Best Health Insurance Plans offer smooth cashless treatment or reimbursement of treatment costs and expenses if and when the insured falls ill.
It can be regarded as a contract between the insurance policy holder and the insurer which ensures that the insuring company pays for expenses incurred when getting treatment for medical conditions covered by the policy.
Health insurance is vital due to the increasing cost of treatment. The policy plays a major role in ensuring that the medical emergency does not convert into a financial problem.
Health insurance helps take care of the health care requirements while simultaneously making sure that the savings remain intact and the long-term goals of the insured do not get compromised.
Some of the main features and benefits of health insurance are mentioned below:
- Cashless treatment: Most insurance companies have tie-ups with hospitals and clinics across the country. Treatment at any of these hospitals is generally free. Policy holders only need to show the policy card and number and the insurer takes care of the expenses. This type of policy is the most preferred because it does not involve arranging varied documents and stress of resolution of claims. It is important to note that hospital expenses which are over the sub-limits specified in the insurance policy need to be paid by the policy holder to the hospital. Another thing to remember is the fact that cashless treatment is unavailable in hospitals with which the insurer has no tie-ups.
- No claim bonus (NCB): The policy holder can avail of this benefit if he/she has not filed any medical claims during the past year. This benefit can be availed at the time of renewal in the form of a cost discount or increase in the assured sum.
- Pre and post-hospitalization fees: Your health insurance plan may include an add-on benefit of pre and post hospitalization fee cover for a period of 30 to 60 days. This feature allows for reimbursement of illness related expenses that are incurred by the policy holder before and after hospitalization for a specific time period.
- Medical checkups: People with health insurance are entitled to get medical checkups regularly. Some insurance providers offer cashless check-ups to policy holders with a history of NCB.
- Tax benefits: As per Section 80D of the 1961 Income Tax Act, Indians with health insurance policies can avail a tax rebate on the premiums paid. Health insurance policy holders aged between 18 to 60 years can avail a tax rebate of up to INR 25,000 while those above 60 years of age can get up to INR 30,000 tax rebate. Individuals who are paying insurance for self and their senior citizen parents can avail of tax rebate of up to INR 55,000 on premiums paid.
- Room rent sub limits: Health insurance policies usually have a variety of sub-limits and room rent is one such sub limit. Insurance companies offer max coverage up to the assured sum, but they often reduce their liabilities by adding the room rent coverage sub limit clause. Sub limit of room rent during hospitalization is calculated on a daily basis. For example, if the room rent sub limit is INR 4000 per day and the per day room charges are INR 7000, then the policy holder will need to pay the extra INR 3000 to the hospital from his/her own pocket. Room rent charges are dependent on the type of room availed during treatment; it can a single room or a shared room.
- Other types of sub limits: Besides room rent sub limits, the insurance policy may also have sub limits for medical tests costs, doctor’s fees, surgery/operation cost, and medicine cost.
- Co-payment: This add-on benefit is helpful in lowering the cost of health insurance. The co-payment feature on health insurance plans have pre-defined data about voluntary deductibles that has to be paid by the insurer. Thus, if medicines are needed as part of treatment then the policy holder will pay some amount while the rest of the cost of medications will be paid by the company. This cost-sharing feature has no effect on the assured sum.
- Portability of health insurance: This option allows the policy holder to change the insurance provider to another company without the loss of continued benefits involving waiting period, pre-existing conditions, and exclusions associated with previous policy, etc. In order to avail the portability option, policy holders need to change to a plan that is provided by the company and then after one year they can switch to another company.
Individuals need to consider the below listed factors before selecting a health insurance plan:
- Select an insurance company with a good claim settlement record. A higher claim settlement ratio means that the insurer is reliable, credible, and trustworthy and your medical expense claims process will most likely be stress free and easy.
- Check and understand the different sub-limits, co-pay, and other caps that make up the health insurance policy. These factors can adversely affect the benefits in the long term.
- Renewability or insurance coverage should be lifelong. This is because health insurance is usually needed in old age. The policy renewal must therefore be continuous and lifelong and any breaks can lead to loss of all benefits and exclusions gained during previous years
- Check the scope of health coverage, and not just the cost, before choosing a plan. Select a policy that offers comprehensive cover, including that for pre-existing conditions.
- Ensure that the cashless hospital network of the insurer is widespread. Also verify if a hospital included by the insurance firm is located near your residence.
- Select a company with a dedicated internal team for medical expenses claims. Firms with third-party Mediclaim administrators often have a longer turnaround time.
- Check the T’s & C’s with regards to premium loading. It will help save and prevent payment of incremental high premium after making an expense claim.
5 Best Health Insurance plan for 2017
Listed below are the 5 best health insurance plans for 2017.
- Iffco Tokio General: The product name is Individual Health Protector. It also covers more than 10 critical illnesses. There is no limit for entry age. It offers coverage during illness, diseases and injuries that require hospitalization. The basic cover includes benefits like no claim bonus, coverage for expenses on treatments like Ayurveda apart from conventional medicine, pre and post hospitalization expenses; etc. The plan includes co-payment after the first claim in the range of 7.5 to 20 percent.
- Max Bupa Health – The product name is Individual Health Companion. The sum assured can be anywhere from Rs. 2 lakh to Rs. 1 crore. The plan offers lifetime renewability and comes with smart top-up options. There is a 12.5 percent discount on the premium if you renew the plan on the second year.
- ICICI Lombard General – The name of the product is Comprehensive Health Insurance. The benefits include coverage of medical expenses during hospitalization, coverage of medical expenses incurred 30 days prior and 60 days post hospitalization, coverage of pre-existing diseases post 2/4 years of continuous coverage within the company, life time renewability, cashless cover, emergency ambulance cover among other benefits.
- Religare Health – The product name is Care. It offers recharge benefit equivalent to 100 percent of the sum assured. This means the insured can restore the sum assured by 100 percent if the sum insured falls short or is completely exhausted due to an unrelated claim in the same policy period. Irrespective of the claims made or not, it offers health check-ups once a year. It provides no claim bonuses and super add-on covers as well.
- Cigna TTK Health – The product is known as Pro Health Protect. There is no maximum entry age. The individual gets a 10 percent discount on the premium amount for enrolling more than two family members under a single individual policy. There is an extra discount of 7.5 percent for choose a 2-year single-premium policy and a 10 percent for a three-year single premium policy. The product comes with a lifetime renewability option.