INFORMATIVE
Health insurance
Health insurance in India is an essential financial tool that provides coverage for medical expenses incurred by policyholders. It helps individuals and families manage the high costs of healthcare and ensures access to quality medical services. Here are some basic points about health insurance in India:
Key points about goods insurance
Types of Health Insurance
India offers various types of health insurance plans, including individual health insurance, family floater plans, senior citizen plans, group health insurance offered by employers, and government-sponsored schemes like Pradhan Mantri Jan Arogya Yojana (PM-JAY) or Ayushman Bharat.
Coverage and Benefits
Health insurance plans in India typically cover hospitalization expenses, such as room charges, doctor's fees, surgical expenses, pre and post-hospitalization costs, and day-care procedures. Some plans may also include coverage for outpatient services, maternity expenses, and critical illnesses.
Premiums and Deductibles
Policy holders pay a premium, either annually or in installments, to maintain health insurance coverage. The premium amount is determined based on factors like age, medical history, coverage limits, and the number of insured family members. Some policies may have deductibles or co-payments that policyholders must bear for each claim.
Waiting Period
Health insurance policies often have waiting periods for certain pre-existing conditions, specific treatments, or maternity benefits. During the waiting period, the policyholder cannot claim benefits related to those conditions or treatments.
Network Hospitals
Insurers have a network of empanelled hospitals and healthcare providers where policyholders can avail cashless treatment. Cashless treatment means the insurer directly settles the hospital bills with the network provider, reducing the financial burden on the insured.
Pre-authorization
For planned hospitalization, policyholders need to obtain pre-authorization from the insurance company to ensure smooth claim processing.
No-Claim Bonus (NCB):
Many health insurance plans offer NCB as a reward for not making any claims during a policy year. It can result in increased coverage or reduced premiums during policy renewal.
Portability
Health insurance portability allows policyholders to switch from one insurer to another without losing the benefits accumulated with the previous insurer. This ensures continuity of coverage.
Government Health Schemes
In addition to private health insurance plans, the Indian government has implemented various health insurance schemes to provide coverage to low-income families and vulnerable sections of society. One such prominent scheme is Ayushman Bharat PM-JAY, which provides health coverage to economically weaker sections.
Tax Benefits
Policyholders can avail tax benefits under Section 80D of the Income Tax Act for premiums paid towards health insurance policies for themselves, their spouse, children, and parents.
It is crucial to carefully assess the coverage, terms, and conditions of health insurance policies to choose the one that best suits individual and family needs in India.