Benefits of Health Insurance

What is Health Insurance? Why Does Health Insurance Matter?

A health insurance plan is a financial agreement between the insurance company and the insured that covers medical expenses for planned and unplanned medical treatments in exchange for a fixed premium amount.

Health insurance typically offers coverage for in-patient hospitalization, pre- and post-hospitalization, ambulance charges, day care procedures and modern treatments. Other benefits of a medical insurance plan include maternity coverage, personal accident coverage, bariatric surgery expenses, hospital cash benefit and preventive health check-ups, among others.

The role of health insurance has expanded from providing financial protection to serving as a preventive care measure. Most plans now include annual health check-ups and wellness benefits to encourage the insured to adopt a healthy lifestyle.

You need health insurance for yourself and your family because of the following reasons:

• Financial Coverage – It provides financial assistance for medical hospitalization, surgeries and treatment of illnesses.
• Protect Your Hard-earned Money – It allows the policyholder to protect their savings from being drained in one go due to medical treatment.
• No Need to Pay Upfront – It enables the policyholder to get cashless treatment without the need to pay from their own pockets before or at the time of hospitalization.
• Peace of Mind During Emergencies – It provides the insured and their family with a sense of peace by covering unexpected medical costs. The policyholder can truly focus on the treatment and recovery rather than being stuck in the hassle of arranging funds.
• Prepare for Future Medical Healthcare Costs – It helps the insured to cope with medical inflation and receive treatment with ease even when the cost of procedures increases in the future.

Top 11 Benefits of Health Insurance in India

Take a look at the top 11 benefits of health insurance in India:

• Coverage for Hospitalization Expenses

  The biggest benefit of buying health insurance is that it covers medical expenses incurred during hospitalization, including:

  • Room rent
  • Doctor's fees
  • ICU charges
  • Surgery costs
  • Nursing fees
  • Medicines

  It also covers pre- and post-hospitalization expenses, such as doctor’s consultation fees and diagnostic test charges. A health insurance policy also covers the cost of day care procedures, domiciliary hospitalization, AYUSH treatments, OPD treatments, maternity expenses and ambulance charges, among others.

• Protection Against Medical Inflation

  Healthcare costs in India are increasing every year with the advancement in technology and inflation. Everything from treatments and medications to hospital stays has become exceedingly expensive, often leaving people struggling to manage their medical bills. This trend is expected to continue in the future as well. Health insurance protects you from medical inflation against the payment of a small health insurance premium.

• Access to Quality Healthcare

  As healthcare costs are skyrocketing, many people compromise on their treatment to save money. However, with mediclaim insurance, you can access quality healthcare services at top hospitals without the stress of managing medical bills.

• Pre-existing Diseases (PED) Coverage

  Treatment for pre-existing diseases often involves recurring expenses, leading to significant financial strain. Medical insurance takes care of these recurrent expenses resulting from PED conditions (usually after a waiting period of up to 3 years). However, there are some health insurance plans that provide PED coverage from day 1.

• Manage Lifestyle Diseases

  Modern times have led to an increase in lifestyle diseases, such as diabetes, hypertension, heart problems, etc. These illnesses often require long-term care, which can be financially draining. Health insurance benefits you through plans, such as health insurance for cancer or diabetes health insurance, by covering the cost of treating lifestyle diseases and ensuring access to the best treatments without financial burden.

• Annual Health Check-ups

  One of the most popular benefits of health insurance is the annual health check-ups. It covers the cost of undergoing tests like complete blood count (CBC), physical exams, and diagnostic screenings that can help identify a potential health issue at an early stage, reducing long-term healthcare costs.

• Cashless Hospitalizations

  Health insurance provides you with the benefit of cashless treatment at any hospital of your choice with its ‘Cashless Everywhere’ feature. This means you can avail quality treatment at the best hospitals without having to pay upfront.

• Tax Benefits

  Health insurance premiums are eligible for tax deductions under Section 80D of the Income Tax Act, 1961. You can claim tax deductions up to ₹25,000 if you are under 60 years of age, while senior citizens can save taxes up to ₹50,000 with medical insurance. The dual benefits of health insurance – financial security and tax savings– make it a lucrative component of financial planning.

• Personalization

  Health insurance provides the option to customize the policy according to your need through various riders and add-ons. This includes personal accident cover (for financial protection in case of accidental death and permanent disability), consumables cover, maternity rider, critical illness rider, and so on.

