cost than purchasing a comprehensive plan with a higher coverage limit. It helps individuals mitigate the financial risks associated with unexpected medical expenses and ensures continuous coverage during critical or prolonged illness.

Who should buy a super top-up health insurance plan?

A super top-up health insurance plan is ideal for:

• Individuals with a basic health insurance policy that has limited coverage.
• Senior citizens prone to frequent hospitalisations.
• Employees with employer-provided health insurance that may not be sufficient.
• Families seeking enhanced medical coverage without a significant cost increase.

Features of super top-up health insurance plan

These are the main features of a super top-up health insurance plan:

• Deductible Clause: Claims are processed only after the deductible amount is exhausted.
• Multiple Claims Coverage: Unlike a top-up plan, a super top-up covers multiple hospitalisations within a policy year.
• Cashless Treatment: Avail cashless hospitalisation at network hospitals.
• Affordable Premiums: Provides extensive coverage at lower costs compared to increasing the base health insurance plan.
• Tax Benefits: Eligible for tax deductions under Section 80D of the Income Tax Act.

Benefits of a super top-up health plan

Listed below are some of the major benefits of a super top-up health insurance plan:

• Increased Coverage:

One of the significant benefits of a super top-up health insurance plan is that it enhances the coverage limit beyond the existing health insurance policy. It provides an additional cushion to protect against high medical expenses, especially in cases where the primary policy's coverage limit is insufficient.

• Cost-effective:

Super top-up health insurance is usually more cost-effective compared to purchasing a separate health insurance policy with a higher coverage limit. It allows individuals to enhance their coverage without having to pay high premiums for a comprehensive health insurance plan.

• Flexibility:

Super top-up health insurance offers flexibility in choosing the deductible limit, which is the amount up to which an individual is responsible for paying for medical expenses. The higher the deductible limit, the lower the premium amount. This allows individuals to avail of a policy as per their budget and needs.

• No Claim Bonus (NCB):

Some super top-up health insurance plans offer a no-claim bonus (NCB) feature. If a policyholder does not make any claims in a policy year, he/she gets rewarded an increase in the sum insured or a discount on the premium for the next policy year.

Difference between super top-up and top-up health plan

These are the key differences between super top-up and top-up in a health insurance plan:

Medical expenses covered under super top-up health insurance plans

Inclusions under a super top-up health insurance plan are:

• In-patient hospitalisation expenses
• Pre and post-hospitalisation expenses
• Daycare treatments
• ICU charges
• Ambulance expenses
• Organ donor expenses

What is not covered under super top-up health insurance plans?

These are the exclusions under a super top up health insurance plan:

• Pre-existing diseases within the waiting period
• Cosmetic or plastic surgeries
• Injuries due to self-harm or substance abuse
• Maternity expenses (unless covered under specific plans)
• Experimental or unapproved treatments

Super top-up policy eligibility criteria

There are certain age and health related criteria that decide your eligibility for a super top-up:

• Age: Usually available for individuals aged between 18 to 65 years.
• Medical Check-up: This may be required for individuals above a certain age.
• Pre-existing Conditions: Subject to waiting periods.

How to file a claim for a super top-up health plan?

Filing a claim for a super top-up health insurance policy is simple:

1. Notify the insurer as soon as hospitalisation occurs.
2. Submit necessary documents like hospital bills and discharge summaries.
3. Ensure that the deductible amount has been met before claiming.
4. The insurer processes the claim and reimburses the eligible amount.

Factors to consider while buying super top-up mediclaim policy

Consider these points if you are planning to purchase a super top-up Mediclaim policy:

• Choose an appropriate deductible amount based on your base health insurance plan.
• Compare multiple plans for benefits and coverage.
• Ensure a wide network of hospitals for cashless treatment.
• Read the terms related to exclusions and waiting periods.

How do health insurance top up plans work?

A super top-up health insurance plan kicks in once the total medical expenses within a policy year exceed the deductible limit. For instance, if you have a deductible of INR 2 lakhs and a sum insured of INR 10 lakhs, the policy covers all expenses exceeding INR 2 lakhs within the policy year.

Why should you get a mediclaim top up plan?

Given below is a list of reasons why you should get a Mediclaim top-up plan: 

• Protects against financial burdens due to unforeseen medical emergencies.
• Provides additional coverage at a lower premium than increasing the base health insurance plan.
• Ensures that frequent hospitalisations don’t drain your savings.

How to buy super top up health insurance plans online?

You can purchase a super top-up health insurance online with these simple steps:

• Visit the insurer’s official website or an insurance aggregator platform.
• Compare different plans based on coverage, premiums, and deductibles.
• Fill out the application form and provide the necessary details.
• Make the payment and receive policy documents digitally.

