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Health insurance is a protective financial plan that covers medical expenses, offering peace of mind by ensuring access to quality healthcare when needed.
Medical insurance is one of the most important investments you can make for yourself and your family. It’s not just about covering health and hospital b ills; it’s about having a safety net that protects you when unpredicted issues arise.
Imagine this: you face a medical emergency, and the costs start piling up. Having a medical insurance policy means you don’t have to worry about how to cover these expenses. Instead, your insurance company steps in to help manage the financial burden, allowing you to focus on what really matters—getting better.
These plans are a type of insurance coverage that covers for health-related expenses. It can cover the costs of medicines, surgeries, hospitalization, day-care procedures, critical ailment treatments, and other medical expenditure the policyholder incurs.
Due to escalating healthcare costs, proper treatment for medical conditions can dent your savings. Also, when a crisis arises, unless you have the funds at hand, arranging for timely medical assistance can be challenging. Health insurance protects you from such financial strains, ensuring access to quality healthcare.
A health insurance plan is essential in India because of escalating medical care costs. Medical inflation is increasing at double the rate of overall inflation. According to the Government’s 2018-19 Economic Survey, the average retail healthcare inflation rate is an alarming 7.14%.
Moreover, in India, the burden of lifestyle disorders is also growing.
Chronic health conditions such as heart problems, cancer, and liver diseases, need long-term follow-up therapies. Studies show that 85.42% of Indian households facing economic instability due to health expenses have a critical illness in the family
Unfortunately, in the matter of health insurance, India is underinsured. As per the National Sample Survey (NSS), over 80% of Indians do not have health insurance. The Insurance Regulatory and Development Authority of India (IRDAI) says that out-of-pocket spending on medical care is 64%.
The lack of health insurance causes Indians to dig into their savings, sell assets, or take loans to pay for medical expenditure.
Therefore, if an unforeseen medical concern crops up, the cost of hospitalization and adequate treatment can derail finances. The situation becomes more complicated if the person whose earnings sustain the household loses their income due to ill health.
Paying the small premium for a health plan insurance can help you avoid such financial uncertainty.
From luxury expenses like foreign holidays to necessary expenditures like children’s higher education, the need for funds is many. Effective arrangement for such funds necessitates planned investments. However, you may have to spend much of your income on basic amenities and immediate needs. It may leave a very little surplus for future requirements. Therefore, financial experts advise that before you consume your entire salary on day-to-day expenses, you should set aside a sum for the future.
The problem arises when the amount that you can save regularly is small in comparison to the funds that you may need later. Herein lays the need for wealth building, which grows the money you put aside. A money-saving plan helps in increasing your savings over time so that enough capital accumulates when the need for funds arises. Here’s a look at reasons for buying such plans.
The cost of quality healthcare is steep. Paying for the treatments from your savings can force your family to compromise with their living costs. Your children’s education or retirement funds can be affected.
The best medical insurance policy covers most medical expenses, such as:
Thus, you can access appropriate treatment on time without risking your loved ones’ financial well-being.
Diseases like heart attack, stroke, liver damage, and nerve disorders are widespread these days. Critical illness insurance policies reduce your financial worries for the treatment of such medical conditions.
Most insurers reimburse costs incurred even when you undergo treatment in any hospital not having tie-ups with the insurance company. Also, critical illness insurance allows you to undergo treatment at any hospital you prefer. You can use the upfront lump-sum payout in any way you choose.
Not all medical expenses can be covered under health insurance plans. However, you can opt for a daily hospitalization cash benefit with your base plan. It pays a fixed sum for each day of hospitalization. You can use the sum as per your need, covering extra costs excluded from your health cover.
Many medical policies offer regular income on the diagnosis of the diseases covered under the policy. Thus, your insurance policy serves as a livelihood if you need to take a career break due to poor health.
Insurers offer premium waivers if your earnings suffer and you fail to pay your premiums due to failing health. Your policy stays in force.
