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What is importance of Health Insurance in 2020 ?

” Health is Wealth ” , We all have learn this line in our school days or had listen this from most of our elderly people. What they said about health is truly valuable. Health is valuable and biggest asset of our life so calling it wealth justifies all the importance of good health.

But due to climate change , busy life style and unplanned nature of it we all are not sure about our fitness and keeping healthy lifestyle and thus we are in need to secure our selves financially for health complaint that may arise. Even a small hospitalisation can cost most of our savings and sometimes we may be short of money . As medical cost are increasing each day.

To secure our self from a financial crisis at the time of hospitalisation and get the treatment in best hospital available , Health insurance has become first choice and in some cases it has become mandatory.

Health Insurance is a transfer of financial risk for the hospitalisation expenses of the individual , family or an organisation to the insurance company. which is also referred as Mediclaim.

Who can purchase Health Insurance in India ?

health insurance
health insurance for family

Any one who is citizen of India or have Indian citizenship with government ID proof can purchase this insurance . And can be purchase for Individual or a family

  • What is minimum entry age to purchase a health insurance ?
    • For an individual minimum entry age is 18 years old to purchase a mediclaim policy.
    • For a dependent child minimum entry age is 90 days old
    • For dependent spouse , and other members also minimum entry age is 18years .
  • What is Maximum entry age to purchase a health insurance ?
    • Maximum entry age to purchase a health insurance policy changes with the product and the insurance companies. Still most common and general maximum entry age for a proposal is most of the health plans is 65 years.
    • So , Does it mean ? Any proposer above 65 cannot purchase a policy ? No , Not really . There are some products and companies which offer policies for proposer more that 65 years of age. With pre-medical evaluation.

What is the process to purchase a health insurance ? Do I need to undergo medical Examination ?

how to purchase health insurance
Source : Google (flickr)

To purchase a health insurance you will need to contact health advisor or simply you can put a call back request on respective companies website. Their executive will call back , make you understand product details and then will assist you to process for issuance.

  • Is it necessary to contact executive or health advisor ? I can purchase online directly by myself ?
    • Health insurance is more different than other insurance . But still like other policies you can directly purchase online without any assistance. Only in case , If your age is in between 18-46 (18< age >46 ) and you do not have any health complaint and your body mass index is normal.
    • If you have any health issue or your age is 46 and above you will have to process through health advisor or Executive.
  • Do I need to undergo medical check up or screening to get policy ?
    • To purchase a health insurance proposer or insurance having pre – existing health issues medical check up is mandatory
    • Also, For the proposer or insured person age more than 46 medical check up is mandatory in almost all the insurance company . Except any relaxation period given by the underwriting team

What is covered in Health Insurance ?

Health insurance cover all our in patient treatment (IPD) , Treatments for which we are hospitalize for at least 24 hours such all treatments are covered in health insurance.

As with the coverage , Some exclusions are also there . Like some illness will have waiting period. Some illness will cover after specific amount of time. Whereas some illness will permanently excluded which will differ according to the plan we are purchasing. You read about this in the exclusion section of the policy wording of the plan you are purchasing.

Hope till now , You must have understand

  • What health insurance is ?
  • Who can purchase health insurance ?
  • How to purchase or process for health insurance ?
  • Who can purchase the health insurance ?

So, Lets understand some important terms specified in health insurance .

Important definition or terms used in health insurance :

  • Sum Insured : This is a cover amount up to which we will get insured for that year. Suppose we are taking 5 lac cover which means our sum insured amount is 5lac. up to this SI (sum insured) we will get treatment in that respective year.
  • No claim bonus : This is important and useful part of health insurance. If we do not use policy in a year like we do not have made any claim in that year you will get no claim bonus. Means our sum insured amount will increase by some % (percent) for next year.
  • Day Care treatments : There are some operations or surgery which do not require 24 hours of hospitalization due to advancement of technology. This type of treatment comes under day care and are covered in health insurance.
  • Pre-Existing Health complaint : If someone is having any health issue before taking policy then such issues are considered as pre-existing health complaints . And pre – existing health complaint have waiting periods in health insurance.
  • Waiting period : This is a specific time period when policy will start covering us for the respective illness. Normally, New policy have 30 days of waiting period for new illness and for pre – existing health complaints it’s 3 or 4 years as per product we are purchasing.
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What is cashless treatment ? Network and non – Network hospitals ?

In health insurance policy , We cannot predict how much specific illness can cost us and thus arranging huge amount at once is also not possible for us . So insurance company has come up with a solution where they have made the tie up with well known hospitals in the city.

Insurance companies having tie up with the hospitals are known as Network hospitals. And the hospitals which are not in tie up with company are call as non – network hospitals.

In network hospital we get cashless treatment . We don’t have to worry much about expenses as they will directly settle between company and the hospital. In case of non -network hospital , It will be a reimbursement process . Means first we will have to pay bills and then will have to claim to the company for reimbursement.

What is Black listed hospitals ?

Insurance company directly settles our claim. But then there are some hospitals we are to take advantage of it by mis-representing documents, doing frauds . Such hospitals get boycott from insurance.

Such hospitals where we will not get cover from our insurance are called as blacklisted hospitals.

Income Tax exemption in Section 80D

One of the important benefit of having mediclaim is , We also get income tax benefit in section 80D. We can take this benefit by purchasing policy for Self , or a family self and spouse , for children and for parents.

Currently , You can claim upto 25000 /- deduction for the premium installment you are paying in that financial year.

How long I can continue Health Insurance ?

While purchasing as discussed before we have minimum and maximum entry age to purchase a medi-claim policy . But as in personal policy most of the companies provide lifelong renewal . Means , We can renew health insurance till lifetime if we wanted to continue.

Source : Google (pikrepo)
  • What is portability in Health Insurance ?
    • Sometimes,We are not satisfied with the insurance company by different reasons then we have a option to switch to other companies .
  • What benefit will I get while porting my health policy ?
    • You will get continuity benefit. Means all those waiting periods that we have served in existing policy will waive of here in the new company .
    • Also , If we have any NO CLAIM BONUS that also get transfer if we do the portability.
  • Do I get free health check up after renewal ?
    • Yes, Some health insurance provide free health check up at the time of renewal every year . Whereas some insurance companies provide after continuous renewal of three years irrespective of any claim made that year.

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