Simplest Guide for Health Insurance in India

These are medical expenses relevant to the disease that results in hospitalization incurred during a period up to the number of days specified in this policy, prior to hospitalization for treatments of disease, illness or injury sustained as part of a claim admissible under the policy.

What it means: It means that you can claim all medical expenses that you undertook for the treatment before you were hospitalized, if the hospitalization is payable. Generally, all expenses incurred 30 days before the hospitalization can be claimed by providing proper receipts and reports required.

To know more see Understanding Hospitalization vis-à-vis insurance

Cosmetic surgery does not affect the life of an individual. It’s main role and benefit lies only in external looks and beauty, which are not life threatening. Hence, cosmetic surgeries of any kind, including botox, liposuction, et al are not payable by the health insurance company. And it is of note, that circumcision is now considered cosmetic surgery under most health care plans and is not covered. Circumcision, plastic surgery will be payable only if it forms a part of the treatment of an illness.

To know more see Your Mediclaim policy excludes these expenses

Before deciding to buy a policy we need to think of who were are buying the health insurance from. People buy health insurance policy from a person, who deals with motor, household and fire policy, or even life policy and not specifically health. In fact buying health insurance directly from the company is preferred over to buying from someone who understands nothing or has only half of health insurance understanding! Here are the benefits of buying health insurance from health expert:

• They handle your Claims Disputes:

A right broker will tell you why your claim has been rejected and whether it is rejected for valid points. If it is unfairly rejected, he will help you in filing your claims again and if needed he will assist you in approaching the ombudsman (a third party platform that resolves claims issues).

There will be times when a claim is rejected by an insurance company that has a good chance of being passed if more reports and evidence is provided. A broker with a good health insurance and health knowledge will be able to discern whether there is scope for reapplying for the claim settlement and what the Insurance Company expects.

• They design policies:

A health expert can help design corporate health insurance policies. His special expertise will help him understand the facts behind the claims and the reasons why there is rise in claims for some diseases and a dip in others. The health and health insurance knowledge clubbed together can help him design a policy that is based on the needs of the company.

To know more reasons see Health Insurance from Health experts

Following are the time when you know that you have to change your Broker:

• No accessibility: When you never seem to get access to your agent or your Broker. His contact numbers are non functional or he is not entertaining your calls.
• No health insurance knowledge: When you ask him simple questions regarding the policy, the broker/ agent is unable to give you adequate information.
• No maintenance of records: When you find that your broker has no computer records of your transactions and renewals or if he does not remind you of your renewals.
• Ineffective: When your Broker is unable to help you at the time when you need him most like when Suresh needed him most. There will be some who do not have those skills that are required to provide the service that customers need.

To read more see Change Broker/Agent

No matter how we try, we can’t always be there to protect and shield our children. There are times when they will get hurt or when they will be unwell. But there is one thing that we can be sure of, that is, providing our children quality health care when they need it. So here are some reasons to buy health insurance for kids:

• In the time of emergency you will not have to think of how you can afford the care your child needs as it most likely covered. Also in case of emergencies when arranging finance at admission is an issue, you can directly be admitted in a network hospital by showing the health insurance card.
• When your child is covered at the younger age, there are almost no restrictions, generally he will not have pre-existing diseases hence he will get full coverage from the start.
• When there is no claim from policyholders for a year, may insurance policies award them with discounts and bonuses, which means reduction in the premium or more cover.

To know more see Don’t forget to cover your Kids!

Yes. Section 80D of the income tax act 1961, ensures that there is a tax benefit available to everyone who has bought a health insurance policy. Every tax payer can avail an annual deduction of Rs. 15,000 from taxable income for payment towards premium of his/her health insurance policy for self and dependants. For senior citizens, this deduction is Rs. 20,000.

To read more see Health Insurance made Simple

To cancel the policy is your decision, and you may do so at any time after buying the policy. However, when you decide to cancel your health insurance policy, the company may incur cancellation charges – which differ from company to company. For instance, if you cancel the policy within 3 months of buying it, the company may deduct 25% of your premium amount and pay you the remaining 75%. If you cancel the policy within 6 months, the company may deduct 50% of the premium amount and pay you the remaining 50% and so on. You will find these in the policy terms and conditions in the policy document of the various health insurance companies.

To read more see Health Insurance made Simple

There are many people who bear wrong conceptions in their minds and many clauses which they don’t read properly in the policy wording of the health insurance policy. It is very important to know the policy fine print along with hidden fine prints before buying health insurance. Some of them are below:

• Waiting Period & Other Diseases
• Pre Existing Diseases
• Renewal Ceasing Age and Age Brackets
• Renewal of the Policy
• Pre and Post Hospitalization Expenses

To read each in detail see 6 Hidden Fine Prints You Must Know

• Online applications: Moreover, while in India, we still regard personal touch to everything, abroad mostly all formalities are done through the web. From selecting a health insurance plan, to checking out the different plans, to comparing the rates to knowing about the policy exclusions, almost all the information is available online and is given in a systematic way that makes it easy to understand.
• Regulatory matters: There are regulations pertaining to health services in the USA, and the delivery mechanism is standardized there, resulting in low claims ratio. However, there is an absence of a governing body and regulatory mechanism in the health insurance sector in India.
• State-wise differentiations: Each state in the USA, has customized health insurance products for people belonging to that particular state. For instance, a particular health insurance policy may be different in Illinois, from that in Texas. But in India, health insurance products are the same across states, throughout the country.
• Disability benefit: Health policies in the USA most of the time carry a disability benefit. Whereas in India, only accident policies carry the disability benefit.

To read more points see Health Insurance in India and Abroad

The ICICI Lombard Health Advantage Plan- the fixed premium of Rs. 15,000 and Rs. 20,000 looks at covering your entire tax exemption limit. This point makes it the selling point but comparing the price of other policies within the same age group shows that even with Outpatient benefit, you are not getting your money’s worth.

For example Premium for an individual policy for a 45 year old in Apollo DKV’s Easy health for Rs. 2 lakh cover is Rs. 6000; compare that to the 15,000 premium you pay for Health Advantage plan. Even taking the Outpatient expenditure i.e. Rs. 6000 for a 45 year old, you pay Rs. 3000 extra to the insurance company!

ICICI’s Health Advantage is a good investment for someone who wants to invest in health insurance mainly for tax benefit purpose. It isn’t such a good option for a buyer who really wants it mainly for health insurance.

To read more details about this policy see Health Advantage- Consider it for Tax Benefits