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Health Insurance 701 views February 26, 2021
One needs to keep doing financial planning irrespective of their lifecycle stage. Be it your early working days or when you get married and have many responsibilities to take care of, you will need to plan your finances smartly. A health insurance plan, like some other financial products, should become part of your life too. The rising healthcare costs only necessitate the inclusion of health insurance, which provides complete financial protection should you witness a medical emergency, in your financial portfolio. Yes, you don’t need to pay for your treatment as the health insurance company will give cover for numerous diseases or conditions. Plus, there is more than one way by which you can get the money from the company for treatment.
Sounds exciting! But one needs to keep paying the premium on time to get all these benefits. So the question that lies before us is – whether health insurance is worth the premium you pay to get it?
The obvious selection strategy would be to go for health insurance that costs you less premium. But at the same time, you can’t compromise on the sum insured amount either. So choose the cover amount-premium combination factoring in your requirements and affordability.
The best part about health insurance is that the premium payment usually happens annually. So you can save regularly and pay the required premium amount annually without any discomfort. The key is to choose the right health insurance policy, which you can do by reading this article further.
Table of Contents
As you would know there is more than one thing that favours health insurance. But it’s important to know about them in detail. Because that will give you a clear picture of health insurance and help you analyze it better. Let’s discuss these without any further delay.
Healthcare costs across the country have gone up considerably these days. Nowadays, a treatment could result in double the amount one used to pay a decade back or so. But salaries may not have grown in line with inflation for some. Plus, if we consider the current times, most are yet to receive their full salary after what COVID brought to them when it emerged in early 2020. But the inflation continues to harden and makes it even more difficult for them.
And amidst these, if a health emergency comes, concerns will only mount for such people! In case they don’t have a health insurance plan, a loan remains the last resort for them. But when you can deal with such situations without having to pay from your pocket, taking a loan and paying interest over it won’t make you feel good!
The best part about a health insurance plan is its broad umbrella that covers not only you but even your family members. The plan generally comes in two variants – Individual and Family Floater. An individual plan covers only a single person, whereas the family floater covers an individual and his entire family members when faced with health emergencies.
Many know that health insurance covers the cost of treatment undertaken at a hospital. But very few would know that it also pays before and after the hospitalization. Once the doctor confirms that hospitalization will happen in some time and you notify the same to your health insurer, you will get cover for both pre-and post-hospitalization expenses. However, the cover would apply for days as specified in the policy. Let’s check out the same along with sum insured and premium amounts for some of the best health insurance policies below.
|Health Insurance Plans||Pre-hospitalization||Post-hospitalization||Sum Insured (In INR)||Annual Premium Amount (In INR)|
|HDFC my:Health Suraksha Insurance - Silver Smart Plan||Up to 60 days before hospitalization||Up to 180 days after hospitalization||1 Lakh- 5 Crore||4,192-9,985 onwards|
|ICICI Lombard Complete Health Insurance||Up to 30 days before hospitalization||Up to 60 days after hospitalization||3-50 Lakh||30,150 onwards|
|Niva Bupa Health Companion Plan||Up to 30 days before hospitalization||Up to 60 days after hospitalization||3 Lakh-1 Crore||5,085 onwards|
|Care Family Health Insurance||Up to 30 days before hospitalization||Up to 60 days after hospitalization||5 Lakh-6 Crore||As specified by the insurer|
|Star Health Comprehensive Plan||Up to 60 days before hospitalization||Up to 90 days after hospitalization||5 Lakh-1 Crore||7,015 onwards|
|Aditya Birla Activ Health Platinum Enhanced Plan||Up to 60 days before hospitalization||Up to 180 days after hospitalization||2 Lakh-2 Crore||As specified by the insurer|
Both pre-and post-hospitalization expenses will be covered on a reimbursement basis, which means you will need to spend first and get it reimbursed from the health insurer later by submitting the required medical bills and other documents.
Besides hospitalization, pre-and post-hospitalization expenses, health insurance plans also pay for treatment less than 24 hours, home treatment and some other stuff. Daycare procedures such as nose and ear operations take less than 24 hours to complete and can get covered under a health insurance plan.
Similarly, if your health condition is such that you cannot be admitted to a hospital or any other healthcare unit, you could receive the treatment at home via the domiciliary hospitalization cover. However, the treatment should last for at least 3 days for you to get this cover.
Health insurers also provide home healthcare cover to meet the expenses of health attendants. You can also get cover for OPD treatment, organ transplantation and many other procedures.
Health insurance plans come with additional protection for you against eventualities such as personal accidents, critical illness, etc. An extra sum insured above the base sum insured will be there for you to deal with these eventualities financially. Extra sum insured means the extra premium for you to pay. So compare the policies in terms of riders and choose the one that offers the maximum sum insured for riders at a premium that you can pay comfortably.
The benefits of health insurance plans are obvious, but how will you get the claim amount? You can have it cashless if the treatment happens at any of the network hospitals of the health insurance company. Just show your health insurance card to the hospital help desk for verification and the insurance company will disburse the required amount to the hospital. In case the treatment happens at a non-network hospital, you will spend on your treatment first and get that reimbursed from the company later. Collect all documents related to treatment and submit the same to the insurer after getting discharged from the hospital for a hassle-free reimbursement claim. The insurer will check the details thoroughly before approving the claim and disbursing the required amount to your bank account.
Everything comes with a limit and health insurance is no exception! A health insurance company can pay you for your medical emergencies up to a certain limit i.e. the sum insured, which you will get to know at policy inception. While the insurance company would pay up to the sum insured for some treatment, it would do up to a certain percentage of the sum insured for others.
Meanwhile, treatment consists of things other than operations and procedures. The place of treatment and more precisely the hospital room in which the treatment happens. The stay in a room will attract rent costs too. While some pay a portion of the room rent, others pay the entire sum. So, read the policy document carefully regarding all these aspects before signing on the dotted lines.
The Bottom Line
There’s no point delaying health insurance given the benefits it comes with. As a customer, you should compare different health insurance plans based on the sum insured, premium amount, the diseases or ailments covered, etc. If you already have any illnesses, the same won’t be covered from the beginning. You’ll need to wait for 2-4 years from the date of policy inception to get a cover for such illnesses. The coverage for any other illnesses or conditions, except injuries due to accidents, will begin 30 days later to the policy inception date.
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