Health Insurance Plans

Even the healthiest of individuals can fall sick without warning and require expensive medical treatments. In such a scenario, being financially unprepared to tackle the costs of the necessary medical procedures is not an option. This is where comprehensive health insurance plans come into play, to ensure the financial comfort of your family and you. Here is an in-depth look at this handy financial tool that has helped many individuals heave a sigh of relief in their hour of need.

What are health insurance plans?

Health insurance plans reimburse insured customers for their medical expenses, including treatments, surgeries, hospitalisation and the like which arise from injuries/illnesses, or directly pay out a certain pre-determined sum to the customer. A health insurance policy offers coverage for any future medical expenses of the customer.

This is an agreement between the insurance company and the customer where the former agrees to guarantee payment/compensation^~ for medical costs if the latter is injured/ill in the future, leading to hospitalisation. In most cases, insurance companies have tie-ups with a network of hospitals, thereby ensuring cashless treatment for patients there.

Types of Health Insurance Plans

• Cancer Insurance Plans - A cancer insurance plan is a health policy specifically designed to offer financial protection against the costs of several types and stages of cancer. The plan can offer high lump sum payouts on the diagnosis of cancer
• Critical Illness Plans - Critical illness plans are a type of health insurance plans which provides money for the treatment of major critical illnesses like kidney ailments, liver disorders, heart attacks, cancer, paralysis, and more. Critical illness plans offer a high sum assured that can be adequate to cover the costs of such illnesses. They also provide lump sum payouts on the first diagnosis of a critical illness without the claimant having to submit any hospital bills
• Individual Health Insurance Plans - This is a basic health insurance plan that covers an individual. The coverage and sum assured can depend on the age, gender, and health status of the person
• Family Floater Insurance Plans - These health insurance plans offer umbrella coverage that covers the entire family under a single policy. These plans have a unified premium and sum assured for all the members of the family. They can be used to cover costs like hospitalisation, surgeries, room rent, and more
• Personal Accident Insurance Plans - A personal accident insurance is a health policy that covers the cost of treatment due to an accident. These plans cover the life assured and offer a payout to cover expenses like ambulance costs, emergency surgery expenses, doctor’s consultation, and more

What is the need for health insurance?

Here is why you need health insurance:

• Health insurance covers future illnesses/medical treatments without depleting your savings or negatively impacting your family’s financial future
• Medical costs are increasing rapidly and for those with insufficient savings, affording medical care becomes a problem during emergencies
• Cashless treatment is possible within network hospitals, while reimbursements are given by insurance companies in other cases
• Health insurance plans offer coverage against several types of ailments and surgeries, along with other aspects of medical treatment
• Health insurance keeps you and your family worry free; you only have to pay an affordable premium for the same
• In many cases, you also get coverage against hospitalisation costs, ambulance costs, consultations, medicines, tests and post-hospitalisation expenditure

What are the kinds of health insurance plans available?

There are several kinds of health insurance plans. Here are the main ones:

• Individual plans These are basic health insurance plans, covering the hospitalisation costs of the person insured
• Family plans These are health insurance plans where all family members can be included in a single coverage model. In this case, a fixed sum assured is provided to any family member who falls ill
• Senior citizen plans These are special insurance policies designed to meet the needs of senior citizens who are above 60 years of age
• Critical illness insurance plans These plans cover specific critical illnesses such as kidney ailments, heart attacks and so on. Cancer insurance and other plans included in this section as well.
• Personal accident insurance These plans offer coverage for hospitalisation in case of any motor accident
• Maternity plans These policies offer coverage for pre and postnatal medical care and delivery expenditure. They also offer coverage for the new-born for a certain duration along with ambulance costs
• Unit-linked health insurance plans These plans offer health insurance coverage while also helping build savings to meet those costs which do not have coverage under the policy. These are insurance-cum-investment plans that help you accumulate corpus

How to choose the right kind of Health Insurance for yourself?

