Health Insurance Plans & Medical Insurance Policies

WHY IS HEALTH INSURANCE IMPORTANT?

All in one : A health insurance policy is an all-embracing package that covers not only primary medical expenses due to hospitalization but also costs associated with it, like ambulance charges and daily hospital cash allowance. Additionally, medical insurance plans also include pre-hospitalization and post-hospitalization expenses like consultation fees, diagnostic fees, medicines and physiotherapy charges.

Medical insurance also includes day-care insurance cover : day-care is a kind of medical treatment that includes hospitalization for less than 24 hours. Many mediclaim policies today cover domiciliary treatment, i.e., when the treatment is taken at home and the bills are submitted from the hospital or clinic for reimbursement. Many health insurance plans and policies do factor in preventive care like master health check up, counseling or preventive diagnostic tests.

Covers family too : The best attribute of health insurance plans is their group or family variant, and all the above benefits are included too. For a single sum insured, the health cover extends to all the members of your family. It is flexible to manage and at the same time, affordable. And the good news is that some medical insurance plans do cover maternity benefits; it has a sub-limit within a plan.

Special health insurance plans like Critical Illness Plans : It is not only important that your medical expenses are covered, you also need to take care of other family expenses; there might be a loss of income due to hospitalization. This is where a critical insurance policy fits in. It covers certain life threatening diseases like heart attack, kidney failure and cancer. A one-time lump sum payment is given to the insured if the diagnosis proves the declared medical condition. This cover comes either as a standalone health insurance plan or as a rider attached to an ordinary mediclaim policy.

Ease and flexibility : Under a health insurance policy, claim settlement becomes hassle free with the aid of TPAs (Third Party Administrators). The TPAs provide cashless facility and specialize in claims processing and reimbursements by interfacing between the policyholders and their hospitals.

Health Insurance - FAQS

Mentioned below are certain terms which one must be aware of while opting for health insurance plans:

What is Health Insurance Plan?
Health Insurance Plan provides protection against medical expenses that you might incur during hospitalization due to illness, disease or accident.

Is Health Insurance the same as Life Insurance?
No, Health Insurance is not the same as Life Insurance. Life insurance plans provide financial protection against loss of income due to death of life assured. Health insurance plans on the other hand provide financial protection against medical expenses that you might incur during hospitalization.

Why do I need Health Insurance?
Cost of healthcare is rising rapidly. With the introduction of newer technology & medicines, the cost of medical treatment may become unaffordable for majority of individuals. You must be ready to protect yourself & your family against any uncertain medical emergencies. Health Insurance Plan provides you financial assistance for such events.

Which are things one should consider while choosing the Health Insurance Plan?
One needs to take into account following things:
- Renewability is guaranteed,
- Type of exclusions and period of exclusion and any premium loading options, Day care procedures are covered or not,

Steps to buy the best health insurance plan

When it comes to selecting the best health insurance plan,buyers often forget to keep crucial factors in mind, for example: If you knew that getting medical bills reimbursed from your insurer is likely to fetch you only half the sum as compared to a cashless claim settlement, it is unlikely that you will opt for the former. In fact, the Insurance Regulatory and Development Authority of India seconds this and if that wasn’t enough, opting for the cashless facility also saves you the trouble of collating all the documents, submitting them to the insurer and following up.

Insurers often dispute that the average claim payout in case of reimbursement settlements is just half that of cashless claim disbursals for the same ailment category and doing due research about the medical insurance provider’s network of hospitals that offer cashless claim settlement is the best option. The information is usually available on the insurer’s website.

However, cashless facility is not the only thing you need to look for and there are many factors that will affect the kind of coverage you receive and the premium that you will have to pay. First and foremost, the insurer's experience, financial strength and service record is quite crucial. An insurer with a lower claim settlement ratio is best avoided. If possible, you should also take into account solvency margins or an insurer's ability to pay out claims and also premium growth registered by insurers.

The type of health insurance policy you need won’t be same as that of your neighbor. The best health insurance policy for you should be determined by your family's needs. The number of family members and their age is critical. To illustrate this further, a young family can do with a basic cover of around Rs 5 lakh, while a family with senior citizens should opt for a larger floater cover, say experts.

