FAQs on Health Insurance Policies

Question 1: I was advised to buy a standard health insurance policy which is cheap and gives all the coverage. Should I?

Answer: The standard health insurance Arogya Sanjeevani policy was designed by IRDAI and is available with all insurance companies. In this policy, maximum coverage is up to Rs 5 lakh and it has a sub-limit on the room rent. If you need policy up to Rs 5 lakh then this is a good option.

However, you should always consider the growing inflation and be ready for it. The policy you opt for should be from a long-term perspective— a policy whose coverage is not insufficient even when you are 65-70 years old. Look at coverages which don't have any capping.

SOME IMPORTANT FEATURES OF AROGYA SANJEEVANI POLICY

• Policy Term: This policy can be availed for a term of one year.
• Pre-Medical Examination: People aged 50 years and above are required to undergo pre-medical screening at the Company's nominated centres before availing this policy.
• Sum Insured: The policy provides the Sum Insured options ranging from Rs. 50,000/- to Rs. 10,00,000/- (in the multiples of Rs. 50,000/-).
• In-Patient Hospitalisation: Hospitalisation expenses incurred for a period of more than 24 hours on account of  illness, injury or accidents are covered.
• Pre-Hospitalisation: In addition to in-patient hospitalisation, the medical expenses incurred up to 30 days before the date of admission to the hospital are also covered.
• Post-Hospitalisation: Post-hospitalisation medical expenses up to 60 days from the date of discharge are covered.
• Room Rent: Room, boarding and nursing expenses incurred during in-patient hospitalisation are covered up to 2% of the Sum Insured subject to the maximum of Rs. 5000/- per day.
• ICU Charges: ICU charges up to 5% of the Sum Insured are covered subject to the maximum of Rs. 10,000/- per day.
• Road Ambulance: Ambulance charges are covered up to Rs. 2000/- per hospitalisation.
• Day Care Procedures: Medical treatments and surgical procedures that require less than 24 hours of hospitalisation due to technological advancements are covered.
• AYUSH Treatment: Expenses incurred for the treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines in AYUSH hospitals are covered up to the limits of the Sum Insured.
• Rural Discount: For identified Rural areas, a 20% discount on premium is available for both Individual and Floater policies.
• Lifelong Renewal: The policy provides lifelong renewal option.
• Cumulative Bonus: Cumulative bonus is provided at 5% of the Sum Insured for each claim-free year subject to a maximum of 50% of the Sum Insured.
• Co-payment: Each and every claim under the Policy shall be subject to a Copayment of 5% applicable to claim amount admissible and payable as per the terms and conditions of the Policy.
• Cataract Treatment: Expenses incurred for Cataract treatment are covered up to 25% of the Sum Insured or Rs. 40,000/- whichever is less per eye in one policy year.
• Instalment Options: This policy premium can be paid on a quarterly or half-yearly basis. It can also be paid annually.

Question 2: My parents are above 60 years old and have no health insurance policy now. Should I include them in my office group policy or buy a separate policy for them?

Answer: You have both the options. The advantage of a group policy is it doesn't have any waiting period for its members. However, if your employer decides to stop the group cover for parents or asks you to bear the price for the same or you switch jobs and join a company which doesn't have a parental cover, they may end up with no cover.

Opting for retail fresh policy will be subject to the under-writing rules of the insurance company and may need medical tests as well. There will be waiting periods and an age co-payment as well.

Ensure that you declare all present/past medical conditions and past hospitalisation history.

In a retail policy, your parents will have a cover for themselves and there will be tax benefit up to Rs. 50,000 under Section 80D. You may go for a combination of base plan and top-up plan so that you don't spend a lot on the premium.

It is advisable to have a separate insurance plan other than Group Insurance Plan coverage of your employer. In case you resign or your employer has stopped your coverage , then you have not coverage in future and this will impact adversely on your financial conditions and future prospects.

Question 3: I am not satisfied with my private company health insurance policy and want to port it to a government company like New India Assurance. How can I do it and will the premium structure be the same?