Some health policy providers offer accident coverage, paying a lump sum in case of death or disability due to an accident. The payouts provide financial relief to your family in their hours of need
You can include your family members under your health plan, ensuring their speedy recovery with your health cover’s financial aid.
Illness or injury can strike when you are away from the scope of proper medical care. Your insurer can organize the transportation and equipment needed to transfer to a reliable medical facility. Also, when your health condition becomes stable, your insurance partner arranges for your return home under medical supervision.
Medical insurance is more than just a financial safety net; it’s an important aspect of securing your health and future. Investing in a health policy can offer various benefits that enhance your overall quality of life.
One of the many benefits of various health insurance policies is their coverage for Outpatient Department (OPD) expenses. OPD coverage includes consultations with doctors, diagnostic tests, and sometimes even minor procedures.
Medical insurance policies usually cover both pre-hospitalization and post-hospitalization expenses, which can be a huge relief. Pre-hospitalization costs include medical tests and consultations leading up to hospitalization, while post-hospitalization expenses include follow-up treatments and medications required after discharge.
Pre-existing diseases are health conditions you opt for before purchasing a medical insurance policy. Many insurers offer coverage for these conditions, though there might be a waiting period. This benefit is significant as it allows you to manage chronic conditions like diabetes, ensuring you get the necessary treatments without worrying about exorbitant costs.
When you’re admitted to a network hospital, the insurance company directly settles the bill with the hospital. This deletes the need for upfront payments and the stress of reimbursement procedures.
You can buy health insurance online to avail the added advantage of tax benefits. Under Section 80D of the Income Tax Act, premiums paid for medical insurance policies qualify for tax deductions.
Many medical insurance policies offer the option to increase your sum insured either through policy upgrades or additional riders. This means you can adjust your coverage as per your needs change, ensuring that you’re always protected against rising healthcare costs.
There are a lot of health insurance plans to choose from, and this could make choosing the right one overwhelming. Listed here are a variety of different types of health insurance plans so that you can find the right one that suits you and your loved one's needs.
Individual medical insurance plans are designed to pay for an individual's medical expenses. This plan is ideal for those who want to obtain health coverage that precisely meets their health needs.
A family floater health insurance plan covers more than one family member on a single policy. In it, the total sum insured is shared among all members, and it is good to have in case you desire to simplify your covers without having many separate policies.
Healthcare needs tend to rise with age, and this is where the senior citizen health insurance plan comes into play. Such plans protect against various age-related health ailments. They generally cover no-claim bonuses, higher sum insured, and in some cases, the sum insured for critical illnesses and even pre-existing diseases.
Critical illness insurance protects against any serious health condition a policyholder may encounter, such as cancer, heart attack, or stroke. Unlike standard medical insurance, these plans also offer a lump-sum payment upon diagnosis of a covered illness, which can be utilized to cover treatment costs, lost income, or other expenses.
Group health plans are policies provided by an employer or organization that cover a group of individuals, usually employees or members. These usually come at lower costs compared to the individual policy because the risk is spread over a large number in the group. They usually give basic coverage and sometimes can be tailored according to the needs of the covered group. If there is a group plan available in your employer, it can be a good option since, many times, this is less expensive when you subscribe to health plans under employers.
Top-up medical insurance plans are designed to add more value to your already existing health insurance coverage. It extends the coverage quantity beyond what is provided by your current policy, and that too at relatively lower premiums. It comes out to be a very good option for those aiming to enhance their safety against exorbitantly high medical expenses.
When it comes to securing your health and financial well-being, a health plan is one of the most crucial investments you can make. Based on the below-mentioned features, you can make a prudent choice and invest in the right health plan.
Sum insured is the maximum coverage your medical insurance policy will allow in case of a claim. The sum assured must be sufficient for the expense, including hospitalization, health status, and family size. It is also essential to understand that it must cover major expenses; otherwise, you may have to pay the rest from your pocket.
Cashless hospitalization is a great feature. The insurer settles the hospital bills directly, so patients can focus on recovery rather than worrying about finances. This is very helpful in emergencies or for planned procedures.
