It is rightly said that necessity is the mother of invention. This also applies to health insurance. Deteriorating lifestyle patterns and rising cost of healthcare in India have paved the way for health insurance services. This need was further aggravated by the fact that unlike in the West, social security systems are non-existent in India. The governments have made all the provisions to collect the tax from the citizens at all possible points but when it comes to health care and social security, it has done nothing.
Therefore, it is the citizen’s responsibility to insure himself. But it is not so smooth to get the right health insurance policy. There are more than two dozen general insurance companies that are offering different types of health insurance plans in India. Many times, people end up buying health insurance plans that are not relevant to them and that do not help them in their time of need.
Therefore, it has a crucial significance to understand the nuances of the health insurance plans and only then take a decision. Here is a quick list for you.
What do all health insurance plans cover?
Health insurance plans are primarily meant to provide you coverage against hospitalization and critical illness. Most plans cover this. But, there are many plans, which do not cover certain types of health diseases. For example, you can find various mediclaim plans that do not cover issues related to blood pressure and diabetes.
The scope of coverage may also be different. For example, not every plan covers post-hospital costs. In some the coverage period can be as long as 45 days and in some the period can be as little as a week.
It is your responsibility to check on these matters. If you are relying on the insurance agent following you, it can cost you dearly at a later date. Agents are interested in making sales and commission. They can show their concern and tend to offer you the best plans, but the reality can be very different. So, just take care of these aspects.
The development of the health insurance industry in India has motivated insurance companies to introduce comprehensive plans. A wide range of riders are also available at your disposal. Therefore, if you buy a standard policy, you can add riders that can provide you cover against many other risks such as permanent disability benefit, diabetes cover, etc.
Do they cover pre-existing conditions?
Most mediclaim plans in India do not cover pre-existing conditions unless specified. Do not assume about this matter. If you are looking for cover against a pre-existing medical condition, then clarify it in the first instance. You can compare health insurance plans online and consult with customer care center through online chat option or phone call.
There are plans that cover pre-existing diseases in certain conditions. Generally, there is a pre-specified period under which pre-existing conditions are covered. The cost of such plans is naturally higher than standard ones.
Can multiple family members be covered under one plan?
Yes, it is possible. You can simply choose a family floater plan and get your family members covered under one plan. There are a large number of benefits of these plans. The premium is a bit higher but quite less if you go for different health insurance plans for various family members. The collective cost for various plans is much higher.
Family floater plans, at the other end, are cost effective. The most frequently asked question about family floater plans is what happens if one member consumes the cover limit and another member falls ill. There are solutions to these conditions.
You can increase the cover limit during the policy period. Of course, you have to pay some additional premium to get the extended coverage.
Can you switch from one health insurance plan to another?
Portability is not limited to the telecom sector only. The Insurance Regulatory and Development Authority of India (IRDAI) has made portability possible in the health insurance sector.
If, for any reason whatsoever, you wish to change your health insurance service company, you can submit a change application. Health insurance is offered by general insurance companies, so far and they cannot refuse your request for portability.
They may try to hold you back but in the end, it is your prerogative to make the final decision. If you encounter any issues related to your health insurance plan, you can lodge a complaint in IRDAI’s online consumer grievance redressal system. It is amazingly efficient and you can expect action in a period of 15-45 days.
However, IRDAI has taken tough measures to protect consumer rights and there are all possibilities that your complaints will be resolved by the insurance company itself at the first stage and you will not have to approach IRDAI in that case.
What about tax exemptions?
In the current fiscal year ending March 2015, you can claim tax deduction up to the limit of Rs 15,000 for paying health insurance premium, under Section 80D of the Act -Income Tax. From the next fiscal year, this limit is set at Rs 25,000 per year.
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