What Does Health Insurance Cover?

Health Insurance Coverage in India: Key Benefits and Inclusions

Health insurance is a financial product that covers an individual’s medical costs, acting as a bond between the policyholder and an insurance firm. It provides a person with financial protection against healthcare expenses due to sickness, injury, or accident in return for a fixed payment of premium contributions. 

Such policies are crucial for every individual, particularly patients in chronic care, families with dependents, and any other person wanting protection against unforeseen health costs. 

Keep reading to know what health insurance coverage in India includes and how it can help cover your medical requirements.  

Top 8 Coverages Under a Health Insurance Policy

The following are the top 8 coverages usually included under a health insurance policy:

1.Pre- and Post-Hospitalization Costs

Health insurance usually covers the expenses made before and after hospitalization. Pre-hospitalization expenses include doctor consultations, diagnostic tests, and medicines before the hospitalization, usually covered for around 30 days prior to hospitalization. 

Post-hospitalization expenses include follow-up consultations, tests, and medication after discharge, usually covered for up to 60 days. However, the duration of coverage may vary depending on the insurance provider and the policy type.

2.Maternity Coverage

This benefit comprises pre-natal charges such as routine health checkups, ultrasounds, and scans to ensure the baby's health. Expenses incurred during the hospital stay for delivery, such as room rent, nursing fees, doctor's fees, anesthesia, and operation theatre charges, for normal and C-section deliveries, etc., are also included under this coverage. 

Furthermore, it covers postnatal costs such as re-visits, testing, and medications post-delivery, typically payable for up to 60 days following discharge. 

Post-delivery newborn baby care and treatment, covering vaccinations, immunizations, and treatment for congenital disabilities, typically up to 90 days from the date of childbirth, are also included in maternity coverage.

3.Expenses of Day Care Treatment

Health insurance usually pays for the cost of daycare treatment, involving procedures which take less than 24 hours of hospitalization. Dialysis, chemotherapy, and eye surgery fall under this type of treatment.

4.In-Patient Hospitalization Costs

In-patient hospitalization costs cover the expenses incurred when a patient is admitted to a hospital for treatment. This includes room rent, nursing charges, surgeon's and doctor's fees, cost of medicines, operation theater charges, etc.

5.Expenses of Preventive Health Checkup

Many health insurance plans now include coverage for preventive health checkups. They help in the early detection of potential health issues, allowing for timely intervention and management. The costs of these checkups, including various tests and consultations, are covered by health insurance policy.

6.AYUSH Treatment

AYUSH (Ayurveda, Yoga & Naturopathy, Unani, Siddha, and Homeopathy) treatments are increasingly being covered under health insurance policies. This inclusion reflects a growing recognition of traditional and alternative medicine systems in healthcare. 

The coverage extends to hospitalization expenses incurred while undergoing AYUSH treatments, providing policyholders with a broader range of healthcare options.

7.Pre-existing Diseases

Most health insurance policies cover pre-existing diseases after a specified waiting period. It includes any ailment or condition that the insured individual had before obtaining the health insurance policy. 

The waiting period for pre-existing diseases can vary, but after this period, the insurance policy will cover the treatment costs, offering significant financial relief to those with chronic conditions.

8.Ambulance Costs

Health insurance policies typically cover ambulance charges, ensuring that transportation to a hospital in an emergency is financially protected. This coverage includes the cost of the ambulance service, providing immediate medical attention and safe transport during critical situations.

It is necessary to understand the inclusions of health insurance coverage to maximize your medical benefits. Knowing the key benefits allows you to choose a policy that best meets your needs and ensures financial protection against unexpected medical expenses. 

If you are looking for comprehensive healthcare coverage that includes the above benefits, contact Star Health Insurance today. 

Our policy premium starts from as low as ₹13/day to make health insurance accessible to all!

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