• Right coverage Make sure your health plan covers a wide range of medical problems and can help you avail of various pre and post-hospitalisation benefits. If the health insurance you have bought is for your family, it is necessary to make sure that it covers the needs of all the family members
• Suits your budget As much as it is important that the health plan meets your needs, it is equally important that it also suits your budget. As your income increases, and the size of your family as well as requirements change over time, the plan can further be reviewed accordingly
• Individual plans or family plans According to your status, select an individual or family health plan. If you have a family who needs your support, opt for a family health plan so as to reap maximum benefits at a comparatively low cost
• Lifetime renewability It is important to know the term for which the policy would cover you. After all, one is more likely to require medical facilities at a later stage in life, as we approach old age. Therefore, a plan which offers lifetime renewability would be more beneficial
• Preferred hospital coverage It is always better to choose an insurance provider that has a wide network of hospitals included in its list. One should also check if the hospitals one prefers are included in the list or not
• High claim settlement ratio It is advisable to choose an insurance provider with a higher claim settlement ratio. The claim settlement ratio is the number of claims settled by the insurance provider over the total number of claims received

Key Benefits of Health Insurance Plans

There are several benefits offered by health insurance plans, including the following:

• Coverage for pre and post hospitalisation expensesInsurance policies usually offer coverage for expenses both before and after hospitalisation up to pre-specified durations/limits
• Cashless facilityIf you are getting treated at a network hospital, you can get hassle-free cashless treatment under your insurance plan
• Ambulance and transportation costsAmbulance charges and other transportation costs of the person insured are also covered under health insurance policies
• No-Claim BonusesThese bonuses are earned by the person insured if no claims are filed for treatments in a particular year
• Room rent coverageRoom expenses are also covered by insurance policies and this is dependent on the premium paid by the customer
• Medical check-upsInsurance policies also offer coverage for periodic health check-ups. Some companies even offer free check-ups on the basis of earlier no-claim bonuses
• Tax benefitsYou can get a deduction of up to `25,000 from taxable income of health insurance premiums paid under Section 80D<sup>*</sup> of the Income Tax Act. The maximum deduction limit for senior citizens is `50,000.

Features of ICICI Pru Heart/Cancer Protect

Fixed benefit health insurance plans like ICICI Pru Heart/Cancer Protect plan pay out a certain amount/sum upon the occurrence of any particular pre-specified event that is covered by the policy. For instance, a critical illness plan will involve the payout of a guaranteed/assured lump sum upon diagnosis of any critical illness covered under the health insurance policy.

Why should you buy Fixed Benefit Health Insurance plans?

• Lumpsum Payout- Fixed benefit health insurance plans pay out a lump sum^# amount upon diagnosis of any disease/ailment covered under the same. This helps you take care of treatment and other costs right from the outset without financial worries. Payouts are made irrespective of the cost of treatment
• No Worries of Sub Limits- Many health insurance plans come with sublimits in terms of room rent, hospitalisation expenses and so on. With fixed benefit health insurance plans, you receive a lump sum payout upon diagnosis of a particular illness without bothering about sublimits and so on
• No Hospital Bills Required- Unlike other health insurance plans, fixed benefit health insurance plans pay upon diagnosis of the illness without the hassle of submitting hospital bills
• Get treated anywhere in the world- Since you get a lump sum payout upon diagnosis, you need not be admitted to a network hospital for cashless treatment. You can opt for treatment anywhere in the world as per your own preferences and convenience
• Affordable and fixed premiums- You can get higher coverage for premiums that are affordable. Premium amounts also remain fixed for the entire duration of the policy.
• Tax Benefits- You can avail tax benefits* under Section 80D of the IT Act on the premiums you pay on these policies. Maximum amount of deduction from taxable income is `25,000 for you and your family (children and spouse) if you are less than 60 years old. If you are all more than 60 years old, the maximum deduction can increase to `50,000. The same is applicable for premiums that you pay for your parents, i.e. a maximum deduction of `25,000 if they are below 60 years of age and `50,000 if they are above 60 years of age

Does your Health Insurance cover COVID-19 claims?

