Health insurance plans


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Buyers Guide on Health Insurance. Choose between individual or family floater plans. Key points to remember, exclusions and benefits. Health Insurance Product Ratings. Where and how to compare health insurance policies

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Health insurance plans

  1. 1. Health Insurance 8 concepts to assist you in making informed buying decision1
  2. 2. 2 i-Save.comHEALTH INSURANCE8 concepts to consider when buying Healthinsurance in India
  3. 3. 3 i-Save.comSome basic Facts1 in 4 women and 1 in 5 men suffer from critical illnesses before they reach retirement age Critical illnesses such as heart ailment, cancer, diabetes, kidney related diseases are the most common Most critical illnesses require high medical and hospitalization costs
  4. 4. 4 i-Save.comTip 1 - Select an adequateSum Assured/Sum Insured The amount of cover purchased from an insurer is called Sum Assured It is typically for 1 year Example: A Rs. 3 lac sum assured will allow you to claim up to Rs. 3 lac for hospitalization and other medical expenses covered by your plan Any expenses higher than the sum assured, will be borne by the insurer
  5. 5. 5 i-Save.comTip 2: Decide on Individual vs.Family Floater A family floater policy covers all family members (Insured, his/her spouse and children) under one single policy  There is a limit on the number of children that can be included and age before and beyond which they are not covered  Parents of the insured are typically not included in a family floater policy An individual policy provides coverage to only the individual for whom the insurance has been purchased While a family floater may turn out to be cheaper than taking 2 or more individual policies, the associated cover provided is at a family level
  6. 6. 6 i-Save.comTip 3: Look for Cashlesshospitalization A feature provided by health insurance companies where a person can get the required treatment and the associated medical expenses are settled by the insurance company directly with the hospital The hospital must come under insurance companies network The treatment should be covered under your plan and up to a maximum of your Sum Assured Compare the associated network of hospitals of each insurer when comparing products to meet your needs
  7. 7. 7 i-Save.comTip 4: Check on MaximumRenewal Age Thisis the age to which the company would continue to provide you with health insurance on payment of premiums A product that offers a higher maximum age of renewal should be considered favorably as it allows you to remain covered under a health insurance plan especially at ages when it matter the most
  8. 8. 8 i-Save.comTip 5: Check on Exclusions Most products come with a set of defined exclusions Any costs associated with an excluded medical condition will not be covered by your health insurance product While exclusions vary across products the following are most common and are excluded under most products:  Expenses arising from HIV or AIDS and related diseases, use or misuse of liquor  intoxicating substances or drugs & intentional self injury  War, riots, strike, nuclear weapon, induced treatment Compare exclusion clauses of insurance products before buying
  9. 9. 9 i-Save.comTip 6: Review the Critical Illnesscover Generally available as a top-up or rider with your health insurance policy. These plans cover you for certain specific critical illnesses that are pre-defined as being covered under the plan The insured is paid the Sum Assured as a lump sum amount within a few days of a critical illnesses being diagnosed. Once this lump sum is paid, the plan ceases to exist Difference between Heath insurance plan & Critical Illness plan  Health Insurance plans cover costs related to hospitalization on account of any medical condition or injury  Critical Illness plans cover only pre-specified illnesses. Both are bought for a specified Sum Assured (the maximum benefit payable by the insurance company). They are typically sold for one year with a renewal option A health insurance policy with a critical illness rider will help you meet your hospitalization expenses for both critical illnesses or even other diseases/accidents through the health policy
  10. 10. 10 i-Save.comTip 7: Understand the WaitingPeriods Most health insurance policies have a waiting period that varies from 30-90 days No claims are permissible during this waiting period Waiting period does not include any accidental emergencies which are usually covered from day 1 The waiting period varies with product and company and is a feature that you should compare at the time of purchasing health insurance There are also certain diseases that are not covered for specific waiting periods. These waiting periods as well as the specified diseases to which these periods apply vary across companies and products and range from anywhere between 1 to 4 years
  11. 11. 11 i-Save.comTip 8: Determine the Pre-existing disease cover Any disease or ailment already in existence at the time of purchasing a health insurance policy is termed as a pre-existing condition All pre-existing illnesses at the time of taking the policy are generally excluded from the health insurance cover In some products pre-existing illnesses may be covered after a specified waiting period. It means that if you continue with an insurance product (i.e. keep renewing your policy) for the specified period, then certain pre-existing illnesses may be covered on the completion of the waiting period This waiting period varies by product and insurance company
  12. 12. 12 October 25, 2011How to get Health Insurance Always Compare available plans before buying Check the product benefits, terms and conditions and company’s service history Review the i-save Ratings for insurance products – as published in India’s leading newspapers