All About Health Insurance Policy In India

Health insurance policy in India is easily available for any person wanting a health cover. But, still there is limited knowledge about health insurance schemes. Here we bring you some of the important aspects of health insurance that every individual needs to know.

What is health insurance?

Health insurance is one of the insurance types, that helps you to cover your medical expenses. There are several terms and conditions that are present in every health insurance scheme. You have to read them carefully before you subscribe to the policy. Once you sign the policy and pay for it and the policy is accepted by the insurance provider, which is the insurance company, it is a legal contract. The insurance policy will cover you financially for the specific illnesses mentioned in the insurance policy document.

Who needs health insurance?

Health insurance is needed for every individual and every family to help them tide over financial crisis during sickness. Sickness itself is a disaster for a family and can lead to high stress situations. If there is financial problem during the sickness and because of the sickness, it can be a double trouble. Any health insurance policy will be able to cover some if not all of the expenses listed below. These expenses may be incurred during the sickness of people who are covered by the policy.

Insurance cover is usually available for…

1. Doctor and nurses fees / Professional fees
2. Charges of other specialists like surgeon, anesthetist and other consultants.
3. Charges related to room and food in the hospital
4. Any treatment costs like medicines, X-ray, Dialysis and other therapies.
5. Cost of artificial devices like artificial limbs (prosthesis), pace makers and other external or internal devices.
6. Cost of other diagnostic tests like angiography and CT-MRI
7. Cost of other interventions like surgery.
8. These days, health insurance policy also coves any preventive health checkups.

Types of health insurance available

There are different forms of health insurance policies and these are based on

1. The number of people who are covered by the policy.
2. The types of illnesses covered under the policy.
3. The duration of the policy.

Health insurance types based on number of people covered

Individual health insurance: These policies are mainly available only for individuals. The policy will cover only one person who is the policy holder and not others.

Group health insurance: This usually covers a group of people. Usually, group health insurance policies will cover a group of people, like those working in an organization and even all the members in a family.

Types of health insurance based on type of illnesses covered

1. The Critical Illness benefit policy: This is useful for those who have a particular disease diagnosed. The policy provides a fixed amount to the insured person who has undergone treatment for that disease. This helps the individual to get financial relied from the various direct and indirect costs spent on treating the disease.

2. Hospitalization policy: This policy covers the individual or group of people for any hospitalization during a period that is covered by the policy. Within the period for which the health insurance policy is valid, the cost of hospitalization will be reimbursed to the policy holder.

3. Hospital Daily cash benefit policy: Under this policy, a fixed amount for each day of hospitalization which occurs during the policy term, is paid to the policy holder.

Where can you buy a health insurance policy in India?

You can buy health insurance policy from a health insurance company and their subsidiaries. A list of these health insurance companies is provided for you to know more about them.

You can also buy health insurance policy in India from health insurance intermediaries. They actually act as links between the policy seeker and the insurance company. Beware that some of them may not be licensed. You should ensure that these intermediaries are licensed by the IRDA (Insurance Regulatory Authority of India)

Health insurance for tax saving

There is a high coverage of health insurance among the young people of the country. Most professionals in the age group of 22 to 40 years have health coverage. A sample study of 1500 people done by ICICI Lombard health insurance Company showed that almost 76% of the participants in the study had health insurance coverage. The health insurance should not be used as a tax saving instrument. This is because the primary, if not the only motive for purchase of health insurance should be health coverage.

Of the 1500 participants in the study, 64% of the females said that they had health insurance primarily to save tax. On the other hand, only 54% of the total group said that they obtained health insurance purely for the sake of health insurance.

India has Worlds lowest health insurance penetration

In India, the percentage of population who has health insurance coverage is only 0.16% of the total population. The Insurance Regulatory development Authority of India (IRDA) data tells that almost 70% of the expenses required for health needs is paid from the pocket of the individual. The reason for most people not subscribing for health insurance is because of the lack of any financial return. People only think of it as a financial instrument for saving. There is poor understanding about the possibility of getting sick in the future and the health insurance policy paying for it.

Terms that will help you need to understand about health insurance

Sum insured: The amount that is payable to a policy holder and as per the terms of the health insurance policy in India.

Cumulative bonus: This is a benefit offered by some health insurance policies. Under this scheme, for any year that is claim free, there is also an additional amount of sum insured.

Benefit: The amount for which your health is insured.

Claim: The amount of money that has been spent on a insured persons’ health and the amount demanded as reimbursement.

Dependent: Any family member who is covered by the family health insurance scheme.

Payer or Carrier: The health insurance company that pays for your health cost reimbursement.

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