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About Health Insurance

Worried about paying for medical emergencies? Here's all you need to know about health insurance.

Health insurance is a contract between the insurer and an individual/group, in which the former agrees to provide specified health insurance at an agreed upon price called the premium. Depending on the policy, the premium may be payable either in a lump sum or in installments. 

Health insurance usually provides either direct payment or reimbursements for expenses associated with illnesses and injuries. The cost and range of protection provided by the health insurance will depend on the insurance provider and the particular policy purchased. 

Do I need health insurance?

Medical care and treatment is quite expensive and keeping that in mind, health insurance has become a necessity in today’s world. The mounting cost of medical treatment today is beyond the reach of the common man. It’s safer to be insured, even if an individual is healthy and has never had any major problem. Obviously, it is not possible to predict the future. 

Health insurance provides the much needed financial relief in case of a medical emergency. Expenditure for a hospital room, doctor’s fees, medicines and related health services all add up to a huge amount and health insurance covers most of it if not all.

Am I eligible?

Health insurance is available to people aged between five and seventy-five (the age limits may vary slightly depending on the policy). The health insurance scheme could either be one taken personally or it may be a group scheme sponsored by your employer. 

Which ailments does it cover?

Its important to remember that health insurance does not cover ailments in the first year after the policy is taken. Thereafter, it covers hospitalisation charges for a variety of maladies, but mainly for:

• Heart attacks
• Strokes
• Prolonged illnesses 
• Loss of limb, eye, or other parts of the body due to accident Injuries
•  Maternity expenses
•  Medicines

What I need to know

Whether you are covered by an office plan or it’s a personal health insurance scheme, you should understand the policy, and become familiar with common health insurance provisions, including limitations, exclusions, and riders. 

It is very important to know what your policy covers and what you have to pay yourself. Health Insurance policies generally cover boarding, nursing and diagnostic expenses, which include room rent charged at the hospital or nursing home, fees of the surgeon, anesthetist, doctor, etc. Some policies even offer fixed cash amount for each day you stay at any hospital for treatment. 

If you have a persistent health problem and then decide to take insurance, it might not be covered. Expenses on hospitalization, incurred in the first 30 days after taking a policy are also not entitled, except in case of an injury from accident. Treatment of certain diseases is not covered during the first year of your policy. The list of diseases may vary form one health policy to another. 

What are the main health policies or schemes offered by Indian insurance companies?

Some of the existing health insurance schemes currently available are individual, family, group insurance schemes, senior citizens insurance schemes, long-term health care and insurance cover for specific diseases. Choose the one that suits you best to insure your health.

Some of the insurance policies on offer are:

• Mediclaim Policy
• Personal Accident – Individual
• Personal Accident – Family
• Group Accident Insurance
• Jan Arogya Bima Policy
• Bhavishya Arogya Policy (Insurance for senior citizens)
• Traffic Accident Policy
• Overseas Mediclaim Policy
• Health insurance companies in India

Health insurance is offered by the following companies in the Indian market.

• The New India Assurance Co. Ltd.
• The National Insurance Co. Ltd.
• The Oriental Insurance Co. Ltd.
• The United India Insurance Co. Ltd.
• Bajaj Allianz
• Royal Sundaram
• ICICI Lombard
• Cholamandalam
• Reliance
• Tata AIG

In conclusion

These days, most offices give the benefit of health insurance to their employees. However, in case your employer does not offer a plan, it is worthwhile to opt for a health insurance scheme. Just make sure you understand the policy and are familiar with its provisions, limitations, and riders.