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Individual Health Insurance – A Quick Guide

Health is wealth which needs to be taken care of and nourished the whole life. Today, where technology is reaching new heights, even diseases are showing up huge escalation. The costly treatments and emergency cases become a tension for many individuals. And, there comes the need of Individual health insurance in everyone’s life. It takes care of your health and expensive medical treatment related to medicines or hospitalization (pre and post-hospitalization) due to accident, sudden illness or surgery, during the policy term. It is an honest solution for people who cannot afford quality treatment because of the high charges and unavailability of cash. 

Individual Health Insurance Policy Covers

The cluster of facilities available in individual health insurance policy is sure to please every person. Individual health insurance covers all pre and post hospitalization expenses incurred around 30 – 60 days prior to and 90 days post hospitalization. It provides cashless facility when you get your treatment done in a network hospital. Even during the non-cashless treatment, the amount is refunded but after a formal approval process. It also covers charges for ambulance and diagnostic tests up to a pre-defined limit. Facilities like daycare are also covered but are subjected to some terms and conditions.

Pre-existing diseases apart from injury due to accidents are treated after a defined waiting period which may vary from months to years. Any surgery like Cataract, treatment of Asthma, hernia, piles etc, maternity related issues or psychiatric disorders are covered after the waiting period.

Benefits of Individual Health Insurance Policy

  • It is quite a beneficial affair to opt for as the individual is provided a cumulative bonus of 5% for every claim free year.
  • Also, if you go for family health insurance as well, you are provided with some discount depending on the insurer and the policy you are holding.
  • Till the age of 45, you don’t require to undergo any medical test. And for people above 45, the pre-policy check up is generally performed at the insurer’s empanelled diagnostic center.
  • The reimbursement of treatment done in non-network hospital is done in few days.
  • Under section 80D of Income Tax Act, tax benefits can be availed on the premium paid.

Exclusions of Individual Health Insurance Policy

  • Pre-existing diseases are not treated as soon as you purchase the policy and there is a pre-defined waiting period for the same.
  • For a few diseases, the cover amount may vary from 10% to 90% of the sum insured.
  • Generally Ayurvedic, Homeopathic or non-allopathic treatments are not included under this policy.
  • Treatment related to intoxicating substances like alcohol is not included.
  • Even cosmetic and aesthetic treatments are not covered under this policy.
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