Individual Health Insurance

In India, the cost of treatment is growing in double digits, and more than 80% of the population do not have access to health insurance. Out of pocket health expenditure is higher in India. The burden of the high cost of health is pitched towards the poor.
There are plenty of reasons why health insurance is not just a good idea but also necessary. Many people face a financial crisis when they have to fund for medical treatment and medical costs. So people dive into their savings and drain it. In such situations, a health insurance plan could be a real “life-saver” because it covers your hospitalization expenses.

Let’s talk on Individual Health Insurance:

Costly treatments and unseen medical emergencies made individuals to understand the need of having health insurance. Individual health insurance covers both pre and post hospitalization expenses, including ambulance charges and diagnostic test charges.
Daily cash plans are also covered under individual health insurance but are subjected to specific terms and conditions. Even pre-existing diseases except for injuries due to accidents are treated only after the completion of a defined waiting period.



What is Critical Illness Plan?

Critical illnesses are diseases and conditions that include but are not limited to cancer, stroke, organ transplants, and kidney diseases, among other health conditions. Critical illnesses are expensive and disruptive.

Begin diagnosed for critical illness means completely wiping away the lifetime savings. So, then your worries regarding the financial security and dependents start haunting you. The only way to get out of this dilemma is a“Buy Critical Insurance Plan.”

Do not let unseen happenings to shatter dreams of you and your family, instead start planning for such incidents. Critical Illness Insurance Plans provides coverage against specific threatening diseases. Treating these illnesses, you may require multiple visits to the hospital over a period of time. Thus, in addition to the hospitalization cost, there will be other costs like doctor visits, medical expenses, etc.

A Critical Illness plan pays a lump sum amount that can be used to cover these high expenses. The lump-sum payout will be an addition to mediclaim or health insurance policy that you may already have.


accident plan

Personal Accident Plan

Personal Accident Insurance plan provides complete financial protection to the policyholders against unseen instances such as accidental death, accidental bodily injuries, and partial/total disabilities, permanent as well as temporary disabilities resulting from an accident.
In the case of accidental death of the policyholder, the nominee gets 100% compensation from the insurance company. There are additional compensations that are offered for accidental disability, such as loss of eyes, limbs, and speech.
Accidents can happen anytime, anywhere, and may result in minor to severe injuries or lead to death. Such uncertainty may lead to a financial crisis. Accidental Insurance policies act as a guard and protect from such uncertainties. It provides the necessary financial assistance to you and your family against accidental death, bodily injuries, and disabilities (Partial/ Permanent/Temporary). There are various other benefits such as accidental hospitalization cover, Hospital Confinement Allowance, and Medical Expense Cover.



What is Mediclaim Insurance/ Mediclaim Policy?

Media claims are the part of health insurance that acts as “a shield” against your medical expenses and also provides protection against unseen happenings in the future. You can avail the benefits of the policy by paying the cost called “Premium.” This plan comes with a defined tenure, after which you have to renew it.
Do not let hospital expenses to drain your pocket. Compare with different policies that are available in the market and make informed decisions.
Mediclaim policy is a general hospitalization benefit offered by both private and public sector insurance companies in India. This policy will cover all the below-given situations:

  1. Covers accident cases
  2. Covers sudden illness cases
  3. Covers surgery cases during the policy tenure


process health insurance

Steps to get your insurance settled

When we buy a health policy, claim settlement is one area we panic the most. With our assumptions, we think the process is complicated because of the lack of proper awareness; it can indeed be hassle-free.
Today, we shall help you with the process to claim settlement on your health policy.
Claim settlements are done in two ways:

  1. Cashless claims
  2. Reimbursements

Steps for Cashless Claims

If it is a planned hospitalization (a situation where you are aware that after a few days, you need to avail medical treatment), you can go for a cashless settlement. Below are the steps you need to follow:


terminology of health insurance

Terminologies of Health Insurance

Do you feel lost when an insurance provider starts talking about health insurance? When he uses the fancy jargons involved with health insurance? It’s OK—we know that the terminologies regarding health insurance can be hard to understand. Hence we have come up with these few terms that are often used with health insurance:

1. Allowable charge: it is also known as “allowed amount,” “maximum allowable,” and “Usual, Customary, and Reasonable (UCR)” charges, this is a fee that is charged by a health insurance company to be a reasonable charge for medical services or supplies based on the area where the service is being provided.

