In the current time of health challenge that entire world is going through, it may not be necessary to emphasize the need to health insurance. In the life time of most of us, we would not have seen such challenging and uncertain times, and so much focus on being health and taking good care of ourselves and our dear ones.

Ever increasing cost of healthcare is making it mandatory to ensure that we are insured and insured enough. The changing pattern of treatment and diagnostics, which is more and more leaning towards tests based diagnostic, rather than traditional method of experience and symptom based diagnostic. And that is adding to the cost of treatment.

In India, public health system has its own challenges, and we don’t need to dwell into it at this time, it suffices to say that for any treatment private hospitals are clearly the only option in most cases. Making it imperative to ensure that our loved ones are adequately covered by insurance in case of any eventuality.

Let start to understand health insurance –

What is Health Insurance?

Health insurance is a contract whereby insurance company agrees to undertake a guarantee of compensation for medical expenses in case the insured falls ill or meets with an accident which leads to hospitalization of the insured, either in full or part depending on the contract terms.

Generally, insurance companies have tie-ups with the leading hospitals so as to provide cashless treatment to the insured. In case the insurance company has no tie-ups with the hospital, they reimburse the cost of treatment incurred by the insured. The government also promotes health insurance by providing a deduction from income tax.

Importance of Health Insurance

Buying a health insurance policy for yourself and your family is important because medical care is expensive, especially in the private sector. Hospitalisation can burn a hole in your pocket and derail your finances. All this can be avoided by just paying a small annual premium which would lessen your stress in case of medical emergencies.

A good health insurance policy would usually cover expenses made towards doctor consultation fees, costs towards medical tests, ambulance charges, hospitalization costs and even post-hospitalization recovery costs to a certain extent.

Benefits of having a Health insurance Policy

  • Cashless Treatment: If you are insured, you can get cashless treatments as your insurance company would work in collaboration with various hospital networks.
  • Pre and post hospitalization cost coverage: Insurance policy also covers pre and post hospitalization charges up to the period of 60 days, depending on the insurance plans purchased.
  • Transportation Charges: Insurance policy also covers the amount paid to ambulance towards the transportation of insured.
  • No Claim Bonus (NCB): This is the bonus element which is paid to the insured if the insured does not file a claim for any treatment in the previous year.
  • Medical Checkup: Insurance policy also provide options for health checkups. Free health checkup is also provided by some insurers based on your previous NCBs.
  • Room Rent: Insurance policy also covers room expenses depending on the premium being paid by the insured.
  • Tax Benefit: Premium paid on Health insurance is tax deductible under section 80D of the Income Tax Act.

How to Select the Right Insurance Policy

It’s difficult to select the best insurance policies as all insurance company provides a similar type of insurance plan. Hence some of the important points that any Person should look before purchasing any plans are:

  1. Sum Assured
  2. Minimum Entry Age and renewability clause
  3. Room Rent Capping
  4. Inclusion and Exclusion
  5. No Claim Bonus
  6. Eligibility Criteria

In India, people under 45 years of age are not required to undergo a mandatory health check-up when obtaining a health insurance policy. They are, however, required to disclose any pre-existing conditions such as diabetes or hypertension. It is, therefore usually advised that one should get a health insurance when young so that the premium would be less.

Documents Required when buying a Health Insurance Policy

There are few documents that you need to provide such as:

  1. Age proof – Any one of Birth Certificate, 10th or 12th mark sheet, Driving License, Passport, Voter ID, etc.
  2. Identity proof – Driving License, Passport, Voter ID, PAN Card, Aadhar Card, which proves one’s citizenship.
  3. Address proof – Electricity Bill, Telephone Bill, Ration Card, Driving License, Passport, should clearly mention the permanent address.
  4. Some plans require a medical check-up (usually for elder people above the age of 45 years)
  5. Passport Size Photo

Types of Health Insurance

  1. Individual Health Insurance:  This policy covers the health expenses and hospitalization expenses of individual who has taken the policy. Premium under this policy is determined as per the age of insured.
  2. Family Health Insurance Plan: Under this policy, an individual can include all the family members against multiple diseases under a single cover.  Family health plan offers a fixed sum assured for the family members, which can be availed by all members of the family or by any one individual in the family.
  3. Senior Citizen Health Insurance Plan: This policy is designed for the senior citizens or individuals over 60 years of age offering protection from health issues during old age.
  4. Surgery and Critical Illness Insurance Plan: This plan is suitable for the insured that requires treatment against critical illness, such as kidney failure, paralysis, cancer, heart attack etc. As the medical expenses of these treatments are very high, the premium applicable to these types of policies is also high.
  5. Maternity Health Insurance Plan: This policy covers costs, including pre and postnatal care, child delivery expenses of newborn babies. This policy is also covered for the newborn up to a certain period of time as mentioned in the plan. Ambulance costs are also covered.
  6. Personal Accident Plan: This policy covers hospitalization expenses in the event of an accident. Premium amount is depending upon the amount of cover taken.
  7. Unit Linked Health Plan: These plans offer a unique combination of insurance and savings both at the same time. This policy helps in building a corpus which can be used to meet those expenditures which are not covered by the insurance policy

Tax Benefits on Health Insurance

The amount you pay towards health insurance premium claimed as a tax-saving deduction under Section 80D. You can claim ₹25,000 annually for a health insurance policy for yourself. If you also pay the premium for a health insurance policy for your parents, you can claim up to ₹30,000 for the same as well.

The Claim process, while similar for most companies, is not covered here for keeping current focus on the need and benefits and will be covered in another article.

Government also runs various healthcare schemes for different income groups.