With the COVID-19 pandemic being the biggest medical concern of the world right now, the Insurance Regulatory and Development Authority of India (IRDAI) has made it mandatory that all health insurance products must cover the treatment and hospitalisation cost of COVID-19 as well. If the insured person has been hospitalised for more than 24 hours after being diagnosed with COVID-19, the insurance policy will cover the hospitalisation costs. There are also several insurance schemes that will cover pre and post-hospitalisation care as well as quarantine related expenses in registered centres. Some policies may also include ICU charges. These are all subject to the terms and conditions of the policy and it is therefore advisable that one contacts the insurance company to gain further clarification on all the expenses covered.

Why should you buy Health Insurance online?

• Safety All insurance companies have made all the information available online. One can easily compile the same under one platform. It is always better that the policyholder selects and compares all the plans so that they can select the one that best suits their needs
• Affordability Online health insurance plans are more cost-efficient than offline ones. This is because of the no-involvement of agents and the policyholder can directly connect with the insurance company to buy the insurance
• Flexibility Online channels offer more flexibility to policyholders than offline channels, when it comes to buying insurance plans. Sitting in the comfort of our homes, one can compare and select different policies that suit one’s needs

Why are many of the policyholders underinsured?

Many policyholders buy insurance to save taxes. The purpose of insurance is security during unforeseen circumstances- not to save tax, it is just an ancillary benefit. The market is filled with a variety of insurance products. However, different products suit different people and if research is not done properly, people usually end up buying policies with higher premiums and inadequate covers

Why Buy a Health Insurance Plan at an Early Age?

• One can avail lower premiums as the premium amount is usually determined on the basis of the current age and health status of the policyholder, by insurance providers
• One can enjoy tax* benefits for a longer duration. One can claim the premium deducted from the income under Section 80D of the Income Tax Act, 1961
• Insurance providers exclude pre-existing conditions. As you grow older, you are more likely to have such conditions and if you buy a policy then, it won't cover them
• As a young person, there are lesser health problems at the onset. This reduces the chances of the health insurance policy getting rejected
• Along with better coverage, buying insurance at a young age helps in better financial planning. If the health aspect is taken care of, one can think of making other financial investments as well
• We are trapped into sedentary lifestyles from a very young age, which lay the foundation of many critical illnesses. In such times, it becomes more important than ever to have a health insurance policy to keep one covered

Fixed Benefit Health Insurance Plans Online by ICICI Prulife that are Worth Checking Out

As you can see, there are various types of health insurance plans in the market. Therefore, choosing the most appropriate one can be confusing. When you select a health insurance plan, it is essential to compare different plans and choose the one that offers an affordable premium for comprehensive protection. Here are some factors that can help you choose a good health insurance plan for your needs:

• A considerable number of network hospitals - It can be beneficial to look for a health insurance plan that covers a wide network of hospitals. Network hospitals simplify and speed up the claim process. They can help you save crucial time during an emergency. So, always check the list of networks hospitals and pick a health policy that covers treatment undertaken in hospitals close to your area of residence
• Cashless hospitalisation facility - With cashless hospitalisation, you no longer have to worry about clearing bills. The hospital settles the bill with the insurance company internally, so you can solely focus on your health. The cashless hospitalisation feature offers convenience and can help you in your hour of need
• A good claim settlement ratio - Claim settlement ratio is the percentage of the individual claims that an insurance company settles in a financial year out of the total claims received in the same financial year. A consistently high Claim Settlement Ratio shows that the company is committed to the needs of its customers
• Range of sum insured - If you have a good range of sum insured amounts to choose from, you have greater flexibility to select the amount you need. This enables you to pick a suitable health policy that can offer you adequate financial protection
• A home care facility - Treatment is not limited to the hospital alone. Many illnesses can require long-term care at home. Therefore, it can help to look for a plan that covers medical expenses incurred at home, such as pre and post-hospitalisation expenses
• Good customer rating and reviews - Customers ratings can be an excellent indicator of a health insurance plan. They can help you understand the services of the insurer. They can also offer a glimpse into the claim settlement process and how prompt the insurer is to solve the customer’s queries and issues. You can check online reviews and customer feedback to ensure that you pick the best insurance company