Benefits of Health Insurance Plans

Health insurance plans protect your savings from getting ruined in case of serious health conditions that result in hospitalisation during the policy period. But most of the people believe that health insurance plans only cover them for hospitalisation expenses, which is not true. The key purpose of health insurance plans is to provide comprehensive coverage to the insured, which they do so by offering protection for various healthcare expenses. Some of these include cover for in-patient hospitalisation expenses, pre-hospitalisation and post-hospitalisation expenses, daycare expenses, domiciliary treatment expenses, organ donor expenses, etc. Apart from coverage benefits, health insurance plans also offer other benefits. To understand them in detail, read below:

Benefits of Health Insurance Plans

1. Cashless Treatment

Health insurance companies, generally, have tie-ups with hospitals wherein the insured can avail the required treatment without paying anything except the non-medical expenses or the expenses that the policy does not cover. Network hospitals are present across India and you can avail treatment in any of them, provided the treatment availed is in accordance with the terms and conditions mentioned under your health insurance plan.

2. Comprehensive Coverage

Health insurance plans offer comprehensive coverage by protecting you from several healthcare expenses. These include the following:

  • In-Patient Hospitalisation Expenses: These include expenses incurred during hospitalisation for at least 24 hours. Under this benefit, the health insurance plans mostly cover you for room rent, nursing, boarding expenses, ICU/ICCU expenses, doctor’s fee, etc.
  • Pre-Hospitalisation And Post-hospitalisation Expenses: These are the expenses incurred for a specific number of days before and after hospitalisation. These include doctor’s consultation fee, x-rays, other tests, etc. Different insurance companies have different periods for which they cover these expenses.
  • Ambulance Expenses: These are the expenses incurred due to transportation of the patient to the nearest hospital in case of an emergency. Usually, insurance companies have a limit to these expenses, which varies from one insurance company to another.
  • Domiciliary Expenses: These are the expenses incurred due to treatment availed at home, mainly due to unavailability of beds in the hospital. Mostly, health insurance companies cover you for these expenses.
  • Daycare Treatments: Daycare treatments are those which can be availed in less than 24 hours. These include radiotherapy, dialysis, chemotherapy, cataract treatment, etc. The number of daycare treatments covered may vary from one insurance company to another.
  • Organ Donor Expenses: Most health insurance plans offer cover for expenses incurred on organ donors for harvesting. These include expenses related to surgery and storage of organs.

3. Portability Benefits

Another benefit of health insurance is that it offers flexibility to port from one health insurance policy to another in case you are not satisfied with the benefits offered under the existing one. Apart from giving the customers flexibility, it also saves them from being taken for granted by the insurance companies.

4. Financial Security Even During Rising Healthcare Expenses

A health insurance plan helps you in combating financial stress in case of an emergency even during rising healthcare expenses. It offers you wide coverage even in times of inflation. Therefore, it is recommended to buy a suitable health insurance policy.

5. Tax Benefits Under Section 80D of the Income Tax Act, 1961

The government of India promotes health insurance by offering tax deductions on the premium paid for the plans, under Section 80D of the Income Tax Act, 1961. To understand the tax benefits in detail, refer to the table below:

The utility of health insurance plans not only depends on the features and benefits offered under them but also on how the insured is able to make the most of it. So, if you don’t want your health insurance policy to be underused, you must thoroughly understand its benefits as well as the process to avail of them.

Top Coronavirus Health Insurance Plans in India

As per the instructions of Insurance Regulatory and Development Authority of India, everyone shall be offered cover for COVID-19 treatment under their existing health insurance plans. Apart from the COVID-19 cover offered in existing health insurance plans, the insurance companies have also launched two special standard health insurance products to cover the disease. These are the Corona Kavach and Corona Rakshak Plans.

