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.

What is the need for health insurance?

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 for 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 expenses-

  Insurance policies usually offer coverage for expenses both before and after hospitalisation up to pre-specified durations/limits

• Cashless facility-

  If you are getting treated at a network hospital, you can get hassle-free cashless treatment under your insurance plan

• Ambulance and transportation costs-

  Ambulance charges and other transportation costs of the person insured are also covered under health insurance policies

• No-Claim Bonuses-

  These bonuses are earned by the person insured if no claims are filed for treatments in a particular year

• Room rent coverage-

  Room expenses are also covered by insurance policies and this is dependent on the premium paid by the customer

• Medical check-ups-

  Insurance 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 benefits-

  You can get a deduction of up to `25,000 from taxable income of health insurance premiums paid under Section 80D of the Income Tax Act. The maximum deduction limit for senior citizens is `50,000

Fixed Benefit Health Insurance Plans

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 lumpsum 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 of 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?

• No Fraud
  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
• Cost-Efficient
  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 of 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

Optional Add-ons in Health Insurance

• Maternity cover add-on
  This optional add-on will cover expenses during childbirth. It is mostly for pre and post-delivery expenses
• Critical illness add-on
  This optional add-on covers the cost of selected critical illnesses with the sum assured paid by the insurance company


• Accidental disability add-on:
  This optional add-on helps the policyholder in case of an accident and the amount paid depends on the sum assured (totally or partially) for the optional add-on. However, the amount that would be paid would depend on the severity of the injury
• Room rent waiver
  The room rent waiver helps the policyholder select the room of their own choice without paying the payment of extra money
• Hospital cash add-on
  If the policyholder has been hospitalized, this optional add-on provides them with the cash amount for all the days of hospitalisation

Factors affecting your Health Insurance Premium

• Pre-existing medical conditions
  Some policies do and some policies do not cover pre-existing conditions. Therefore, policyholders need to disclose their accurate medical records at the time of purchase to avoid further disparity
• A family medical history of critical illnesses can cause the rate of premium to be higher
• The younger the person, the lesser chance of pre-existing medical treatments. Policy premiums therefore keep increasing with age
• If a person has a high BMI, they have a higher possibility to contract heart diseases, diabetes and so on. This can again lead to a higher premium
• If a person is a substance user of drugs, tobacco or alcohol, it can severely affect their wellness and cause a lot of health issues. The premium again tends to be higher during such circumstances
• If a person works in a dangerous environment or a risky profession, they are more likely to land in unfortunate circumstances. Therefore, the premiums for such persons tend to be higher

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

Important documents to get your Health Insurance claim amount easily