A health insurance plan covers an individual’s medical and surgical expenses if they are hospitalised during the policy period. It ensures that an individual receives cashless treatment or expense reimbursement in the event of illness. The insured gets a tax exemption for the cost of health insurance under section 80D of the Income Tax Act of 1961.
Health insurance companies now cover daycare hospitalisation, pre-hospitalisation, and post-hospitalisation. The costs incurred are reimbursed to the insured individual or paid directly to the healthcare provider. It can be a wise investment if thorough research is conducted on the various health insurance plans and coverages available. *
Terms used in health insurance –
Let us look at the jargon used in the health insurance industry.
1) Survival time:
The term “survival period” is commonly used in critical illness insurance policies. In most cases, the policyholder must survive for at least 30 days following the diagnosis of the medical condition to receive claim benefits. If the insured lives for at least 30 days after being diagnosed with the medical condition, he is eligible for claim benefits.
2) Pre-existing conditions:
A person has a pre-existing illness before purchasing an insurance policy. Many insurance companies only provide pre-existing illness coverage once the policy has been in effect for a specified period, such as four years.
3) Hospital networks:
Network hospitals are those with which health insurance providers have an affiliation.
4) Waiting time:
There is a waiting period for every health insurance policy. After the waiting period, you can begin using the benefits of your health insurance plan. The length of the waiting period varies depending on the insurance company and the program selected. For general health insurance plans, it is usually 30 days.
5) Additions:
Inclusions are the benefits provided by a health insurance plan. The inclusions are described in detail in the policy documents. You must renew health insurance plans before they expire to receive the benefits of the coverage provided.
6) Exemptions:
Exclusions are items that are not covered by a health insurance policy. The policy documents go into detail about the exclusions. Most health insurance plans have some standard exclusions, such as AIDS treatment, dental treatment, self-injury, etc.
In India, there are various types of health insurance policies –
1) Personal health insurance policy:
It protects individuals against illnesses by offering health insurance benefits such as cashless hospitalisation, reimbursement, pre-hospitalisation costs, post-hospitalisation costs, and add-ons. The entire sum assured is only for one person. *
2) Family health insurance:
With this policy, the entire family can be covered under a single health insurance policy. A fixed sum is ensured to family members under Family Floater mediclaim policies of health insurance plans for family. One or all family members can use it for claims made during the policy’s term.
3) Plan for critical illness:
A critical illness insurance policy is purchased to cover the costs of treating acute illnesses such as kidney failure, paralysis, cancer, heart attack, etc. The insured pays a lump sum benefit if diagnosed with one or more terminal conditions.
Select a health insurance plan only after you are satisfied with the coverage and your needs are met.
* Standard T&C Apply
** Currently, there are 2 tax regimes in India – new and old. To get the tax benefit you desire, choose the correct one after consulting an expert. You can opt for a regime change during the next financial year.
# Visit the official website of IRDAI for further details.
## All savings are provided by the insurer as per the IRDAI-approved insurance plan. Standard T&C apply
Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.