Answer: Both private and PSU companies are regulated by IRDAI. The same rules apply to both. The premium structure varies from product to product and from company to company. You can apply for porting 45 days in advance to your current renewal due date and ensure the activity is completed well within time.

Porting is a right given by IRDAI to health insurance policy holders. If you are not satisfied with services of your current insurer, you can port your policy with another one. The benefits earned such as pre-existing, disease period, No Claim Bonus etc. will be carried to your new policy. You can also port your group insurance policy with individual with the same insurer according to the terms and conditions of underwriting norms of the insurer.

Please note that Sum Insured in Porting Policy will be same as in existing health insurance policy or as per norms of existing insurer.

Question 4: I am facing a cash crunch; can I defer payment of health insurance premium for six months?

Answer: Renewal payment can't be deferred by six months as grace period offered to renew a health policy is 30 days. Once the policy expires after renewal due date, the claims that arise during the grace period and beyond are not payable.

If you are not in a position to pay the full premium at the moment, one way out is to request the insurer to offer you the monthly instalment payment option (if available) during the subsequent renewal.

PLEASE NOTE THAT: you can renew your insurance policy by paying fees/penalty with due premium according to terms and conditions of the insurance policy. But note that any claim /damage arised during period ending of Grace and the date of renewal will not be entertained by the insurance company.

Question 5: My wife works with a MNC and has a family cover from her office. She is planning to start her own business. I am an entrepreneur. Should we take a family floater policy now?

Answer: Yes, you should. It is important you stay sufficiently covered for unforeseen exigencies and protect your hard-earned savings. You should also evaluate if the group insurance policy that your wife holds from her employer, allows her to migrate to a retail cover from the same insurer with continuity benefits on the waiting periods served.

Question 6:My father was discharged from the hospital. He needs nursing, oxygen support, etc. Can I claim money from insurance for home arrangements?

Answer: Yes, you can if the health policy covers these expenses under home treatment benefit. Generally home treatment covers the expenses incurred for a specific period of time, on account of nursing expenses, portable and surgical medical equipment such as special beds, oxygen cylinders, etc., if they are recommended at the time of discharge from in-patient hospitalisation.

PLEASE NOTE THAT:

1. You can claim nursing expenses under the medical policy only if your health insurance provider covers it under post-hospitalisation expenses.
2. The majority of the health insurance providers cover ambulance service charges under the medical policy.
3. Post-hospitalisation expenses are the charges and fees you paid during a defined number of days, soon after the discharge from the hospital. Various diagnostic charges, consulting fees and medicine costs are covered under these post-hospitalisation expenses.
4. Please clarify the same with the insurer at the time of inception of insurance policy.

Question 7: I have health insurance through my employer. If I quit my job, how can I get same health cover later?

Answer: Please check with the insurance company on migrating this group employer-employee policy into its retail individual policy with continuity benefits.

In case it accepts the request of migration, subject to underwriting, then you can migrate yourself to the retail policy. However, if it does not allow migration, you will have to opt for a fresh retail policy and serve the applicable waiting periods.

Question 8: I am 64 years and have an individual health insurance plan. I plan to undertake a cataract surgery. My insurer says it will pay a fixed amount which is half of the amount that the hospital will charge. What should I do?

Answer: This varies as per the product guidelines of the insurance firm. There are some who have a capping when it comes to procedures like cataract. There are some who apply a mandatory age-based co-pay at the age of 64 and there are some who honour the full claim without any co-pay.

I would request you to refer to the terms and conditions document in your policy kit and understand the benefit better.

CATARACT SURGERY

A cataract is a condition that occurs when the natural lens of your eye becomes cloudy and causes blurry vision. The risk of developing a cataract increases with age; the condition is common among people over 40 years old. Other factors that can lead to this eye condition are diabetes, UV rays, trauma, family history of cataracts, and eye conditions such as myopia.

Considering that cataract is an important vision correction procedure, most insurance companies in India cover cataract surgeries of policyholders.

However, there can be a pre-determined sub-limit or cap on the maximum amount the insurance company will pay for your cataract surgery.