• Peace of Mind During Emergencies

  Mediclaim insurance ensures peace of mind by covering hospitalization expenses, especially during emergencies. Whether you meet with an accident, undergo surgery, or are diagnosed with a sudden illness, your health insurance company will handle your hospital bills, allowing you to focus completely on recovery.

• Incentive for Maintaining a Healthy Lifestyle

  Many health insurance companies in India offer wellness benefits as incentives for maintaining a healthy lifestyle. These benefits may include discounts on renewal premiums, rewards for achieving fitness goals, or additional services like free health check-ups. With health insurance discounts, insurers encourage policyholders to save money and, in turn, adopt a healthy lifestyle.

Why is Health Insurance Necessary?

The simple answer to the question, why you need health insurance, is that it has become a necessary financial tool to cover medical expenses and stay prepared for the rising medical costs in India.

The impact of not having a health insurance plan is much more than the premium that you pay for it. In situations involving prolonged or expensive medical treatment, the costs incurred are substantial. If you do not have a mediclaim policy, you will have to pay all the expenses out of your own pocket. On the other hand, a health plan allows you to get financial coverage with no or only a portion of expenses to be actually paid by you.

For instance, you need to undergo a bypass surgery, which costs around ₹2 lakh. Now, if you have a health insurance plan, the insurer will cover the surgery cost per the policy’s terms and conditions. However, if you do not have health insurance, the full amount of ₹2 lakh has to be paid by you. This shows why health insurance is very important.

How to Choose the Right Health Insurance Plan?

Check out the key factors to consider while choosing the right health insurance plan:

1. Assess your Health Needs

   Start by assessing your medical needs and those of your family. Consider whether you need a critical illness cover, maternity benefit, or any other specific coverage. Choose a medical insurance plan that meets your health needs without adding unnecessary features that could increase your premiums.

2. Claim Settlement Ratio

   The Claim Settlement Ratio (CSR) indicates how likely a health insurance company is to settle your claim. A higher CSR means the insurer is more likely to settle claims and is reliable. Hence, you must select an insurer that has a higher claim settlement ratio to gain confidence that your medical expenses will be covered without fail during emergencies.

3. Coverage for Pre-Existing Diseases

   Check your preferred health insurance plan for coverage of pre-existing diseases. Many mediclaim policies have a PED waiting period of 2 to 3 years before they cover the treatment cost. However, several plans today also come with PED coverage from day 1. If you already suffer from a health condition, it is wiser to choose a plan with a shorter waiting period for pre-existing diseases so that it can be covered as soon as possible.

4. Compare Multiple Health Insurance Plans

   With plenty of options in the market, it is essential to carefully explore and compare health insurance plans before making a decision. You must compare their premiums, sum insured limits, inclusions, exclusions, and additional benefits before selecting a health policy. Policybazaar.com lets you compare various plans from different insurers on a single platform.

5. Check Sub-Limits

   Most health insurance policies have sub-limits, which put a cap on specific expenses like room rent, ambulance charges, or treatment costs for certain illnesses. Make sure to carefully review these sub-limits so that you do not face unexpected costs later.

6. Check the Co-Payment Clause

   Co-payment in health insurance requires you to pay a fixed percentage of your medical expenses out of pocket when raising a claim. The insurer only pays the remaining amount during claim settlement. Ideally, you must opt for a plan with no co-payment or a co-payment percentage that you can easily afford to pay without creating any financial burden.

7. Extended Coverage Beyond Corporate Health Plan

   If your employer provides corporate medical insurance, you must analyze its benefits and ensure that you buy a private health insurance plan that provides medical coverage beyond what is already covered.

Important Tip: Insure Early to maximize the health insurance benefits!

Young people often believe they are healthy and may neglect the need for insurance coverage for medical emergencies. The importance of buying health insurance early cannot be overlooked because of the following reasons:

• Young people can easily serve the health insurance waiting periods without falling ill or needing a claim.
• More claim-free years mean more accumulation of no claim bonus (NCB), providing higher benefits.

How to Buy Health Insurance Online?

To buy health insurance online from Policybazaar.com, follow the steps below:

Step 1: Go to the 'Health Insurance' icon on the homepage of Policybazaar.com.

Step 2: Select your gender and choose the family members you want to insure, along with their respective ages.

Step 3: Mention personal details (like your city, name and mobile number) and medical history of everyone you wish to cover under health insurance.

Step 4: Compare and choose the suitable health insurance plan from the options displayed. You can also select the "Get Free Advice" option to get help or suggestions.

Step 5: Make the health insurance premium payment online.

Step 6: Once the payment is successful, you will receive the copy of your health policy on your registered email ID.