The cost of healthcare in India is on an uphill ride. With medical inflation rate peaking at 15%, most Indians do not have access to affordable healthcare. In such a scenario, investing in a health insurance policy is essential. A comprehensive health plan with enough coverage will ensure that all the expenses pertaining to necessary treatments are taken care of. Additionally, health plans are also helpful during times of emergencies like road accidents when there won’t be much time to arrange money for the treatment. The sedentary lifestyle that most citizens lead makes them more vulnerable to diseases. In a country like India where cardiac diseases and lifestyle illnesses are at an all-time high, it is imperative for people to buy a plan that protects them and their family financially against such troubles.
Benefits of a Health Plan:
Here are some major benefits of investing in a health insurance policy:
- Most insurers provide cashless facilities at their network hospitals which can be availed through a hassle-free process.
- It protects a policyholder and his/her family from financial stress that might arise from the expenses related to healthcare.
- It is especially helpful during medical emergencies when the time to arrange finances is limited.
- Health plans are a necessary element of financial planning to counter the rising costs of healthcare.
- It offers tax benefits on the policy premiums under section 80D of the Income Tax Act of 1961.
Features of Health Insurance:
A comprehensive health plan includes various features that are crucial in making healthcare affordable. Mentioned below are some notable ones:
- Hospitalisation expenditure: Health plans cover the expenses incurred during hospitalisation for a minimum duration of 24 hours. The charges covered include room charges, doctor's consultation fee, surgery expenses, etc.
- Pre-hospitalisation charges: Expenses pertaining to lab tests, medication, etc., incurred from 30 days to 60 days before the date of hospitalisation are also covered by most insurers.
- Post-hospitalisation charges: Post-hospitalisation charges include follow-up consultations, medication, and lab tests among other things. Many insurers cover the expenses incurred from 60 days to 180 days after hospitalisation.
- Critical illnesses: Critical illnesses like cancer or cardiac attacks can be fatal and the treatments are nowhere near affordable. Usually, insurers provide add-on covers for critical illnesses.
- Organ transplant: Organ transplant is a big and inevitable expense for people facing organ failure. Fortunately, some insurance providers offer coverage for the organ donation process. Such policies also support the donor financially.
- Day-care: Treatments like eye-surgery, colonoscopy, chemotherapy, radiotherapy, etc., fall under the category of day-care treatments. Certain policies cover these expenses, however, the premiums can be much higher for such plans.
- AYUSH treatment: Health plans are not restricted to allopathy treatment. Policyholders can opt for AYUSH treatments like Ayurveda, Yoga and Naturopathy, Homeopathy, and so on.
- Check-ups: Certain insurers also cover health check-ups.
- Ambulance charges: Most health plans cover ambulance charges. This ensures that the policyholder can seek treatment worry-free.
- Daily allowance: Hospitalisation keeps the patient away from work. It might result in the loss of pay sometimes. However, the daily allowance provided by some insurers ensures that the policyholder can afford additional charges like food, hospital stay, transportation, etc.
How to Choose a Health Plan?
The market today is flooded with offers on health plans from different insurance providers. With so many options available, it is imperative to choose a policy that provides sufficient coverage within budget. Here are some parameters that can be used for finding the right policy:
- Budget: When buying a policy, it is important to settle for a plan that fits in the consumer's budget. However, it is also important to make sure that the plan provides a good amount of coverage. Though basic plans are cheaper in nature, they do not contain as many features as comprehensive plans.
- Co-payment: Co-payment refers to a fixed amount the insured is expected to pay for each claim. It is a standard feature in many policies. Therefore, before buying a policy it is important to check for a co-payment clause and percentage of the amount the insured is expected to pay. A higher co-pay percentage will translate to higher expenses on the policyholder's part.
- Claim-settlement: Claim settlement process is the real test of health insurance policies. Nowadays, most insurance companies provide quick and hassle-free claim settlement which is ideal for a policyholder.
- Number of members covered: When buying a family floater health policy, it is important to check the number of members the policy covers. In India, most insurers usually cover 4 to 6 members.
- Comparing policies: Before settling for any policy, it is crucial to compare different plans from various insurance providers to find the one that provides optimum coverage at an affordable cost.