Corona Kavach Policy

Corona Kavach is an indemnity based health insurance policy that covers you for hospitalisation (of at least 24 hours) expenses due to positive diagnosis of COVID-19. The policy can be purchased by anyone who is aged between 18 years and 65 years, for short terms of 3.5 months, 6.5 months, or 9.5 months. The policy can be bought either on an individual or family floater sum insured basis, for a wide range of sum insured options, as per their requirement. The sum insured options start at Rs. 50,000 and go up to Rs. 5 Lakh (in multiples of Rs. 50,000). Apart from in-patient hospitalisation expenses, the policy covers the insured for pre-hospitalisation and post-hospitalisation expenses, road ambulance expenses, home care treatment, and consumable items like gloves, mask, oxygen cylinders, PPE kits, ventilators, etc. The policy comes at an affordable premium, on which you can avail tax benefits under Section 80D of the Income Tax Act, 1961.

Corona Rakshak Policy

Corona Rakshak Policy is a benefit based short like policy that provides you a lump sum amount equal to 100% of the sum insured, on positive diagnosis of COVID-19. The condition is that the diagnosis should be done at a government recognised diagnostic center and the hospitalisation should be of at least 72 hours. The policy can be bought for 3.5 months, 6.5 months, or 9.5 months, and the premium will be different for different policy terms. One can buy this policy if they are aged between 18 years and 65 years for sum insured options between Rs. 50,000 and Rs. 2.5 lakh (in multiples of Rs. 50,000).

Arogya Sanjeevani Policy: A Health Insurance Policy For All

Arogya Sanjeevani Policy is a standard health insurance policy that protects you and your family against major healthcare expenses. Launched by the Insurance Regulatory And Development Authority of India (IRDAI), the policy is offered by all the insurance companies offering health insurance plans in India. The eligibility to buy this policy is 18 years and 65 years and you can buy the policy for a term of 1 year on an individual or family floater basis. It comes with sum insured options ranging between Rs. 1 Lakh and Rs. 5 Lakh as per your requirement. The policy covers you for in-patient hospitalisation expenses, pre-hospitalisation and post-hospitalisation expenses, daycare expenses, AYUSH treatment expenses, road ambulance expenses, cataract surgery for a specific period, new age treatments, and so on. There is 5% co-payment applicable on all admissible claims.

Common Inclusions Under Health Insurance Plans

Every health insurance plan is unique in terms of its offerings. Some common inclusions in most health insurance plans in India are as follows:

  • In-patient hospitalisation expenses
  • Pre-hospitalisation expenses
  • Post-hospitalisation expenses
  • Daycare expenses
  • Domiciliary hospitalisation expenses
  • Road ambulance expenses
  • Organ donor expenses
  • Critical illnesses
  • Health check-up
  • Outpatient expenses

Common Exclusions Under Health Insurance Plans

While health insurance plans offer wide cover for most healthcare expenses, there are still a few expenses that they do not cover the insured for, and he/she shall have to bear them out of their own pocket in case they arise. Some common exclusions are as follows:

  • Cosmetic procedures
  • Dental procedures
  • Expenses related to treatment required due to the insured committing any breach of law
  • Expenses related to treatment required due to participation in adventure sports such as mountain climbing, parasailing, bungee jumping, etc.
  • Congenital diseases
  • Supplements that can be purchased without prescription
  • Pre-existing diseases (covered after waiting period in some plans)
  • Treatments taken outside the geographical boundaries of India

Role of Health Insurance Plans During the COVID-19 Outbreak

The pandemic declared coronavirus has impacted the lives of many in India. During times like these when medical emergencies can arise any time, having a health insurance policy comes in handy. Whether you are married, single, have children, are young, old, or do not have any children, you must have a reliable health insurance policy that protects you in case of serious illness, sickness, disease, or an accident. Whether you choose individual health insurance plans or family health insurance plans, remember that the choice will not only affect the quality of healthcare but also affect your wallet.

During coronavirus times, the policyholders are often confused if the policy under which they are covered protects them from hospitalisation expenses arising due to coronavirus or not. The answer is ‘YES’. All new health insurance plans in the market will cover the insured for coronavirus cases after 30 days i.e. the initial waiting period. COVID-19 related claims will follow the normal processes and will be treated as a normal illness like chikungunya, pneumonia, or any other virus. The good news is that so far there is no exclusion.

So, if you still have not insured yourself and your family, then you should get coronavirus health insurance as soon as possible.

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