Health Insurance Policies
There are different types Health insurance policies available in India like Mediclaim policies, Top-up plans, critical illness plans and Accident policies.
Basic features of the health insurance policies available are:
- Mediclaim Plans:
A Mediclaim policy covers hospitalization expenses for the treatment taken for disease or illness or accident. It also covers pre and post hospitalization expenses up to certain days and certain limit of sum assured. This limit differs from company to company depending upon the policy and sum assured. Mediclaim policies are available as individual plans and also as family floater plans. Individual Mediclaim policy covers each individual with separate sum insured and in floater policy all family members get covered under one Mediclaim policy with one sum insured. Health Insurance is the one year contract with the insurance company, so the policyholder needs to renew policy every year.
Mediclaim plan also pays pre hospitalisation and post hospitalisation bills for certain days and also pays ambulance charges over and above actual hospitalisation bill. One should remember the following points before buying a new product, i.e. life time renewability, no sub-limits on room rent or diseases, no co-pays, no loadings after claim and coverage of pre-existing disease. It is always advisable to buy it from agent as the role of agent is very important while settling the claim and it also requires continuous follow up and good agent can give you required service. Normally Mediclaim plans have a waiting period of 30 days and one should also know the list of exclusions before buying new plan.
- Top-up Plans:
Top-up plans also cover hospitalization expenses just like Mediclaim plans. The major difference here is that these plans cover the expenses only if the total expenses exceed a pre-specified threshold limit which is called deductible. Since these plans have deductible, the premiums of these plans are very low. One should buy first basic Mediclaim policy and then buy a top-up plan with a deductible of the amount equal to the cover in the basic health plan. This plan can help when there are major hospitalization expenses arising out of serious illnesses, critical illness or major accident.
- critical illness Plans:
critical illness is a different type of policy which is a pure benefit policy and pays a lump sum amount (sum assured) on diagnosis of the specified list of critical illness covered in the plan. All major diseases like Cancer, Multiple Sclerosis, Paralysis, Coronary artery bypass surgery, Major organ transplant, First heart attack, Stroke, Kidney failure and Aorta graft surgery are covered under the critical illness plan. The list of critical illness varies from company to company and one needs to check before opting for it. There is a waiting period of first 90 days and also you need to survive for 30 days after the diagnosis of the illness; only then the sum assured is paid. This cover helps you continue your regular lifestyle even after the loss of income due to diagnosis of critical illness. Premium of critical illness plans is too high compared to all other insurance plans available in the market and therefore most of the people stay away from buying critical illness.
- Accidental Death and Disability Insurance:
Accidental death and permanent disability insurance pays you a lump sum amount (sum assured) in case of an uncertain event of death or disability due to an accident. The disability may be permanent like loss of both the limbs, hearing impairment of ears, eyesight etc. or permanent partial disability like loss of one limb, hearing impairment of one ear and loss of eyesight etc. This cover helps you continue your regular lifestyle even after loss of income due to permanent partial or total disability. Premium of this policy are very low still most of the people do not buy this plan.
There are other plans like hospital cash benefit plans which are also available that pays you fixed amount for every day of hospitalisation provided you are hospitalised for minimum days as per policy condition.
Most of the plans now are available online. One also needs to compare the products on the basis of features of the product and also premium payable before opting for any health insurance plan. It is always advisable to disclose all the facts correctly in the proposal form including details of adverse health history and existing policies before buying new product.
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