Important Points to Remember While Choosing a Plan:
These tips are to be kept in mind when investing in a health insurance policy:
- Sub-limits on the policy: When buying a policy, it is important to check the sub-limits on the facilities. For instance, an insurer might provide only 2% per claim on hospital room rent. In such a scenario, the policyholder will have to pay the remaining amount out of his/her pocket. If the insured exceeds the sub-limit, the remaining amount won't be covered by the insurer during claim settlement.
- Coverage: It is the most important aspect of health plans. The coverage level determines the treatments that the insurer will pay for. It is advisable to only add necessary features for coverage. Adding unnecessary features will only increase the policy premium without being useful.
- Waiting period: Waiting period refers to the duration after the start of the policy when insurers exclude certain treatments from coverage. Different waiting periods apply to different ailments. The duration also differs from one insurer to another. A quick comparison can help consumers find policies with a shorter waiting period.
- Age restrictions: Usually the entry age for health plans is set at 18 years and the maximum age goes up to 65 years. This factor is important when buying family floater plans as the age of dependents is considered by the insurers.
- Cashless claims: Cashless claims is a facility where the policyholder can seek treatment at any of the insurer’s network hospitals without paying cash. This facility is very convenient as the insured doesn’t have to shell out any money from his/her pocket to pay the bills.
- Network hospitals: When selecting an insurer, it is advisable to learn about their network hospitals. A wider network and higher number of partner hospitals is always good as it gives the insured more options to avail cashless benefits.
- Add-on benefits: Insurers provide various add-on riders that consumers can choose from. It is important to add only the ones that seem essential. Being wise while choosing add-ons can enhance the policy coverage without weighing down the premium.
- Premium: When buying a policy, compare premiums of different plans. Though higher premiums have more benefits associated with them usually, it is important to choose a premium amount that is justifiable and doesn’t hamper the insured’s finances.
- Renewability: Lifelong renewability is always ideal when settling for a policy.
- Exclusions: Different insurers have different exclusions. For instance, some insurance companies might cover critical illnesses while some might not. Therefore, being aware of the exclusions before buying a health plan can save the policyholder from disappointment later.
Best Health Insurance Plans Available in India:
Mentioned below is a list of the best insurance policies available in India along with their features, coverage, and network hospitals:
|Insurance provider||Policy||Features||Sum insured||Network hospitals|
|BHARTI AXA Health Insurance||Smart Health Basic||
||Rs.3 lakh to Rs.1 crore||5,420+|
|Smart Super Health|
|Cigna TTK Health Insurance||ProHealth Protect||
||Rs.2.5 lakh to Rs.25 crores||4,500+|
|HDFC ERGO Health Insurance||Health Suraksha Gold||
||Rs.3 lakh to Rs.50 lakh||8,600+|
|Health Suraksha regain gold|
|New India Assurance Health Insurance||New India Family Floater Mediclaim||
||Rs.2 lakh to Rs.15 lakh||1,200+|
|Care Health Insurance||Care Mediclaim Super Saver||
||Rs.3 lakh to Rs.40 lakh||5,420+|
|Care Mediclaim ELite|
|Royal Sundaram Health Insurance||Family Good Health||
||Rs.2 lakh to Rs.1.5 crores||3000+|
|Star Health Insurance||Health Optima||
||Rs.2 lakh to Rs.25 lakh||8,800+|
|Universal Sompo Health Insurance||Individual||
||Rs.3 lakh to Rs.10 lakh||7,700+|
|Complete Health Care|
|National Health Insurance||National Mediclaim Plus||
||Rs.1 lakh to Rs.10 lakh||6,000+|
|IFFCO Tokio Health Insurance||Swasthya Kavach (Basic)||
||Rs.50,000 to Rs.20 lakh||4,200+|
|L&T Health Insurance||Health Medicare Classic||
||Rs.1 lakh to Rs.10 lakh||2,800+|
|Health Medisure Prime|
|Max Bupa Health Insurance||Health Companion||
||Rs.2 lakh to Rs.1 crore||4000+|
|United India Health Insurance||United India Insurance Gold||
||Rs.1 lakh to Rs.10 lakh||7,000+|
|United India Insurance Family Medicare|
|TATA AIG Health Insurance||MediPrime||
||Rs.2 lakh to Rs.10 lakh||4,610+|
|Future Generali Health Insurance||Health Suraksha Individual||
||Rs.50,000 to Rs.10 lakh||4,300+|
|Health Suraksha Family|
|Reliance Health Insurance||Health Gain||
||Rs.3 lakh to Rs.9 lakh||4,000+|