Therefore, before going for the surgery, it is important that you check the terms and conditions of your health insurance policy to know the sub-limits and other conditions to avoid any confusion later.

Question 9: I, along with my spouse and two children, are holding a Mediclaim policy. My 81-year-old father-in-law does not have any health cover. Can he be included in our policy?

Answer: In case your policy is an individual policy with four members in it then your father-in-law can be added at renewals. In case it is a family floater, then you will have to purchase a separate policy for your father-in-law. Declare his pre-existing medical conditions while opting for this cover.

He may be asked to undergo pre-policy medical check-up. Also check the applicable conditions like maximum entry age, co-pay, sub-limits.

PLEASE NOTE THAT: you can take health insurance for your father-in-law and mother-in-law as long as they meet the eligibility criteria set by the insurance provider. Generally, health insurance policies cover spouses, parents, and dependent children of the policyholder.

You will need to check with different insurance providers to see what their policies cover and what kind of coverage you are looking for. You may also want to consider the age, health status, and medical history of your in-laws as this can affect the type of policy and the cost of premiums.

Once you have identified a suitable insurance policy, you can proceed with the application process and provide the necessary documentation and details of your in-laws to the insurer.

Question 10: I had a family health insurance floater policy about seven years ago. I went to Dubai and my family had a cover from the employer. I have lost my job and we are back in India. Can I revive the policy and get the benefits?

Answer: This is kind of difficult as the maximum grace period generally allowed for renewing a health insurance policy is 30 days. In all probabilities you will have to opt for a fresh cover.

REVIVAL OF LAPSED HEALTH INSURANCE POLICIES

What is the Reinstatement of health insurance?

Reinstatement of health insurance refers to the process of restoring a health insurance policy that has lapsed, or been cancelled, due to non-payment of premiums or other reasons. When a health insurance policy lapses, it means that the coverage provided by the policy has ended and is no longer in effect.

You must contact the insurance company to request a reinstatement of a lapsed health insurance policy. The insurance company may require you to pay any outstanding premiums or fees that are due and may also need you to pay a reinstatement fee. The insurance company will provide you with information on the specific process for reinstating your policy, including letting you know of any fees that may be required.

It is important to carefully review the terms and conditions of your health insurance policy before requesting reinstatement, as you may be subject to certain conditions or restrictions that could impact your ability to reinstate the policy.

When Does Reinstatement in Health Insurance Occur?

On one hand, healthcare costs are increasing and on the other ailments and health problems are always on the rise. Therefore, your sum insured can run out even before you renew your policy, and there will be nothing to protect you in case of emergencies. In fighting this, reinstatement becomes the option.

In other words, when the basic health insurance limit has been exhausted, the reinstatement is needed.

How Does Reinstatement Provision in a Health Insurance Policy Work?

Imagine an unfortunate situation where you've­ used up all your health insurance cove­rage before the expiry date of your policy. Suddenly, you're left with no backup for e­mergencies. He­re's where the­ reinstatement provision ste­ps in.

When your insured sum runs out, it's rese­t to its original value under this provision. But, kee­p in mind, there are rule­s and conditions tied to the reinstate­d amount. To get clarity on rules for­ carry overs and usage, give your policy docume­nt a good read.

Question 11: What is co-pay in a health insurance and will it reduce the premium?

Answer: There are different kinds of co-pay such as mandatory co-pay basis entry age, voluntary co-pay, etc. The one which reduces premium is called voluntary co-pay where you agree to bear a per cent of the admissible claim and hence get the premium reduced as per the terms of the product.

One takes a call on opting for voluntary co-pay, considering age, health status and possibility of claim etc.

PLEASE NOTE: Simply put, health insurance co-pay is the fixed percentage of the claim amount that the policyholder pays. The insurer pays the rest as per policy terms and conditions.

For example, if your payable claim amount is ₹2 lakhs and your policy has a co-pay clause of 10%, the insurer will pay ₹1.8 lakh minus non-payable costs, while you will have to bear the remaining amount on your own.

While some health insurance policies come with a mandatory co-payment clause, others leave it to the policyholders to decide if they want to opt for it.