Referred to as riders, add-ons are additional benefits that one purchases to gain extra advantage in the basic health policy. They may include coverage for accidental death or maternity benefits, among other things. Add-ons work best if one wants to tailor the policy to meet needs that are not covered under a standard plan.
Co-payments or co-insurance refer to the deductions on claims, that is, amounts that you have to pay out of pocket when making a claim. For instance, if your policy has a 10% co-payment clause, you pay 10% of the claim amount, and the insurer pays 90%. It is critical to understand such deductions since they do have an impact on the overall cost at the time of making a claim.
The middleman commission refers to the payment given to the agents or brokers for selling the policy by the insurance company. Although this does not generally affect the policyholder, one should keep in mind that sometimes, part of the premium is paid as a commission.
Pre-hospitalization expenses are incurred before the policyholder is admitted to the hospital. Examples of such expenses include one or more diagnostic tests or consulting a doctor.
These expenses are similar to those incurred after the policyholder is discharged. They could include follow-up visits, further treatments, or medicines. Check whether your plan covers these expenses and for how long because this can make or break your pocket.
This feature automatically restarts the sum insured once it has been exhausted due to a claim. This is particularly handy in cases where you have multiple issues in a policy year, and your coverage isn't depleted. It's a great feature for those seeking comprehensive protection.
Covid-19 treatment in the recent context has been mentioned in many health insurance plans. It includes coverage for the expenses related to hospitalization, medicines, and other related expenses. Make sure your plan offers this coverage if you want to be prepared for such emergencies.
AYUSH treatment comprises alternative therapies like Ayurveda, Yoga, Unani, Siddha, and Homeopathy. Some health insurance plans cover these treatments, which is a good option if one needs or prefers alternative medicine.
Under Section 80D of the Income Tax Act, premiums paid for health insurance policies are eligible for tax deductions. The deduction is available for policies covering yourself, your spouse, children, and even your parents. The maximum deduction allowed depends on the age of the insured individuals.
A quick claim settlement process ensures you receive your claim amount after submitting the necessary documents. This process is designed to minimize the waiting period, allowing you to access funds without delay, which is crucial during medical emergencies or when facing unexpected expenses.
Health insurance portability is the ability to switch from one insurer to another without losing any accrued benefit or cover that you have collected over time. Such a feature can be put to good use if you need better coverage or if you want to seek cheaper premiums. Make sure your current policy supports portability so that you have the benefit of relocation if needed.
To approximate the cost of your health insurance premium, you should follow these steps:
Calculate how much coverage will be needed considering your health status, the size of your family, and goals concerning finances. It also takes into account sum insured coverage options and add-on benefits.
Use an online premium calculator to find out how much coverage is suitable for you. Just feed in your age, health condition, coverage requirement, and lifestyle choice to get an approximate premium.
Compare various available health insurance plans along with their premiums from various insurers. Consider the coverage, benefits, and exclusions of different plans to choose the best value for your needs.
If you are unsure how to calculate the premium or select a plan, it is better to approach an insurance advisor. They can give you an opinion concerning your peculiar situation.
A mediclaim policy protects against health emergencies, ensuring you don’t have to dip into your savings or take on debt to cover unexpected healthcare costs. Whether you are new to the concept or looking to deepen your understanding, here are some reasons why you must know all about the policy before choosing one.
Mediclaim policy offers financial security during a medical emergency, enabling you to deal with unforeseen medical expenses.
You can avail of medical treatment without bothering about the cash payment at the time of hospitalization; the insurer will directly take the bill amount from the hospital. It is also easier in case of an emergency.
Mediclaim provides a reasonably inexpensive method of availing health care facilities and, as such, relieves you of the undue burden of healthcare expenditure.
Since your medical expenses are covered, you can concentrate on availing the best medical care instead of bothering about the expenses.
You may either get an individual or a family floater Mediclaim policy, whichever suits your health requirement and budget.
