Global Courant
It is rightly said that necessity is the mother of invention. This also applies to health insurance. Deteriorating lifestyle patterns and rising healthcare costs in India have paved the way for health insurance. This need has been exacerbated by the fact that, unlike in the West, social security systems do not exist in India. The governments have made every provision to tax the citizens in every possible way, but in the field of health care and social security they have done nothing at all.
It is therefore the responsibility of the citizen to protect himself. But it’s not that easy to get the right health insurance. There are more than two dozen general insurance companies offering different types of health insurance in India. Many times people end up buying health insurance policies that are irrelevant to them and don’t help them in their time of need.
Therefore, it is critical that you understand the nuances of health insurance and only then make a decision. Here’s a short list for you.
What do health insurance policies cover?
Health insurance plans are primarily designed to provide you with coverage for hospitalization and critical illnesses. Most plans cover this. But there are many plans that don’t cover certain types of health conditions. For example, you can find several mediclaim plans that do not cover blood pressure and diabetes-related issues.
The coverage ratio can also differ. For example, not every plan will cover costs after hospitalization. In some cases, the coverage period can be up to 45 days and in some cases even up to a week.
It is your responsibility to check these matters. Relying on the insurance agent chasing you could cost you dearly later on. Agents are interested in sales and commission. They may show concern and tend to offer you the best plans, but the reality may be very different. So just take care of these aspects.
The development of health insurance industry in India has motivated insurance companies to adopt comprehensive plans. A wide range of riders is also at your disposal. So if you buy a standard policy, you can add drivers that can cover you against many other risks, such as permanent disability benefits, diabetes coverage, etc.
Do they cover pre-existing conditions?
Most mediclaim plans in India do not cover pre-existing conditions unless specified. Do not assume in this matter. If you are seeking coverage for a pre-existing medical condition, clarify this in the first instance. You can compare health insurance policies online and contact customer service through an online chat option or a phone call.
There are plans that cover pre-existing conditions under certain conditions. Generally, there is a pre-determined period of time during which pre-existing conditions are covered. The cost of such plans is naturally higher than the standard plans.
Can several family members be covered by one insurance policy?
Yes, it is possible. You can easily opt for a family float plan and have your family members covered under a single plan. There are countless benefits of these plans. The premium is slightly higher, but a lot lower if you take out different health insurance policies for different family members. The collective cost for different plans is much higher.
Family floater plans, on the other hand, are cost effective. The most common question about family floater plans is what happens if one member runs out of coverage and another member gets sick. There are solutions for these conditions.
You can upgrade the cover limit during the policy period. Of course, you have to pay some extra premium to get the comprehensive coverage.
Can you switch from one health insurance policy to another?
Portability is not limited to just the telecom sector. The Insurance Regulatory and Development Authority of India (IRDAI) has enabled portability in the health insurance industry.
If you want to change health insurer for any reason, you can submit an application for the switch. Health insurance is so far offered by general insurance companies and they cannot deny your claim for portability.
They may try to keep you, but ultimately it’s your prerogative to make the final decision. If you encounter problems related to your health insurance plan, you can file a complaint with IRDAI’s online consumer complaint redress system. It is amazingly efficient and you can expect an action within a period of 15-45 days.
Nevertheless, the IRDAI has taken tough measures to protect consumer rights and there are every possibility that your complaints will be resolved in the first stage by the insurance company itself and in that case you will not have to approach IRDAI.
What about tax exemptions?
In the current fiscal year ending in March 2015, you can claim a tax deduction up to a limit of Rs 15,000 for the payment of health insurance premium, under section 80D of the Income Tax Act. From the next fiscal year, this limit will be set at Rs 25,000 per annum.
Are you buying the right health insurance plan?
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