FAQs

1. How does a super top-up health insurance plan work?

A super top-up health insurance plan offers added coverage, in addition to the deductible amount allowed under a policy. Once the medical expenses exceed the deductible in a policy year, the super top-up plan starts covering the remaining costs.

2. What factors should I consider before purchasing a super top-up health plan?

Before buying a super top-up plan, consider the deductible amount, sum insured, policy exclusions, network hospitals, premium affordability, and waiting periods for pre-existing conditions.

3. What is meant by a deductible in a super top-up medical insurance plan?

A deductible is a predefined amount that the policyholder must pay before the super top-up plan starts covering expenses. It is calculated on an aggregate basis within a policy year.

4. Are Ayush treatments included under super top-up health insurance plans?

Some insurers offer coverage for Ayush (Ayurveda, Yoga, Unani, Siddha, and Homeopathy) treatments under super top-up plans, but it varies based on the policy terms. Always check with the insurer before purchasing.

5. Can I opt for a higher deductible amount in a super top-up plan?

Yes, policyholders can select a higher deductible amount, which usually results in a lower premium. However, it is important to choose a deductible that aligns with your financial capacity and existing health insurance coverage.

Conclusion

Super top-up health insurance is an effective way to enhance the coverage limit of an existing health insurance policy at an affordable cost. But most importantly, understanding what is a super top up Mediclaim policy will help you make a well-thought-out choice. With its flexibility, affordability and comprehensive protection, super top-up health insurance can be a valuable addition to your healthcare strategy.

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.

To avail of health insurance coverage benefits, the policyholder typically pays a premium to the insurer. To get the best out of this contract, it is necessary to know the various features of a health insurance plan. One important feature of health insurance policies is the cumulative bonus. A cumulative bonus in health insurance incentivises policyholders to maintain a healthy lifestyle and avoid making claims during the policy term. By doing so, the policyholders reduce the risk of illnesses and help the insurance company to manage their costs effectively. It builds loyalty among policyholders and encourages them to renew their medical insurance plans with the same insurance company.

What is cumulative bonus in a mediclaim policy?

Let us start with understanding the cumulative bonus health insurance meaning. A cumulative bonus is a reward that health insurance companies offer to their policyholders for not making any claims during the tenure of the policy. It is an additional benefit that accumulates over the years, and the policyholder can avail of it at the time of renewal. The cumulative bonus is a percentage of the sum insured; it gets added to the policyholder’s sum insured without any additional cost.

How does cumulative bonus work in health insurance?

Cumulative Bonus works as an incentive for policyholders who maintain a claim-free record. Each year without a claim results in an increase in the sum insured by a predefined percentage, usually ranging from 5% to 50% per year, depending on the insurer. However, if a claim is made, the accumulated bonus may be reduced or reset as per policy terms.

Types of cumulative bonus in health insurance plans

Following are the different types of cumulative bonuses in a health insurance policy:

1. No-Claim Bonus (NCB): The sum insured increases annually for each claim-free year, without a premium increase.
2. Discount on Premium: Instead of increasing the sum insured, some insurers offer a discount on the renewal premium for every claim-free year.
3. Hybrid Cumulative Bonus: Some policies provide a combination of an increased sum insured and a discount on the premium.

Benefits of cumulative bonus in health insurance policy

The key benefits of a cumulative bonus in health insurance are:

1. Cost-Effectiveness: One of the primary benefits of the cumulative bonus in health insurance is that it increases the sum insured without any extra cost.
2. Creates Good Financial Sense: The cumulative bonus health insurance provides an incentive for the policyholder to develop habits that promote a healthy lifestyle and avoid raising claims. By not making any claims, the policyholder can accumulate the bonus and use it to increase his/her coverage. This encourages the policyholder to take preventive measures and reduce the risk of illnesses. The cumulative bonus provides additional coverage to the policyholder, which is useful in case of medical emergencies and unexpected illnesses.
3. Increases Savings: The cumulative bonus in health insurance is a cost-saving tool as well. This is because, with a cumulative bonus, policyholders can increase their sum insured without paying an additional premium. This helps reduce the financial burden of healthcare expenses and provides peace of mind to the policyholder.
4. Builds Trust: In addition to the cost-benefit, the cumulative bonus helps build loyalty and encourages policyholders to renew their policies with the same insurer. Renewing the healthcare plan with the same insurance provider becomes way more beneficial because of the cumulative bonus in health insurance.

