Types of Health Insurance Plans
Health is wealth; the age-old adage has increased relevance in our times, especially with soaring prices of essential commodities and healthcarefacilities.
While being conscientiousabout our diet, exercise, and other core habits may ensure longevity, hereditary diseases, plaguing epidemics,and other health emergencies are beyond one’s control.
In case of such unforeseen events, what are the options to prevent a financial setback and safeguard one’s precious earnings?
Health insurance plan is one of the safeguards in such situations.It servesas an agreement between you and the Insurance Company wherein the company agrees to bear your healthcare and hospitalization expenses in lieu of a yearly charge known as premium.
Here is aguide that will take you through the key aspects of a comprehensive health care insurance plan:
What to look for in Health Insurance
Health insurance plans offer the following benefits:
Reduced Financial Liabilities
A reliable healthcare plan can reduce your financial burden in the event of a medical emergency.
Quality Healthcare Services
Opt for a health insurance plan to get hassle-free access toany of the network hospitals.
A health plan helps you work your finances around rising costs of healthcare services.
Peace of Mind
Comprehensive health insurance takes care of the expenses involved in medical exigencies. Such support offers immense peace of mind especially in an already emotionally-strained situation.
Health Insurance v/s Life Insurance
Life Insurance offers a onetime sum to the policyholder’s kinat the time of his death. Health insurance plan on the other hand, takes care of the medical / hospitalisation expenses when the insurer faces a medical emergency.
Types of Health Insurance Plans
Health insurers can aid you in two ways. One way is by compensating alump sum amount when the insuredis diagnosed with acritical illness that is covered. This is the benefit plan.
On the other hand, the policyholder can opt for an indemnity plan, where the company pays out the costof treatment through either a cashless channel or a “pay-and-claim” method.
Unsure About the Coverage Amount?
If so, opt for the health plan along with a top up plan. Available at nominal rates, these plans (like Healthcare Plus) cover expenses in case your existing healthcare policy coverage proves to be inadequate.
Complete Health Insurance – iHealth Plan is a comprehensive plan designed to cover your health-related expenses during emergencies thereby minimizing yourfinancial stress and possiblyeliminating subsequent ill-effects to your health.
What does Complete Health Insurance - iHealth Plan Cover?
The plan offers to provide a cashless facility for covering expenses incurred during hospitalization such as room and boarding, fees of surgeon, anaesthetist, nurses, specialists, the cost of diagnostic tests, medicines, blood, oxygen, appliances like pacemaker, artificial limbs and organs, etc. among other in-patient hospitalization expenses.
Day Care Treatment and Surgeries
The plan also covers expenses on minor surgeries and day care requirements that do not necessarily require hospitalization.
As the name suggests, it covers all the expenses that have been incurred 30 days prior to being hospitalized. The expenses include medical and diagnostic tests, visit to the doctor, cost of prescribed medicines etc.
The plan provides cover for an additional 60 days after being discharged from the hospital. It pays for out-of-pocket expenses, follow-up visits to the doctor, further medical check-ups, cost of medication, etc.
The plan provides you with the benefit of reimbursing emergency ambulance services up to Rs. 1,500 per hospitalization.
Value Added Services
Free health coupons, discount coupons, online chat with doctors/dieticians, and e-consultations are few of the value added services provided by the iHealth Plan.
Add-on Options of iHealth Plan
By opting for additional covers or riders, you can include your specific risks which may not be covered under the general plan. You can increase your coverage by choosing either or both of these optional add-ons:
Optional Add-on #1
Hospital Daily Cash
Sum Insuraed of Rs. 1-2 lakhs
Sum Insured of Rs. 3-5 lakhs
Sum Insured of Rs. 7-10 lakhs
|Allowance of Rs. 500 per day
||Allowance of Rs. 1,000 per day
||Allowance of Rs. 2,000 per day
Hospital Daily Cash
This rider enables you to cover daily hospital expenses. Limitations: The cover is subject to deductibles and limited by the sum insured.
This benefit entitles you to a fixed amount in your post-hospitalization recovery period, whereby you may incur other out-of-pocket expenses besides the medical fees. Complete Health Insurance - iHealth Plan - providesa convalescence benefit of Rs. 10, 000, once during the insurance policy period.
Critical Illness Cover
This cover offers you 100% sum assured benefit in case a critical illness is diagnosed. The patient receives the sum assured as a lump sum amount during the initial diagnosis/treatment.
It aimsprovide financial relief to the donor in case of a transplant surgery.With this add-on a maximum sum of Rs. 50, 000 can be reimbursed to a donor towards medical expenses incurred while donating the organ.
Beneficial Features of iHealth Plan
9 Diseases Covered under Critical Illness Add-on
- Coronary Artery By-pass Graft Surgery
- Myocardial Infarction (Heart Attack)
- End Stage Renal Failure (Kidney Failure)
- Major Organ Transplant
- Heart Valve Replacement Surgery
- End Stage Liver Failure
The plan can be renewed as many times for a lifetime and is especially beneficial as you grow older and your health risks increase.
Note:Any applicant above 18 years of age can apply for iHealth Plan as there is NO Maximum Entry Age Limit. However,medical tests are mandatoryfor new customers after the age of 46. Therefore, it is advisable to buy this insurance at an early age.
Some Exclusions in the First 2 Years of the Policy
Benign Prostatic Hypertrophy
All types of Hernia, Hydrocele
Fissures &/or Fistula in anus, haemorrhoids /piles
Arthritis, gout, rheumatism and spinal disorders
Joint replacements unless due to accident
Sinusitis and related disorders
Stones in the urinary and biliarysystems
My company has a compulsory Group Health Insurance Plan for all itsemployees; do I need an individual health insurance plan for myself?
A Group Health Insurance Plan offered by your employer is an added advantage. However, the plan may not be comprehensive and relying solely on it is not advisable. Moreover it may not cover your health risks while you change jobs or retire.
I live with my parents together with my wife and kids, will a Floater Plan cover all our health risks sufficiently?
Floater policies are best suited for small families with young children. Senior members with history of medical illnesses should opt for individual health plans. This ensures adequacy of cover for all policy members.
Pre Existing Condition Waiting Period
Pre-existing diseases are covered under the iHealth Insurance Plan; however, not in the first two years.
-Coverage after two years:For policies with a sum insured of 3 lakh and above
- Coverage after four years:For policies with a sum insured of 2 lakh
This clause is valid only if you renew the policy every consecutive year.
The premium paid for this health insurance plan is deductible under Section 80D of the Income Tax Act.
No Claim Incentives
You are eligible to a policy with lower premiums or a higher sum assured on renewal if you have not made any claim in the precedingpolicy period.
A single iHealth - Floater Plan can cover all your dependant family members. Children above three months of age are eligible for a floater cover along with one adult.
Major Exclusions of the iHealth Plan
iHealth Plan covers critical health risks.Peruse through the policy document to lookout for the treatments and diseases not covered under the iHealth Plan to avoid unpleasant surprises at the time of a claim. Some of the major exclusions include:
Any illness contracted within 30 days from the commencement of the policy
Non allopathic treatments
Treatment taken outside the country
Therapeutic alternatives such as acupressure or acupuncture
Complete Health Insurance - iHealth Plan covers various healthcare expenditures to ensure your well-being. Opt for it to enjoy a stress-free and secure future.