2. Benefit – the amount payable by the insurance company to a policyholder for medical costs.

3. Benefit level – the maximum amount that a health insurance company agrees to pay to the policyholder.

4. Benefit year – the 12 months for which health insurance benefits are calculated, not necessarily coinciding with the calendar year. Health insurance companies may update plan benefits and rates at the beginning of the benefit year.



Reasons to buy a Health Insurance

“The task we set for ourselves is not to feel secure but to be able to tolerate insecurity.”
-Erich Fromm.

Health insurance is essential for every individual. A medical emergency can devastate anyone, anytime and impact an individual emotionally and financially. It is advisable if you to buy a health plan early in life. Here are the top reasons to convince you to purchase health insurance:

1. Start early

The health insurance premium is highly dependent on age, and there is a pitch in the premium slab post 30. For instance, if you purchase a health plan of Rs. 5 Lakh at the age of 25 years, then you need to pay a premium of Rs. 5000 but the same policy would cost you more at the age of 35, even with a change in your health indicators. Hence, buy a policy as early as possible to pay a lower premium.

2. Incidence of illnesses have increased

You don’t have to be 60 to buy health insurance. Inactive lifestyle has increased the occurrence of lifestyle disorders involving heart, cancer, lung conditions and stroke, stress-related hypertension is affecting young corporates who have no idea how unhealthy they are until something severe happens, and they wake up to reality. Moreover, health insurance policies offer annual health checks ups to encourage health awareness. Also, preventive services include counseling, screenings, and vaccines that help you to manage your health better.



Understanding Defined Benefit Plan

Health insurance covers your unfortunate medical expenses. Your hard-earned money can be utilized for better. The cover you buy also includes pre and post hospitalization expenses and other benefits. On the other hand, defined benefit plans policy work the same.
Defined benefit plans are the type of health insurance plan where a predefined payment will be made to the policyholder on the occurrence of predefined events irrespective of how much expenses have been incurred as hospitalization expenses. Thus, the sum assured is not dependent on your hospitalization expenses — no need to furnish hospital bills or any other bills to claim the benefit.
Under the defined benefit plan, we have

  1. Critical illness plan
  2. Hospital Daily cash plan
  3. Any other health insurance plan which makes pre-defined payments to the policyholder on the occurrence of a pre-defined event irrespective of whether and how much expense has been incurred on treatment.



What are Indemnity Plans?

Like other plans, an Indemnity plan will reimburse the cost of medical expenses to the policyholder. This plan will refund the actual amount incurred as an expense during the medication, and the reimbursed amount should be within an assured medical cover.
Indemnity health plans are also known as:

  1. Traditional indemnity plan
  2. Fee- for service plan

For example, the cost of cover is Rs 5 lakhs, and a hospital billing amount is Rs 2 lakhs. The company has to pay Rs 2 lakhs to the policyholder. The balance amount is left with the company until the maturity of the policy.
And this agreement with the company will be predetermined. The best example is the “Mediclaim Insurance Plan”- a popular health product.
Generally, this plan has a predetermined deductible. The part of medical expenses will be paid to the policyholder, and the insurance company will pay the remaining amount, and this is “co-pay.” Some health insurance plans will not have any deductibles, where the insurance company will incur the entire cost.


health insurance

Importance of Health Insurance

“Good Health and Good Sense are two of life’s greatest blessings.”

There are plenty of reasons why health insurance is not just a good idea, but it is a necessity. The benefits will depend on the plans you buy and exclusions of the policy.
Many will face a financial crisis when it comes to medical emergencies and to meet the medical cost, people will switch into their savings, and they drain it entirely. So, in situations like this, a health insurance plan could be a real “life-saver” because it covers your hospitalization expenses.

Health insurance increases your accessibility to quality health treatments, including private healthcare, where the cost is still a barrier for many. Health insurance ensures you to get appropriate treatment promptly irrespective of their financial capability.
Especially in a country like India, people have a reduced capability to afford proper medical treatment. Medical insurance provides the much-needed financial stability to an individual.

Why is Health Insurance important?