Conclusion

A cumulative bonus is a valuable feature in health insurance plans, offering policyholders additional financial benefits over time. While purchasing a health insurance plan for family, it is essential to consider the cumulative bonus benefit for long-term security and better healthcare coverage. Although the terms no-claim bonus and cumulative bonus in a Mediclaim policy get used interchangeably, they are not the same. And understanding the distinction can help policyholders make informed decisions about their medical insurance policies.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It may contain outdated data and information regarding the topic featured in the article. It is advised to verify the currency and relevance of the data and information before taking any major steps. ICICI Lombard is not liable for any inaccuracies or consequences resulting from the use of this outdated information.

Health insurance can involve a plethora of terms and concepts that may be difficult to comprehend. Two of these concepts are copay and coinsurance.

While both terms refer to the amount you pay out of pocket for medical care, they work in different ways. Copay is a specified amount you pay for a covered service, while coinsurance is a percentage of the cost you pay after paying the deductible amount mentioned in your policy.

Understanding the difference between these two concepts is crucial for making informed decisions about your health insurance coverage.

In this blog, we will delve into copay and coinsurance in health insurance, their differences, and how they impact your health insurance policies.

What is Co-Pay in Health Insurance?

Copays refer to the fixed amount an individual must pay out of pocket for a covered healthcare service. However, the copay amounts may vary depending on the specific health insurance plan and the type of service received.

Copays are a cost-sharing mechanism between the individual and the insurance provider. This helps to make healthcare more affordable and accessible while also discouraging unnecessary claims. For example, a copay might discourage individuals from scheduling unnecessary doctor’s appointments or tests since they will have to pay a portion of the cost themselves.

Let’s say you have a medical insurance policy with a copay of Rs 500 for a specialist visit. If you schedule an appointment with a specialist for a health concern, you will be responsible for paying Rs 500 at the time of your visit. Your insurance provider would reimburse the remaining cost of the visit.

Overall, copays are an important component of health insurance plans that help make healthcare more affordable and accessible for individuals. It is essential to understand your specific copay requirements and how they fit into your overall healthcare costs.

What is Co-Insurance in Health Insurance?

• Co-insurance is a cost-sharing mechanism between the individual and the insurance provider, similar to a copay.
• However, while copays are a fixed amount, co-insurance is a percentage of the total cost of the healthcare service. The percentage of co-insurance required may vary depending on the specific health insurance plan.
• Co-insurance typically applies after an individual has met his/her deductible, which is the amount the person must pay out of pocket before the insurance coverage kicks in.
• For example, an individual has a health insurance plan with a Rs 5,000 deductible and a 20% co-insurance requirement. If the person undergoes a healthcare service that costs Rs 10,000, he/she would be responsible for paying the first Rs 5,000 (the deductible). After that, the person would be responsible for paying 20% of the remaining Rs 5,000, or Rs 1,000. The insurance provider would cover the remaining amount.
• Co-insurance helps to incentivise individuals to choose more cost-effective healthcare options, as they will be responsible for a portion of the cost. However, it can also result in higher out-of-pocket expenses for individuals if they require extensive or expensive healthcare services.

What is the difference between Co-pay and Co-insurance?

Both co-pay and co-insurance are cost-sharing mechanisms between the individual and the insurance provider in health insurance plans. However, they vary in the following aspects.

• Copay is a fixed amount paid by a person at the time of service, while co-insurance is a percentage of the total cost of a healthcare service paid by the policyholder after the deductible gets paid.
• While copays can differ based on the type or procedure, coinsurance applies the same percentage to all procedures.
• Copay is more common in less comprehensive plans; co-insurance is more common in comprehensive plans with higher premiums.

Overall, while coinsurance and co-pay in health insurance differ in the way in which the cost gets shared - a fixed amount for copay (co-payment) versus a percentage of the total cost for coinsurance (co-insurance) - they are both cost-sharing mechanisms between the individual and the insurance provider. After a policyholder pays his/her co insurance and co payment amount, the insurance provider covers the remaining cost of the healthcare service. By knowing the amount you will be responsible for paying out of pocket for each healthcare service, you can better budget your healthcare expenses. Additionally, understanding the difference between copay and coinsurance can help you select the right health insurance plan for your specific healthcare needs and financial situation.

Accidents in India occur frequently and can result in major financial burdens. Investing in an insurance plan, such as Personal Accident Insurance, is highly beneficial in mitigating the financial impact on the policyholder as well as his/her family. Coverage for personal accidents benefits both policyholders and their families. Personal accident insurance is crucial as it provides financial protection against accidental injuries, disability, and death. Some significant benefits of personal accident insurance are financial assistance for medical expenses, loss of income, and other related costs.

Advantages of Personal Accident Insurance

Some of the significant benefits of personal accident insurance are as follows.

