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It is rightly said that necessity is the mother of invention. This also applies to health insurance. Deteriorating lifestyle patterns and rising cost of health care in India have paved the way for health insurance services. This need is further exacerbated by the fact that unlike in the West, social security systems are non-existent in India. 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.
In such a situation, 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 offering different types of health insurance plans in India. Many times, people end up buying health insurance plans which are not relevant to them and which do not help them in times of need.
Hence, it is of vital 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. But, there are many plans which do not cover certain types of health ailments. For example, you may find many mediclaim plans that do not cover blood pressure and diabetes related issues.
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 the period 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, 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 aspects.
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 which can provide you cover for various other risks such as permanent disability benefit, diabetes coverage etc.
Do they cover pre-existing conditions?
Most mediclaim plans in India do not cover pre-existing conditions unless specified. Don’t think in this matter. If you are looking for coverage for a pre-existing medical condition, make that clear upfront. You can compare health insurance plans online and consult the customer care center through online chat option or telephonic 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 ones.
Can multiple family members be covered under one plan?
Yes, it is possible. You can simply opt for a family floater plan and cover your family members under a single plan. There are innumerable benefits of these plans. If you go for different health insurance plans for different members of the family, the premiums are slightly higher but substantially less. The collective cost for various plans is very high.
On the other hand, family floater plans are affordable. One of the frequently asked questions about family floater plans is what happens if one member consumes the coverage limit and the other member falls ill. There are solutions to these situations.
You can top-up the coverage limit during the policy term. Of course, you need 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 want to change your health insurance service provider, you can file an application for switch. Till now health insurance is 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 PlanYou can register a complaint in 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 there are high chances that your complaints will be resolved at first stage by the insurance company itself and you need not approach IRDAI in that case.
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 for 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.
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