It is rightly said that necessity is the mother of invention. This also applies to health insurance. Deteriorating lifestyle and rising cost of health care in India has paved the way for health insurance services. This need is exacerbated by the fact that social security systems are non-existent in India, unlike in the West. Governments have made all the provisions to collect taxes from the citizens at every possible point, but when it comes to health care and social security, they have done nothing.
So it is the responsibility of the citizen to keep himself safe. But getting the right health insurance policy is not that easy. There are more than two dozen general insurance companies in India offering different types of health insurance plans. Many times people buy health insurance plans which are not relevant to them and which do not help them in their time of need.
Hence, it is of utmost importance that you understand the nuances of health insurance plans and only then take a decision. Here’s a quick list for you.
What do health insurance plans cover?
Health insurance plans are mainly meant to provide you coverage against hospitalization and critical illnesses. Most plans cover it. However, there are many plans that do not cover certain health ailments. For example, you can find many mediclaim plans that do not cover issues related to blood pressure and diabetes.
The scope of coverage may also be different. For example, not every plan covers post-hospitalisation expenses. In some the coverage period can be as long as 45 days and in some it can be as short as a week.
It is your responsibility to investigate these matters. If you are relying on the insurance agent who is following you around, it may cost you at a later date. Agents are interested in making sales and commissions. They may show their concern and offer you the best of plans, but their reality may be very different. So just take care of these things.
The growth of the health insurance industry in India has prompted insurance companies to offer comprehensive plans. There is also a wide range of riders available at your disposal. Thus, if you buy a standard policy, you can add riders that can cover you against various other risks such as permanent disability benefits, diabetes coverage, etc.
Do they cover pre-existing conditions?
Most mediclaim plans in India do not cover pre-existing conditions unless specified. Do not make any assumptions in this matter. If you are looking for coverage for a pre-existing medical condition, make it clear up front. You can compare health insurance plans online and consult the customer care center through online chat option or telephone call.
There are plans that cover pre-existing diseases subject to certain conditions. Generally, there is a pre-specified period within which pre-existing conditions are included. The cost of such plans is naturally higher than the standard plans.
Can multiple family members be covered under one plan?
Yes, it is possible. You can simply opt for a family floater plan and get your family members covered under a single plan. There are innumerable benefits of these plans. If you take separate health insurance plan for different family members then the premium is slightly higher but quite less. The collective cost of the various schemes is very high.
On the other hand, family floater plans are cost-effective. The most frequently asked question about family floater plans is what happens if one member consumes the coverage limit and the other member falls ill. Solutions to these situations do exist.
You can top-up the coverage limit during the policy term. Of course, you will have to pay some extra premium to get the extended coverage.
Can you switch from one health insurance plan to another?
Portability is not limited to the telecom sector only. The Insurance Regulatory and Development Authority of India (IRDAI) has made portability possible in the health insurance sector.
If, for any reason, you wish to change your health insurance service provider, you can file an application for switch. Health insurance is till now offered by general insurance companies and they cannot deny your claim for portability.
They may try to retain you but in the end, it is your prerogative to make the final decision. If you face any problem related to your Health Insurance Plan, You can register a complaint on IRDAI’s Online Consumer Grievance Redressal System. It is amazingly efficient and you can expect action within a period of 15-45 days.
However, IRDAI has taken strong steps to protect consumer rights and it is most likely that your complaints will be resolved by the insurance company at the first stage itself and in that case you will not need to approach IRDAI.
What about tax exemption?
In the current financial year ending March 2015, you can claim a tax deduction to the extent of Rs 15,000 on the payment of health insurance premium under Section 80D of the Income Tax Act. This limit has been fixed at Rs 25,000 per year from the next financial year.
Source by Naval K Goel
