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  • Benefits Offered By Health Insurance Policies

    Health insurance is something which most of us are familiar with. The health insurance industry in India has progressed a lot since its early days. With time, many companies have come up which offer health insurance solutions for a variety of requirements and budgets. When it comes to health insurance, the most important purpose that it serves is to help people get access to quality medical services without having to worry about the financial part of it. Medical insurance policies can help you preserve your savings which otherwise may be spent at times of a medical emergency. It also provides you with peace of mind which you get knowing that the policy will help provide financial assistance in case of a medical incident.

    In India, there are many companies which provide health insurance plans at various price points and for varying needs. With the help of multiple mediums of advertising, a majority of people who are looking to buy health insurance are already aware of the benefits which these plans provide. However, besides the widely advertised benefits, there are a number of other benefits which sometimes don’t make it to the public’s attention. In this article, we bring you a list of some such benefits which you may not know about.

    Restoration of Insurance Cover:

    Certain health insurance policies come with the option of restoring the policy sum assured if the policyholder has exhausted their entire original policy sum assured during the policy year. This way, they can continue to be covered under the policy without having to worry about raising a claim at the time of a medical emergency. An example of this is the health insurance policy offered by Apollo Munich where the sum assured restoration option can be utilised for covering the costs of an ailment or treatment which is different from the illness for which a claim has already been raised. Another company which offers a similar benefit under their health insurance plans is Religare Health Insurance wherein the policyholder can enhance their sum insured even if the present cover has not been exhausted yet.

    Second Opinion:

    When it comes to health-related issues, many people prefer to take a second or even a third doctor’s opinion to be absolutely sure before proceeding with a particular treatment or medication. However, a regular health insurance policy usually provides cover for a single doctor’s consultation expenses. Considering how important it is to be sure in medical matters, of late, many health insurance providers are now starting to provide cover for a medical specialist’s fee from whom the policyholder may be seeking a second opinion. This benefit is usually provided in case of the diagnosis of a major illness. Religare health insurance is one such provider who provides coverage for a second doctor’s opinion.

    Vaccination Cover:

    Until some years back, health insurance policies rarely provided cover for pregnancy-related expenses. However, lately, these expenses are covered under health insurance policies, on the condition of a certain waiting period. Similarly, many health insurance providers have also started providing cover for vaccinations which the child requires. The vaccination cover benefit is usually provided subject to a waiting period of 2 to 4 years, like the maternity benefit.

    Cover for OPD Expenses:

    Conventionally, health insurance policies provide cover on the condition that the policyholder has been hospitalised for a minimum duration of 24 hours. However, for many illnesses or injuries, it is not necessary for one to be hospitalised as these treatments usually fall under the OPD (out patient department) category. As a result, many health insurance providers are now providing policyholders with cover for OPD expenses like dentist consultations, routine medical check-ups, dentist treatments, etc. This essentially implies that the policyholder need not be hospitalised as is required under a traditional medical insurance policy. For instance, the ICICI Complete Health and the Star Health Comprehensive policies offer cover for OPD expenses as well.

    Varied Premiums:

    Premiums for health insurance policies remained uniform for all policyholders across the country. However, lately, companies providing health insurance plans have started offering varied pricing for health plans. Insurers such as Star Health, Bharti AXA, L&T insurance, New India Assurance, and Max Bupa have started offering zone-based premiums. Here, the premiums charged in metro cities will be higher than those charged from policyholders living in smaller towns, since costs of treatments and medical expenses are significantly higher in metro cities as compared to smaller towns.

    Lifelong Renewal:

    Traditional health insurance policies usually come with an age limit beyond which the policyholder cannot receive cover from the policy. However, some companies have done away with this clause and offer health insurance plans which can be renewed for a lifetime. This is important considering that a person’s health is likely to deteriorate as they grow older. Age limits on health insurance cover can either make it too expensive for individuals to get a new policy at an older age or eliminate their chances of getting any health insurance coverage at all. With the elimination of the exit age clause, customers can now enjoy health insurance cover throughout their life.

    Attendant Allowance:

    One of the least-known benefits that is a part of health insurance is the Attendant Allowance. This allowance is basically meant for the family member, friend or caretaker of the hospitalised policyholder to take care of their personal needs such as food, etc. this allowance is given on a daily basis for the duration that the insured has been hospitalised.

    Good Health Bonus:

    The concept of Good Health Bonus is similar to the No Claim Bonus provided by motor insurance policies. The difference being, a Good Health Bonus is provided as an incentive by health insurers to policyholders who maintain their health and have not raised a claim on their policy during the policy term. This bonus, may be known by a different name for different insurers, is provided by way of discounts on the policy premiums or as an enhancement in the sum insured that the policy provides.

    Donor expenses:

    One of the most routine medical procedure that is carried out is an organ transplant which can drive up the one’s medical expenses. Not only do they have to cover their own medical treatment, but also bear the donor’s hospitalisation expenses as well. Considering the financial burden that it puts on the policyholder, many health insurance providers are now offering to provide cover for the donor’s hospitalisation expenses as well, in addition to covering the insured’s treatment costs. While such benefits usually do not have restrictions on the treatment costs, but, may not cover certain expenses which the donor incurs after the harvesting of the organ.

    Convalescence Benefit:

    To help the insured take care of their expenses or compensate for the loss in income due to inability, many health insurance providers offer a Convalescence/Recovery Benefit. Under this benefit, the hospitalised policyholder is provided with a fixed sum of money on a daily basis, for the number of days that they are hospitalised. This benefit is provided subject to the condition that the policyholder is hospitalised for a minimum duration of 10 days.

    Free/discounted Health Check-ups or Treatments:

    Many health insurance providers offer policyholders the benefit of availing health check-ups or treatments either free of cost, or at heavily discounted rates. This facility is usually provided at diagnostic centers or hospitals which the insurer may have partnered with. This benefit can usually be availed by the policyholder after they have spent 2-5 policy years without raising a claim.

    Alternative Treatment Cover:

    Given their high success rate in treating illnesses successfully, many alternate forms of medicine and treatments such as Ayurveda, naturopathy, Yoga, Unani medicine have become highly popular in recent times. As a result, many insurers are now offering cover for these treatments. However, if your insurer is offering cover for such treatments, do make sure to enquire about all terms and conditions related to the coverage before you take the policy.

    Cover For Domiciliary Treatment:

    Traditional health insurance policies usually provide cover for treatments where some duration of hospitalisation is involved. However, it often is the case that the insured is unable to seek treatment at the hospital due to a variety of reasons. The most common ones being unavailability of rooms/beds at the hospital, or the insured’s delicate medical condition which restricts any movement. As a result, the insured may be forced to be get treatment at home. The good news is that many insurers are now offering cover for such treatment, known as domiciliary treatment, which is taken at home and not a hospital. What one must remember is that, in case of domiciliary treatment, the treatment must have been prescribed by a registered/certified doctor or medical practitioner.

    When it comes to health insurance, the Indian market is filled with choices. There are several insurance providers who have introduced health insurance policies which cater to not only different customer needs, but also different budgets. However, with increasing competition, insurers are out to woo customers by offering value-added benefits on policies.

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