• Financial protection against accidental injuries: One of the major benefits of purchasing personal accident insurance is the coverage it offers for medical expenses incurred due to accidental injuries, including hospitalisation, surgeries, and rehabilitation, helping policyholders cope with the financial burden of unexpected medical bills.
• Income replacement: Another significant benefit of purchasing personal accident insurance is that it offers coverage for loss of income or disability caused by accidental injuries, ensuring that policyholders can maintain their financial stability even if they are unable to work due to an accident.
• Accidental death benefit: Personal accident insurance provides a lump sum amount to the nominee in case of the policyholder’s accidental death, providing financial support to the family during a difficult time.
• Customisable coverage: Coverage for personal accident benefits can be customised to suit policyholders’ specific requirements, allowing them to choose the coverage amount and add-on benefits as per their preferences.

Features of a Personal Accident Insurance Policy

Some of the prime features of a personal accident insurance policy are:

• Coverage for accidental injuries and death:

  Personal accident insurance provides coverage for accidental injuries resulting from events such as road accidents, falls, burns, and drowning, as well as accidental death.

• Permanent total disability coverage:

  These policies offer coverage for a permanent total disability caused by accidental injuries, providing financial support to policyholders who are permanently disabled due to accidents.

• Temporary total disability coverage:

  Personal accident insurance provides coverage for temporary total disability, which refers to the inability to work for a temporary period due to accidental injuries. This ensures that policyholders can maintain their income during the recovery period.

• Education benefit:

  Some personal accident insurance policies offer an education benefit to the insured’s dependent children in case of the policyholder’s accidental death or permanent total disability, helping to cover their education expenses.

• Affordable premiums:

  Such policies in India typically have affordable premiums, making them accessible to individuals with varied needs and budgets.

The benefits of purchasing personal accident insurance include financial protection against accidental injuries, income replacement, and customisable coverage. The features of such policies include coverage for accidental injuries and death, permanent and temporary total disability coverage, and affordable premiums. Having personal accident insurance can give individuals peace of mind as well as financial security in times of need.

HR Maternity Leave Policy

• Maternity paid leave is available for up to 26 weeks, with 8 weeks of pre-natal leave.
• Employees with two or more children are entitled to 12 weeks of maternity leave, while adoption leave is also available for 12 weeks.
• Commissioning mothers who use their eggs to create an embryo implanted in another woman are also entitled to 12 weeks of leave.
• Maternity leave is fully paid, subject to eligibility criteria, and a medical bonus is provided.
• Employees must follow a formal maternity leave procedure to request maternity leave and benefits, and HR must approve any deviation from the policy.

Maternity Leave Challenges For Employers

• According to a report, a major concern for 95% of managers is how to find a replacement for an employee who announces her pregnancy. This challenge is even greater for managers who have employees in client-facing roles or work in a team and are not individual contributors.
• Companies are uncertain whether the employee will continue working for them after having a baby.
• The report also found that 88% of women feel managing uncertainty is a significant challenge without guidance and support from mentors, especially when there are health issues involved.
• Managers also face difficulties preparing for the employee's return and managing their workload.
• Insufficient support from organisations makes the reintegration process less smooth. While managers are open to providing flexible working hours, this can be a challenge without support from the organisation's policy.
• To prevent conflicts in the workplace, it is crucial for companies to anticipate and make arrangements for paid maternity leave. This can involve conducting a risk evaluation and creating unambiguous guidelines.
• Effective communication is equally crucial and can facilitate the determination of when an employee desires to resume their job. This encompasses flexible work requests and any phased reintegration schedules.

Employers that lack supportive maternity leave policies may face a considerable strain on resources, decreased productivity, difficulty retaining top talent, and uneven distribution of work.

Additionally, employers should also look into offering health insurance coverage with maternity coverage. While not mandatory, it is an additional benefit that can be of great help. 

Whether you are a first-time expectant mother or have experienced the joy of being a mom-to-be, there may be several questions regarding the Maternity Leave Policy and its rules.

You might have asked your friends and colleagues but didn’t find satisfactory answers, or their replies have left you more puzzled than before. If you’re back to square one, let us walk you through the benefits, the eligibility criteria, and more so that you can find proper answers to your queries.

We will also provide an example of how to write a letter to HR applying for maternity leave and whether you will receive a partial or full salary if you apply for maternity leave.

Maternity Benefit ACT 1961

The purpose of this benefit is to assist women in caring for their children. The ACT ensures job security for working women and applies to all establishments with ten or more employees. The ACT also covers government organisations and establishments employing women to perform acrobatics and equestrian exhibitions. The employer is liable to pay maternity benefits to the women employees. The ACT permits the combination of maternity leave with other forms of leave. In case of gross misconduct, the employer can dismiss the employee or deprive her of the benefit or bonus. But neglecting to adhere to the regulations outlined in the legislation can result in grave repercussions for employers.

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.