Insure Your Health
Insure Your Health
Disclaimer
Not all policies will provide all coverages mentioned on this page. Please read each policy document carefully before presenting and finalizing insurance proposals.
What is Health Insurance?
Health insurance is a type of insurance coverage that pays for medical expenses incurred by the insured. It provides financial protection against unexpected medical expenses due to illness, injury, or other covered health issues. With health insurance, you can manage costs related to:
Hospitalization
Doctor consultations
Diagnostic tests
Medications
Preventive care (if included in the policy)
Why Do You Need Health Insurance?
Health insurance is essential for safeguarding your finances and ensuring access to quality healthcare without worrying about the high costs associated with medical treatment. Key reasons include:
Peace of Mind: Protection against unexpected medical costs.
Financial Security: Covers expenses such as hospitalization, surgeries, doctor's visits, and medication.
Quality Care: Access to quality healthcare facilities during emergencies.
Key Benefits and Features:
Reduces financial burden during medical emergencies.
Provides access to quality healthcare facilities.
Preventive care to maintain overall health (if covered under policy features).
Tax benefits under Section 80D of the Income Tax Act.
Comprehensive coverage for hospitalization and medical expenses.
Cashless treatment at network hospitals.
Coverage for pre-existing diseases after a waiting period.
Optional riders for enhanced protection (e.g., critical illness, maternity benefits).
Annual health check-ups.
What Does Health Insurance Typically Cover?
Health insurance policies generally cover:
Hospitalization expenses (room rent, doctor’s fees, surgical expenses).
Pre- and post-hospitalization expenses.
Diagnostic tests and medications.
Ambulance charges.
Daycare procedures.
Alternative treatments like Ayurveda, Homeopathy, and AYUSH treatments (depending on the policy).
Types of Health Insurance Plans in India
1. Individual Health Insurance:
Covers medical expenses for a single individual.
2. Family Floater Health Insurance:
Provides coverage for the entire family under a single policy.
3. Group Health Insurance:
Offered by employers to their employees.
4. Critical Illness Insurance:
Covers specific serious illnesses like cancer, heart attack, or stroke.
5. Senior Citizen Health Insurance:
Tailored for individuals aged 60 years and above.
Choosing the Right Health Insurance Plan
When selecting a health insurance plan, consider these factors:
Coverage Limits: Ensure the policy covers your expected medical needs.
Premiums: Check affordability and value.
Network Hospitals: Confirm the insurer’s network of hospitals includes trusted healthcare facilities.
Pre-existing Conditions: Understand the waiting period for pre-existing diseases.
Add-ons: Look for options like maternity coverage, OPD expenses, and wellness benefits.
Tips:
Assess your healthcare needs and budget.
Consult an advisor for personalized recommendations.
Important Health Insurance Terms
What is a Pre-existing Disease?
A pre-existing disease is a health condition the insured has before purchasing the health insurance policy. Pre-existing conditions are subject to a waiting period before coverage begins. Always disclose pre-existing conditions accurately to avoid claim rejection.
What is the ‘Waiting Period’?
The waiting period is the time during which certain pre-existing conditions or specific treatments are not covered under the policy. Typically, this period is three years. Read the waiting period clause carefully before purchasing a policy.
What is Critical Illness Cover?
Critical illness cover provides a lump-sum payment upon diagnosis of serious illnesses such as cancer, heart attack, or stroke. This financial support can help cover:
Medical expenses.
Rehabilitation costs.
Other financial obligations during recovery.
Portability of Health Insurance
You can port your existing health insurance policy to another insurer without losing benefits accrued under the previous policy. Portability ensures continuity benefits like:
Waiting period credit.
No-claim bonus.
Pre-existing disease coverage.
What is a Cashless Claim?
A cashless claim allows the insured to receive medical treatment at network hospitals without upfront payment. The insurer settles the bills directly with the hospital within the policy’s coverage limits.
How Does it Work?
Seek treatment at a network hospital.
Provide your health insurance details.
The insurer coordinates with the hospital to settle the bill.
Can I Avail of Cashless Treatment at Any Hospital?
No. Cashless treatment is only available at network hospitals with a tie-up with your insurance provider. Check the list of network hospitals before seeking treatment.
Top-up Health Insurance Policies
What is a Top-up Policy?
A top-up policy provides additional coverage beyond the limits of your existing health insurance policy after a specified deductible amount is exceeded.
Can Top-up Policies Be Purchased Without a Base Policy?
Yes. However, the deductible amount in the policy must be paid by the insured before the top-up coverage kicks in.
Making a Health Insurance Claim
Steps to File a Claim:
Notify your insurer about the hospitalization or treatment within the stipulated timeframe.
Submit required documents such as:
Hospital bills.
Medical reports.
Discharge summaries.
Claim form.
Types of Claims:
Cashless Claim: Register the claim on the day of hospitalization and provide the claim registration number to the hospital.
Reimbursement Claim: File for reimbursement by submitting the claim registration number and required documents to the insurer after treatment.
Optional Riders for Enhanced Protection
Optional riders are additional covers that can be added to your base policy for extra protection. Examples include:
Critical illness coverage.
Maternity benefits.
Personal accident cover.
OPD expenses.
Choosing Riders:
Discuss your needs with an advisor to determine the most suitable riders for your health insurance plan.
Contact Us
For more information on health insurance plans, contact our experts at Hedge Equities. Let us help you secure your health and financial future.
