In this day and age of rising medical inflation, health scares have unfortunately become a norm rather than an exception. Opting for a health insurance policy, therefore, has become imperative. The health insurance sector is India is complex and growing. Most health insurance policies will cover expenses related to pre and post hospitalization, day care and ambulance charges among others. It is important to note that many insurance providers in the country offer health insurance products which offer a wide variety of benefits beyond cover for hospitalization related expenses.
Benefits of health insurance:
The benefits of health insurance are listed below:
Online buying facility
Gone are the days when customers had no other option to buy insurance policies except through agents. Policies can now be easily bought online courtesy specialized insurance brokers who can make a comparative analysis (merits and demerits) of various products offered by different insurance companies for the benefit of customers who can choose the best plan most suitable to their requirements.
Different premium payment scenarios
Hitherto, the premium payments structures most health insurance policies in India were, by and large, the same. However, many companies such as Bharti AXA and Star Health among others have set up a ‘Zone based premiums’ for towns and metros. Consequently, health insurance policies are costlier in metros compared to towns given the higher medical expenses which may be incurred in the former.
In the recent past, insurance companies are providing a wide range of products to cater to all kinds of requirements. For instance, many health insurance companies are increasingly offering family floater policies which provide cover to the entire family under a single umbrella. As a result, family members share the sum assured and can therefore, avail of the benefit in case of any untoward occurrence within the policy term.
As opposed to traditional health insurance policies which had a fixed age limit, many current policies entail greater flexibility in terms of renewal in that customers can now renew their coverage at any time throughout their lives.
No claim bonus
In the recent past, insurance companies are increasingly offering their customers higher amounts of no claim bonus as a strategy to retain them. Some insurance providers are offering a ‘no claim bonus’ for up to 100 % of sum insured.
While according to traditional health insurance products, customers have to be hospitalized for at least 24 hours to claim reimbursement, the current insurance providers provide cover for outpatient department (OPD) expenses as well. As a result, the insured do not necessarily have to be admitted into a hospital to avail of the benefits. As of now, Star Health and ICICI Complete health provide health insurance covering OPD expenses.
In some health insurance policies, the sum insured is reinstated if the insured exhausts the coverage amount in a year. For instance, the restoration benefit can also be used in cases where an insured has to bear expenses for any medical condition which is different from the condition for which a claim was made.
In this day and age, several health insurance providers are offering maternity cover as opposed to traditional insurance companies. Major companies such as Star Health and Max Bupa among others even provide cover for vaccination expenses of the new-born.
Experts have asked customers to have a clear picture of sub-limits before signing up for a health insurance policy. Most traditional policies entail a sub-limit such as cap on doctors’ fees, boarding or room rents and other charges related to operation theatre, latest policies offered by insurance providers such as Tata AIG and Apollo Munich do not have such sub-limit clauses.
Cashless hospitalization services
Several leading insurance providers in the country have a network of hospitals which can offer cashless hospitalization services for the benefit of customers. Customers, therefore, do not have to unduly worry about immediate cash requirements in case of any emergencies. In several cases, the third party administrators pays the bill to the hospital or institute.
Policyholders can avail of some tax benefits under section 80D (deduction for premium paid in addition to separate deduction for buying policies for parents who are senior citizens) and 80DD of the Income Tax Act 1961. In all, a policyholder can avail of tax benefit of up to Rs.55,000 under section 80D. The sum insured is not considered as ‘income’ and therefore, exempt from tax. However, several conditions have to be met to claim deduction as listed below:
- Policyholder should either be HUF or individual
- Payment of premium by any other means except in the cash mode
- Payment proof
Policyholders can now avail of a facility wherein they can switch their current insurance policy to another insurance provider seeking higher quality of services and benefits on offer.
GST rate of 18% applicable for all financial services effective July 1, 2017.
Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.