Types of co-pay clauses in health insurance

Not all health insurance policies come with a mandatory co-payment clause. Different insurers may apply co-pay condition in different ways for various circumstances. The table below depicts the different types of co-pay clauses and the scenarios in which they are applicable:

Question 12: My firm has a group health plan for my family. Can I port that policy post-retirement and continue with the same or a new insurance provider?

Answer: As per the guidelines on Portability and Migration, all group insurance policy customers are eligible to migrate into a retail product offered by the same insurer. This migration, however, would be subject to underwriting.

You should approach your HR team and establish contact with your group insurance provider and procure details at the earliest and continue to stay secured.

PORTABILITY OF HEALTH INSURANCE POLICIES

When you change your health insurance policy from one insurance company to another, you don't have to lose the benefits you have accumulated.

In the past in health insurance policies, such a move resulted in your losing benefits like the waiting period for covering "Pre-existing Diseases".

Now IRDA protects you by giving you the right to port your policy to any other insurer of your choice. It has laid down that your new insurer “shall allow for credit gained by the insured for pre-existing condition(s) in terms of waiting period.”

This applies not only when you move from one insurer to another but also from one plan to another with the same insurer.

Rights

1. You can port your policy from and to any general insurance company or specialised health insurance company
2. You can port any individual/ family policies
3. Your new insurer has to give you the credit relating to waiting period for pre-existing conditions that you have gained with the old insurer
4. Your new insurer has to insure you at least up to the sum insured under the old policy
5. The two insurers should complete the porting as per the timelines prescribed in the IRDA (Protection of Policyholders' Interests) Regulations and guidelines

Conditions

1. You can port the policy only at the juncture of renewal. That is, the new insurance period will be with the new insurance company
2. Apart from the waiting period credit, all other terms of the new policy including the premium are at the discretion of the new insurance company
3. At least 45 days before your renewal is due you have to

i) Write to your old insurance company requesting a shift

ii) Specify company to which you want to shift the policy

iii) Renew your policy without a break (there is a 30 day grace period if porting is under process)

IRDA Facilitation

IRDA has created a web-based facility to get and maintain data about all health insurance policies issued by insurance companies to individuals so that it can be accessed by the new company to which a policyholder wishes to port his policy.

This enables the new insurer to obtain data on history of health insurance of the policyholder wishing to port his policy.

Question 13: We are a family of four covered under an individual health insurance plan with highest age member (52 years). Can we convert it into a family floater plan?

Answer: This is possible but subject to the product and underwriting guidelines of the insurer. However, in the current circumstances, where there is a chance of the whole family getting infected, continue with the individual policies as the coverage shall be available for every member.

In floater plans the premiums are payable, generally basis the age of eldest insured member, which the younger insured may not find relevant.

PLEASE NOTE: This will be happen or Individual Plans can be converted into Family Floater Plan through Porting of Individual Policies with Family Floater Plan with the same insurer. Please refer Porting Rules mentioned above.

Question 14: Can I pay premium of three years in one-go? Will I get any discount on it?

Answer: Yes, you can pay your health insurance premium for a three-year term at one-go provided the insurance company has that feature available in their product. Whether paying for a two- or three-year term makes you eligible for a discount on premium depends on the product but in general, there is a long-term discount available for two- and three-years policy tenure.

Question 15: My sister is a single mother and is dependent on me and my wife. Can I include her and her minor daughter in our family floater plan which includes my wife, our two sons and I?

Answer: A family floater policy generally refers to self, spouse, two or three dependent children-. You can opt for a floater plan where your sister and her daughter are covered as insured members and your sister can be the proposer.

You may also go for multi-individual policy where spouse, children, brother and sister, niece and nephew could be covered under the same policy with individual sum insured.

PLEASE NOTE: Family floater health insurance, also known as family health insurance, covers your entire family under a single plan. The sum insured applicable under these plans covers all the family members included under them. Primarily these plans cover individuals, spouses, and children. However some plans cover Parents, Parent-in-laws and siblings also.