Another example could be that if the parents are too old, opt for separate cover for them, and not include them in your floater cover. Similarly, if you are planning a baby within two years' time, you will be better off without the maternity cover which comes with a long waiting period and almost doubles the policy premium. Be careful when opting for a maternity cover as part of your health insurance policy. Currently, this may get you a private room, unless you insist on high-end corporate hospitals, and you need not stretch your resources to buy a premium variant, without a room rent sub limit.

If you prefer access to high-end hospitals with better rooms, then plans with room rent sub-limits will not be a good option for you. Given healthcare inflation, these room rent sub limits may not even suffice for a good hospital room a few years from now. All the other expenses are linked to room rent eligibility, bringing down your entire claim eligibility. Go through the fine print to understand the limitation and exclusions of the plans. Most basic plans carry sub-limits for specific treatments. Ordinarily, a cover of Rs 5-lakh could restrict the daily room rent to 1% of the sum insured.

You should neither focus on buying the cheapest policy nor one that offers a plethora of benefits. The best health insurance plan should simply be a policy that fulfils your specific medical requirements. Several health insurers have come out with premium variants that offer services like doctors' second opinion, vaccination cover, wellness benefits, etc. Paying higher premiums for benefits you may never use is not advisable just like it is not advisable to buy a high-end cover merely for availing tax saving schemes that offer greater rewards.

Glossary Terms

Mentioned below are certain terms which one must be aware of while opting for health insurance plans:

Day Care Procedure :
Day Care procedures are surgeries or procedures which do not require hospitalization and can be finished in few hours because of technological advancement. These could be performed in Hospitals or specialized Day Care centers which are fully equipped with advanced technology and specialized infrastructure for the eligible procedures

Free-Look Period:
Free look period is 15 days from the date of receipt of the health insurance policy document and in case of distance marketing it s 30 days.

Co-Pay :
Co-pay means the percentage of admissible claim amount which has to be fully borne by customers opting for health insurance plans.

Cashless Claims Services :
Cashless service is a facility provided by Us wherein the Life Insured can get admitted and on seeking preauthorization can undergo the required treatment without paying directly for the medical expenditure. The medical expense, thus incurred and preauthorized, shall be settled by Us/TPA directly with the hospital. The Cashless claim facility can be obtained only at the Network

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HDFC Life Health Plan slide appears

HDFC Life Standard Life Insurance Company Ltd. In partnership with Standard Life plc. Insurance is the subject matter of the solicitation. Health Plans is the name of the Health Plans category offered by HDFC Life. The name of the company - HDFC Standard Life Insurance Company Limited, the name of the brand - HDFC Life and the name of the category - Health Plans does not indicate the quality of the plan, it's future prospects or returns. For more details on risk factors, associated terms and conditions and exclusions please read the product brochure carefully before concluding a sale. HDFC Standard Life Insurance Company Limited is . IRDAI Registration No 101. ARN: MC/05/2015/6456. CIN No. U99999MH2000PLC128245

DON’T BELIEVE THE FRAUD CALLS!

IRDAI IS NOT INVOVLED IN:

1) ANNOUNCING BONUS IN INSURANCE POLICIES
2) INVESTING PREMIUMS
3) SELLING INSURANCE POLICIES

Issued in Public Interest by

HDFC Life | INSURANCE REGULATORY AND DEVELOPMENT AUTHORITY OF INDIA

*premium Amount for Male, 35 yrs, 10 year term, Silver option, including tax.
HDFC Standard Life Insurance Company Limited.

Insurance is the subject matter of the solicitation. For more details on risk factors, associated terms and conditions and exclusions please read the product brochure before concluding a sale. HDFC Life Health Assure Plan (Form No. P501-105, UIN: 101N087V01) is the name of traditional health plan offered by HDFC Life. HDFC Standard Life Insurance Company Limited is only the name of the Insurance Company, HDFC Life is only the name of the brand and HDFC Life Health Assure Plan is only the name of the product. The name of the company, name of the brand and the name of the product does not in any way indicate the quality of the contract, its future prospects or returns. HDFC Standard Life Insurance Company Ltd. IRDAI Reg No. : 101. ARN: MC/03/2015/6186.
CIN: U99999MH2000PLC128245. Tax benefits are subject to change in tax laws.

Corporate Office & Registered Address

HDFC Standard Life Insurance Company Ltd.
Lodha Excelus, 13th Floor Apollo Mills Compound,
N.M. Joshi Marg, Mahalaxmi
Mumbai, Maharashtra 400011
Telephone: (022) 67516666

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