Types of health insurance policies


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There are three types of health insurance cover available in the market today. These are:


These policies cover you for hospitalization expenses. Actual hospitalization expenses are paid subject to a maximum limit of the sum assured opted for. All insurers offer policyholders cashless treatment in their network of hospitals. Policyholders can also pay upfront and then claim reimbursement from the insurer.

We recommend Mediclaim as a basic “must have” health insurance to our customers. Mediclaim can be individual or a family floater. In individual every person has his or her own individual policy. In a family floater the members of a family pay a single premium and have one insurance policy that covers the family. Sometimes parents and in-laws can also be included in the family cover. A floater cover provides a lot of flexibility for the family and normally works out more economical.

Fixed Benefit Cover

These is a new class of insurance products in the Indian market. These plans pay a pre-determined sum of money depending upon the number of days a person is in hospital and the type of surgery done. This amount may be more or less than the actual expenses you incur. We recommend this as an additional insurance to purchase after you have the basic mediclaim policy. Similar to the indemnity cover, fixed benefit cover has individual and family floater options. Fixed benefit policies will pay you the benefit even if the actual costs are reimbursed by a mediclaim policy.

Critical Illness plans

In these plans a fixed sum of money is paid if the person gets certain pre-specified diseases. Plans can cover anywhere from 9 to 35 diseases. In our view these plans are best bought after one has the basic medicliam and fixed benefit plans. They are ideal for diseases that are debilitating but may not require constant hospitalization - for example cancer or renal failure.

Each of the insurance plans described here can be taken for a single Individual or may include dependents such as the spouse, minor children, parents, parents-in-law, grandparents and grandchildren.

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Types of health insurance policies

  1. 1. There are Three Basic Types of Health Insurance Policies Mediclaim Policy Fixed Benefit Plans Critical Illness Plans SecureNow
  2. 2. Mediclaim Policy It is an Indemnity Policy Case 2 Your Actual Insurance Case 1 Actual treatment Cover, The expense – Sum treatment expense – Z (> X) Insured - X Y (< X) Amount Amount Reimbursed = Y Reimbursed = XYour insurance payout will be the lower of the two values – SecureNow the sum insured and the actual expenses
  3. 3. If the insurer is offering cashless facility at its approved hospital networks…..…. You would need to pay only the amount in excess of the amount being coveredIf you are being treated in a hospital outside the insurer’s network OR the insurer doesnot offer cashless facilities, you need to pay first and then claim reimbursement SecureNow
  4. 4. Individual and Family Floater Mediclaim Family Floater Policy manages Policiesyour risks better In case of individual policies, 2L for member than individual 1 and 50,000 for policies in most member 3 will be paid circumstances. out. 50,000 of first Actual Expense member’s expenses Illustration for a Individual Family during a year will not be paid family of 3 (2 Cover Floateradults, one child) Total Premium paid pa – Rs 7,912. Member 1 2 Lakhs 2.5 Lakhs 4 In case of a Member 2 2 Lakhs floater policy Lakhs cover of 4 Lakhs, the entire amount will be Member 3 50 paid out. 2 Lakhs Thousand Total Premium paid pa – Rs 7,702.
  5. 5. Fixed Benefit Plans In the event of hospitalization, the insurer pays a predetermined amount irrespective of actual expense A certain amount per day spent in hospitalA certain addl. amount per day spent in ICU of the hospital A certain addl. amount in the event of surgery at the hospitalWhether the actual expense is more or less than the actual expense, the benefit SecureNow a given premium paid. is fixed for
  6. 6. Critical Illness Plans Similar to fixed benefit plans in structureOnly pre specified diseases are covered – range from 9 to 35 for various insurers Any disease outside the pre specified diseases are not covered Ideal for diseases that are debilitating but may not requireconstant hospitalization - for example cancer or renal failure SecureNow
  7. 7. Our RecommendationBuy the Comprehensive Medicare Policy first as your basic cover. It takes care of most of your needsEvery 5 years or so, add a fixed benefit Plan to take care of added costs of medical care.Buy a critical illness plan as a rider plan to take care of the rare but debilitating diseases SecureNow
  8. 8. Get Your Health Insurance Cover Now!
  9. 9. Fill in your details on our inquiry form. We will call you back!SecureNow Insurance Broker Private Limited 3rd Floor, 29 Hauz Khas Village, New Delhi 110016 Web – www.securenow.in SecureNow