Premiums paid towards mediclaim policies are allowed as a deduction against income tax, thereby giving extra financial benefits.
To buy health insurance online is the most responsible and significant step toward securing not only your health but also your financial future. However, before setting on the right policy, here are a few things you must know-essentially, the eligibility criteria that define who can buy a plan and under what conditions.
For most health insurance providers, the minimum age is available, starting from 18 years. This is the legal age for entering into a contract of insurance. For child plans or family floater policies, the minimum age for children is around 91 days or older.
The insurance providers usually put a cooling-off period on such diseases. For example, you will have to serve a cooling-off period of 2-4 years before you can claim pre-existing diseases. In some plans, pre-existing diseases may be covered but for higher premiums or at the cost of additional riders.
Though there is no income constraint to purchase health insurance, the premium payable should be affordable for a person. Some insurers check your financial stability to ensure that you can pay the premium. Therefore, when you select higher coverage or any riders, the premium paid will increase, so your choice of health insurance policy should be based on your financial status.
The insurer may access your family's case history of certain diseases, especially those passed down through genes. It may not be a strict criterion for eligibility but may impact your premium or the availability of cover.
The notable components of a medical insurance plan include:
A health insurance policy is an agreement between you and your insurance provider. You agree to pay a fixed premium. In exchange, the insurer promises to pay for the healthcare costs covered under your plan, arising during the policy period.
Health insurance can be classified into two categories:
These policies pay the treatment costs up to the sum insured when you are admitted to a hospital. The amount paid depends on the actual expenses. You need to submit the hospital bills.
If the hospital is listed under the insurance company’s network, the insurer will directly settle the bills with your hospital. You need not bear any expense.
If you have to get admitted to any hospital outside your insurer’s network, you have to pay the bills yourself. The insurance company will later reimburse the expenses subject to your policy’s terms and conditions. But treatments at hospitals outside India are usually not included.
Such health plans cover specific life-threatening ailments that often need prolonged treatment and regular check-ups. Examples of such non-infectious lifestyle diseases include heart attack, stroke, liver damage, and cancer.
These fixed-benefit policies provide a pre-decided lump-sum payout upfront on the first diagnosis of the listed diseases. You need not submit any medical bills. A medical test report proving the diagnosis suffices.
The payouts are based on the cover you choose and not on the actual expenses. Thus, you are free to undergo treatment from any hospital of your choice, even abroad. The monies help you meet costs such as
You can also use the payout to fund your family’s living costs, EMIs, your children’s education fees, and more.
Health insurance plans are a necessity today. The coverage opens the gates to quality medical care regardless of your family’s resources.
Therefore, if you have started earning, and want to protect your finances against rising healthcare costs, you must buy health insurance. You will stay financially prepared and free from anxiety in a health-related contingency. It can also maximize your tax savings.
The quantum of cover depends on the following parameters:
There are indeed some important reasons why you should go for coverage as early as possible.
The biggest advantage of buying health insurance when still relatively young is the overall lower premium cost.
Health issues can knock your door anytime, and being covered early ensures that you are taken care of should something happen. Most health policies have a waiting period for conditions that one has had before the coverage date.
Younger people often qualify for lower premiums when purchasing health insurance because they live more active and healthier lifestyles. Their youth typically means they have fewer health issues, making them less of a risk for insurance companies.
Medical emergencies can strike at any age, and these can be very expensive. Having health insurance provides immediate financial backup should any treatment be required.
It is the most important investment, especially when it comes to safeguarding you and your family against medical emergencies. This investment not only helps you cover these significant medical expenses but also gives attractive income tax benefits.
Health insurance premiums are entitled to tax benefits under Sec 80D of the Income Tax Act. This means you can deduct what you pay for your health premium from your taxable income up to a certain limit. In this way, health insurance is not only one of the best things you can do for your health but also a smart financial move.
When it comes to safeguarding your health and managing medical expenses, you might come across two terms: Mediclaim and Health Insurance. While they might seem similar, they offer different types of coverage and benefits.
