General Insurance
Where Every Angle Matters
Why Health Insurance
80 Percent of Indians do not have Health Insurance
As per a survey conducted by NSSO, it has been found out that 86 percent of people in the rural areas and 82 percent in urban areas did not have any health insurance cover, neither public nor private. It has been observed that most depend on savings or household income to fund health related expenses, sometimes even borrowing in order to meet hospitalization and other medical related expenses. This survey also confirms the fact that India is one of the most privatized systems in the world for healthcare with people opting for ‘out of pocket’ expenditure for medical expenses.
It has also been found out that some of those from the lower economic strata in rural areas resort to selling their possessions in order to pay for medical expenses and over 5 percent look for help from their family and friends. The recent survey echoes earlier studies conducted in the domain regarding the financial strain placed on people due to medical expenses and are known to be one of the main causes for accumulation of debt.
Through the survey it is also known that a majority still opt for healthcare services from private players placing them under a heavy financial burden, also the reimbursement of expenses regarding hospitalization was not done always.
As most of the employers are not providing complete family health insurance, and not only that, if you do not buy it now, then it will be very difficult for you to buy a new policy at the requirement time or after retirement. If you want to buy it at the time of your retirement, you will not get all the benefits and the premium will also be very high.
Health Insurance
A Health Insurance Policy would normally cover expenses reasonably and necessarily incurred under the following heads in respect of each insured person subject to overall ceiling of sum insured (for all claims during one policy period).
a) Room, Boarding expenses, Nursing expenses, Fees of surgeon, anesthetist, physician, consultants, specialists
b) Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines, drugs, diagnostic materials, X-ray, Dialysis, chemotherapy, Radio therapy, cost of pace maker, Artificial limbs, cost or organs and similar expenses.
Waiting Period and Exclusions
30-days waiting period:-Medical expenses incurred within 30 days from the commencement of the policy are not covered.
2-years and more waiting period:- When you compare health insurance plans, you need to check the conditions and treatments that have a longer waiting period of 2 or more years. Often conditions, such as bile duct stones, hemorrhoids, varicose veins, ulcers, and knee replacement surgeries have longer waiting periods. This means that if you need treatment for such conditions, the health plan will not cover the expenses until the end of the waiting period.
Pre-existing conditions:-Most insurance companies do not offer coverage for pre-existing conditions until a certain period from the commencement date of the policy. When you are doing a health insurance comparison, it is recommended that you check this period and avail a policy that has a lower waiting period if you suffer from any pre-existing condition. Pre-existing conditions are those medical ailments that you have already been diagnosed at the time of buying the policy. Individuals are advised to give truthful and accurate information while availing a health plan to ensure there are no issues in the future, when you need to file claims under the insurance policy. Health insurance is vital for every individual. The earlier you start investing in this type of insurance, the more beneficial it is. However, it is important for you to research the different products that are available before buying any plan.
Features to Consider before
❯ Room Rent Sub limit amount
❯ PED covered after years
❯ Maternity coverage
❯ OPD coverage detail
❯ Pre Hospitalization Coverage
❯ Post Hospitalization Coverage
❯ Domicillary Hospitalization Covered upto
❯ Daily Cash Benefit limit (Amount & Days)
❯ Health Maintanance Benefit
❯ Day Care Procedures Details and limits
❯ Organ Donor Coverage
❯ Ambulance Service Covered upto
❯ Free Health Check Up's
❯ No Claims Benefits Provided
❯ Claim Based loading
❯ Co-Payment
❯ Age untill Renewals Allowed
❯ Eligibility Criteria (Entry AGE)
❯ Cashless facility
❯ Sub-Limits- desease specific
❯ Relapse Period
❯ Family Discount
❯ Pre Medical Checkup
❯ Term Discount
❯ Restoration of SI
Section 80D Limit:
As per Section 80D, a taxpayer can claim deductions on health insurance premiums paid for self/family and parents, apart from deductions on expenses related to health check-ups. The overall deduction limits are as follows:
Persons Covered Exemption Limit Health Check-up Exemption Total
Self and family Rs.25,000 Rs.5,000 Rs.25,000
Self and family + parents Rs.(25,000 + 25,000) = Rs.50,000 Rs.5,000 Rs.55,000
Self and family + senior citizen parents Rs.(25,000 + 30,000) = Rs.55,000 Rs.5,000 Rs.60,000
Self (senior citizen) and family + senior citizen parents Rs.(30,000 + 30,000) = Rs.60,000 Rs.5,000 Rs.65,000
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