Question 16:Two years ago I bought a health insurance policy and am not satisfied with it. If I port the policy, will all the benefits be carried to the new policy?

Answer: Yes. Portability is allowed under all individual indemnity health insurance policies issued by general insurers and health insurers including family floater policies. Wherein, the continuity benefits are offered on time-bound exclusion to the extent of the previous sum insured.

Question 17: I plan to visit the US next year. Will my family floater plan cover any treatment, if required, in the US?

Answer: Usually, health plan bought in India do not cover any treatment outside India. However, there are a few high-end products which offer coverage outside India. Check the terms of your policy to see if treatments outside India are covered.

It is better to opt for Travel Insurance Plan.

Some beneficial features are

Travel insurance plans cover various kinds of situations such as hospitalization due to Covid-19, other diseases, injury etc., loss of check-in baggage or delay in check-in baggage, flight cancellations and any other unpredictable circumstances.

Thus, whatever is the purpose of your trip: leisure or business related.

A travel insurance policy is a vital document that you carry with you when you travel. You buy it depending on the dates you are traveling on so that you can enjoy your journey without any problems. You should choose a policy depending on the requirements and budget of your trip and if you are traveling single or in a group.

There are different types of travel insurance available focused on the needs and goals of your trip. They are detailed so that each step of your journey is covered, as financial security is the main priority of the travel insurance plan.

• Single Trip Travel Insurance: Single Trip Travel Insurance is the most commonly availed insurance where the insurance is taken for a specific travel abroad to a country for the duration of stay there. It can be availed for all family members travelling with separate individual Sum Insured.
• Senior Citizen Travel Insurance: Senior Citizen Travel Insurance is aimed at individuals above the age of 70. Since elderly people usually travel after retirement and in a group or as a couple, the plan safeguards them against risks.
• The Multi Trip Travel Insurance: The Multi Trip Travel Insurance plan is suited for people traveling for work-related purposes. Multiple trips in a year are covered and it avoids taking separate insurance policies each time.
• Student Travel Insurance: Student Travel Insurance caters to students going abroad for further studies. It provides complete coverage for the duration of stay of the student in a foreign country.

Question 18: How much discount will I get if I buy a health insurance policy online?

Answer: Discounts are based on the product you intend to buy. While many life insurance products offer discounts for online purchase given the long-term policy nature, many health insurance products do not provide any discount.

Question 19: I have an office group cover and a family floater policy. Can I claim a part of the bill from my office policy and the rest from my floater policy?

Answer: of course you can. If coverage from one policy is insufficient to pay the bills, then you can claim the remaining amount from another policy. The rule is that the same expense cannot be claimed twice from two different insurers.

Suppose you got hospitalisation expenses of Rs. 9 Lakhs and your Group Insurance Policy SI is of Rs. 5 Lakhs and Your Individual Policy is of Rs. 7.50 Lakhs. In this case you can choose Rs. 5 Lakhs from Group and Rs. 4 Lakhs from your individual insurance policy to pay bill.

Question 20: My wife is aged 50 and I am 56. My son is 22 and my daughter is 19. Till what age can they be included in health floater policy?

Answer: It depends on the product / company where you and your family members are intending to be covered. Generally, in many products, the dependent children are covered till the age of 25 years. You may want to check with the prospective insurers and decide accordingly.

AGE OF CHILDREN TO BE COVERED UNDER HEALTH INSURANCE OF PARENTS

In India, different types of health plans are specifically designed for children to ensure they receive the best medical care when needed. These plans typically have specific eligibility criteria to ensure children can benefit from them.

To be eligible for children's health insurance in India, your child usually needs to be between 3 months to 25 years old. This age range may vary slightly depending on the insurance provider and the specific policy you're looking at.

Most health insurance plans for children will require them to be Indian residents. This means your child should have a permanent address in India.

Additionally, you usually need to be the policyholder or co-policyholder. This ensures you are responsible for managing the policy and making necessary payments.

When applying for insurance, providing accurate and complete information about your child's health and medical history is essential. This helps the insurer gauge the risk and tailor the policy to your child's specific needs.