Aspect | Mediclaim | Health Insurance |
Cover | Primarily covers hospitalization expenses and related costs. | Covers a wider range of medical expenses, including outpatient care, preventive services, and more. |
Add-on Covers | Typically limited add-ons, if any. | Offers a variety of add-on covers such as critical illness riders, maternity benefits, and personal accident covers. |
Sum Insured | Fixed sum insured that is usually lower; covers specific hospitalization expenses. | Generally offers higher sum insured options, often with the flexibility to increase coverage as needed. |
While choosing a health insurance plan, you need to weigh in the following factors:
Assess your healthcare needs. If your family members depend on you financially, you need health covers for them too. However, including elderly parents in family floater plans can make the premiums costly. The price depends upon the age of the oldest member covered. Hence, picking a joint cover for yourself and your spouse, buying separate plans for your parents could be cost-effective.
Also, if your health status or family’s medical history increases the risk of lifestyle diseases, consider buying critical illness insurance
Select a plan that offers comprehensive coverage as per your age and health.
Also, if your profession involves working in hazardous conditions or frequent travels, an accident protection shield could prove valuable.
Choose plans that provide the coverage you need at premiums that suit your budget. Also, select a premium payment frequency matching your cash inflow.
Need for health insurance increases with age. Buy a plan featuring a long policy term to enjoy coverage in your old age.
For a nominal premium hike, you can extend your base cover to include:
Medical emergencies might need a quick transfer to suitable medical centres. If you fall ill away from home, you may need assistance to return. A family member’s presence during your illness could be invaluable. Opt for a plan that provides such useful facilities as a part of the base cover.
Read the fine print carefully to understand if any expense is not covered under the plan. Compare brochures for health insurance online to locate the best offering.
The extent of the insurer’s hospital network is the key to accessing medical care anywhere in India. However, when buying critical illness insurance, this need not be a concern since you can undergo treatment wherever you choose.
When you buy health insurance plan, you should have the right documents handy to ensure a hiccup-free process.
Health insurance selection is more like going through a maze of choices and confusing terms. Of course, there are several plans out there, that can overwhelm a person. Don't sweat! Once you target a few key elements, you will find one that fits and provides peace of mind.
First things first, what do you need from your health insurance? Do you need basic coverage, or will you require more comprehensive coverage? Consider your current health situation and any future needs. Know your needs to choose a plan that strikes the right balance between good coverage and affordability.
The sum insured is the maximum amount your insurance company will pay for your medical expenses. It is important that you select a sum insured that would address your needs in healthcare. You will have to increase the sum insured if you reside in an area where medical costs are really high or if there is a specific health condition you are addressing.
Cashless treatment is one of the advantages of health insurance wherein you are covered for medical treatment without paying a single penny. Check out the network of hospitals tied up with the insurer so that you can avail this facility.
Premiums are the regular payments one pays to keep the insurance alive, while deductibles mean the amount one pays out-of-pocket before the insurance covers one. Compare the premiums and deductibles for different plans so that you may find a balance that fits your budget.
In India, the cost of medical facilities is skyrocketing. You would not want your family to suffer from monetary shortfalls due to a medical crisis. Hence, financial preparedness is vital to avoid burning a hole in your pocket due to medical emergencies.
Buying a health plan with an adequate sum assured helps you avoid financial shortfalls in medical emergencies. Moreover, life-threatening medical conditions are rampant these days.
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The information herein is meant only for general reading purposes and the views being expressed only constitute opinions and therefore cannot be considered as guidelines, recommendations or as a professional guide for the readers. The content has been prepared on the basis of publicly available information, internally developed data and other sources believed to be reliable. Recipients of this information are advised to rely on their own analysis, interpretations & investigations. Readers are also advised to seek independent professional advice in order to arrive at an informed investment decision. Further customer is the advised to go through the sales brochure before conducting any sale. Above illustrations are only for understanding, it is not directly or indirectly related to the performance of any product or plans of Kotak Life.
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