Make sure to read and understand the terms and conditions of the health insurance policy for children thoroughly. Choosing a policy that provides adequate coverage for your child's healthcare needs is critical.

Question 21: I have a family floater policy and my daughter aged 23 is also included in the policy. She is getting married next month. Can she continue with the policy and avail all the benefits accumulated over the last 12 years?

Answer: The child is mandatorily shifted into an individual policy when the child attains the age of majority as defined in the policy or if the child is no more dependent (becomes independent).

Since the daughter is getting married, her dependence would shift from the existing family to the new family if the daughter is not earning. Continuity benefits are offered on such policies.

PLEASE NOTE THAT: Even if a woman is married, she is eligible for an insurance claim under a policy purchased by her father, ruled the Vadodara Consumer Disputes Redressal Commission. It ordered the New India Assurance Company Ltd to pay Bharat Chaudhary the amount he had claimed for his daughter's medical treatment.

IN THIS CASE: The insurance firm, however, rejected the claim on the ground that daughter was married when she was medically treated and hence according to the policy's terms and conditions , she would not covered under the Family Floater Policy taken by her father. The insurer further argued that Insured has not informed the insurance company that his daughter got married.

The Forum said that the Policy Clause nowhere say that a married daughter is not covered under terms of policy. “The terms only say that policy would cover dependents from three-month old baby to 25 years old offspring who are dependent on their parents.”

Question 22: My office health insurance covers myself, my wife and two kids. If I pay extra premium, my parents can be included. Should I go for this or take individual health insurance for them?

Answer: Employee group insurance does not have any pre-existing waiting period. So any hospitalization incidence would be covered from day one. In retail policy, a pre-existing waiting period is applicable. Retail health insurance can be renewed lifelong but group coverage ends when the employee exits the group and so the parents could be left without any insurance. Hence, take an independent retail policy for parents as well.

Question 23: Last year, I paid more than Rs 45,000 for cataract eye surgery. The insurance company did not pay the full amount as reimbursement. It said the amount is fixed at Rs 30,000. What should I do?

Answer: If there is any capping on certain procedures such as cataract, etc., the amount shall be paid as per the applicable sub-limits. However, super top -up which has no such sub limits and capping could be a good choice to cater to such out-of-pocket expenses.

Question 24: I had bought a family floater health insurance policy 10 years ago and did not renew it after five years because I got a job that had an insurance cover from my office. After the pandemic, I lost my job. Can I port my office health insurance into a family floater or should I have to buy a new policy?

Answer: Individual members including family members covered under an indemnity-based group health insurance policy have an option to migrate at the time of exit from group or in the event of modification of the group policy or withdrawal of the group policy, to an individual or family floater health insurance policy offered by the same insurer subject to underwriting.

In this case, if you are currently not covered under any group health insurance policy, you may want to get you and your family covered under a new retail health insurance policy.

Question 25: I will be 69 this month and my wife will be 61 in April, 2021. We don't have any health insurance policy. I had a bypass surgery in 2016 and now I am in perfect health. My wife is suffering from rheumatic arthritis now. Should we take a comprehensive health insurance policy?

Answer: You may want to look at different covers for both of you as the age group and health issues are different. Some insurers have a restriction on entry age beyond 65 years. As you have been treated for a heart problem and your wife has a chronic condition, check with some insurers on acceptance as underwriting guidelines differ from insurer to insurer and product to product. Some insurers have certain plans for senior citizens with chronic health issues.

Question 26: Will an insurance policy have a cap on room charges every day? How can it be increased without a substantial rise in the premium?

Answer: Policy premium depends on the features of the policy you have opted for. There are policies which offer room rent as a per cent of the sum insured, there are some which offer specific room category or even any room without any limitations as a per cent of sum insured.

Policies which have capping on room charges also have optional covers to remove capping or enhancing the room category. It is better to have minimum restrictions even if it costs a little more premium.

Question 27: As I am 65 years old, what kind of health policy should I buy and what will be the premium?

Answer: It is important to opt for a health insurance plan at the earliest and not let any unforeseen hospitalisation claims eat up your hard-earned retirement savings.

You should look for such plans where there are no restrictions on entry age. If you can afford the premium, considering your age, it is advisable to have a comprehensive cover with high sum insured. You can look for a plan which covers in-patient hospitalisation, day care treatments, pre & post hospitalisation, ambulance, donor expenses apart from other health and wellness related benefits. Check for the sub limits and co-pay which can impact your claim pay-outs.

Question 28: My wife, daughter and I have individual health insurance of Rs 3 lakh each. Should I convert it into a family floater for Rs 10 lakh?

Answer: I would recommend a sum insured of Rs 10 lakh or more as a floater cover given the fact that in case one of you gets hospitalised then you have a sufficient cover at your disposal. Most insurers offer a restoration or recharge benefit in their core product proposition which works really well in a floater cover and acts as a backup for the family. Alternatively, you may increase the sum insured by purchasing top-up plan.

Question 29: How can I opt for OPD cover as I am spending a lot of money on doctor consultation for my dental problem?

Answer: There are many plans available which gives the OPD cover. But while buying a plan, it is always better to go for comprehensive cover which can take care of all kinds of health eventualities and not just dental or OPD related expenses.

COMPREHENSIVE HEALTH INSURANCE POLICY

A comprehensive health insurance policy offers extensive coverage and acts as a financial pillow in case of medical emergencies. Unlike basic health insurance plans, a comprehensive policy covers outpatient as well as inpatient treatments, including consultations, medical tests as well as hospital stays.

Some insurance companies offer comprehensive health insurance that even provides limited cover for physiotherapy, homeopathy, acupuncture, and osteopathy. Few plans also cover the expenses of oral surgery, the use of a private ambulance and home nursing. Moreover, by paying some extra cost, you can even add a routine dental and optical cover to your medical plan.

Here's a list of benefits you enjoy having a comprehensive health insurance policy

Pre and Post Hospitalization: Covers pre and post hospitalization expenses for a month or 60 days, and the person is reimbursed after submitting bills and other cost related documents incurred during the period of hospitalization.

1. Day Care Procedures: Treatments like dialysis, chemotherapy, angiography, radiotherapy, appendectomy, hydrocele, eye surgery, colonoscopy, lithotripsy, etc. are covered under this policy. Some health insurance policies cover all day care procedures.
2. Ambulance Cover: Covers the cost of ambulance service.
3. Check-ups: Covers the cost of regular health check-ups as a preventive measure.
4. Expenses for Organ Donation: Certain comprehensive health insurance policy covers the costs incurred in the process of organ donation. In case you are undergoing organ transplantation, your donor will be financially covered by your health insurance plan.
5. Critical Illnesses: Some common critical illnesses covered under a comprehensive health insurance plan are paralysis, stroke, cancer, coronary artery disease, heart attack, major organ transplant, chronic lung disease, etc.
6. Cashless treatment: Allows you to get admitted to any listed hospital as per the list of hospitals of the insurance provider without paying anything for treatment.

There are several types of health insurance​ policy available in the market like individual health insurance, family floater health insurance, personal accident insurance, and critical illness insurance, among many others.

You should choose the policy that suits your requirements and offers complete coverage. Buying a health insurance policy is an essential part of your financial planning.

CONCLUSION

Considering increasing medical and hospitalisation cost, it is essential to have an adequate health insurance plan for your and your family. If your employer has provided coverage for you and your family in this case also you should have an individual health plan. Since you don't know future circumstances, may be possible that you will leave the job or under some circumstances your employer terminates your services. In this case having a separate plan provides you a cushion and protect you from financial drain. There are a lot of plans from various insurance companies in the market, you have to choose according to your requirement and assessment of your financial conditions. Please note that your dependent children from age of 3 months to 25 years dependent on your will be covered. Your parents also covered in your insurance policy as well as Group Insurance Policy Coverage provided by your employer.

DISCLAIMER: The article presented here is only for sharing information with readers. The views are personal, shall not be considered as professional advice. In case of necessity do consult with professionals for more understanding and clarity on subject matter.