Health Insurance: All You Need to Know

Uncovering the Important Aspects of Health Insurance Policies

World is changing faster parallelly health issues also gets modifying from its regular form. But always there is a need for a best treatment for any health issue. In this speedy world, getting treatment for health problems has become costly in many  cases. The cost increase of the medical treatments may lead to a unexpected financial burden for many people. The  health issues or medical emergencies that are not expected may put an individual to sudden stress. Here is why the health insurance is needed, which protects an individual from the financial burden of medical emergencies. 30 Lakh Health Insurance serves as one of the comprehensive coverages that offer many benefits.   
 

Health insurance is a safety net through which the insured can safeguard their health and finances by paying premiums on an individual or a family floater basis. One can get a higher coverage at an affordable cost with the help of best health insurance plans in India from Star Health. 

Why is Health Insurance Policy Important for an Individual?

All individuals seek to acquire health insurance because it serves to provide security and financial support towards treatment when sickness strikes unexpectedly. The importance of health insurance can be analysed by different aspects, which include:

1. Impairment of high medical expenses: Medical services may be very expensive, especially when it comes to cases of chronic diseases or even when one has to undergo surgery or is hospitalised. In the absence of health coverage, individuals may have to self-finance these expenses, which may lead to financial constraints or even bankruptcy. Health insurance assists in the settling of medical expenses and offers burden relief to families and individuals.

2. Access to medical care on a timely manner: Health insurance covers the cost of medical services, including outpatient and inpatient care, diagnostic services and therapies, and also preventive and promotive services that consist of routine health check-ups and assessments. This enables individuals to seek health care even when the problems are not advanced and helps to address the potential for more complex and expensive health care.

3. Encouragement of preventive measures: In most cases, insurance company provides members with services that enable them carry out vaccinations, immunisations, physical examinations, and wellness check-ups. Precautionary measures are very effective since they can help in identifying any health issues before they get complicated. It increases the chances of improving the health status and cut down on the future health costs.

4. Protection from health-related risks: Health problems and accidents are unpredictable; however health insurance serves to lower the risk of being financially disrupted due to unprepared circumstances. Be it losing control of a vehicle, suffering from a long term condition, or falling ill unexpectedly, health insurance assures that treatment will be provided.

5. Increased access to a network of healthcare providers: Almost all health insurance policies come with a network of healthcare centres and hospital providers. Hence, it saves you paperwork hassles as your insurer will settle the medical bills with the hospital.

Advantages Of Health Insurance Plans

There are several advantages of health insurance plans that make it apt for your health insurance needs. Here are some of the benefits of health insurance.

1. Your Convenience 
You have many choices from the comfort of your home, so that you can save large effort and time.

2. Cashless Hospitalisation
One can benefit from cashless hospitalisation. The cashless hospitalisation feature allows insurance companies to settle medical expenses and bills directly with network hospitals.

3. Cost savings 
You can find out the best values for your health requirements and choose the medical insurance plan that suits your financial estimate(budget), depending on your health insurance premium. 

4. Easy Access to Network hospitals
During a medical emergency, there may be difficulty in finding a hospital. A health insurance plan may help to break this difficulty. 

5. Cumulative Bonus Advantages
In some plans, you can get a cumulative bonus of between a few per cent on the sum insured, based on the plan that you choose. However, this feature is available only for some plans.

6. Flexible Plan Options
You can choose a health insurance policy based on your needs. You may choose individual, floater or family plans depending on your needs.

7. Tax Exemptions
Below Section 80D of the Income Tax Act, the premiums that you pay to maintain most of the health insurance policies are exempt from taxes. With some of the health insurance policies, you can claim an additional deduction per year. 
However, note that these tax benefits are subject to changes in income tax laws.

8. Online Options
Instead of standing in long queues to buy or renew health insurance, you could opt for the online process. You could buy or renew policies online. 

9. Reduction of Financial Burden
Whenever you are stuck with a medical emergency where you need to pay a huge amount, then it may stress you financially. At that time, health insurance may serve as a financial stress reducer for you. 
Some basic health insurance information needs to be known before you buy health insurance.  

Types of Health Insurance Plans

Our Star Health Insurance provides different types of health insurance policies.

Here is the list of types of health insurance plans available :

Know the health insurance policy age limit and other criteria before choosing the right one.

What must be included in your Health Insurance Plans?

Choose health insurance plans wisely by seeing what they include as per their terms and conditions. Many medical insurance plans include some necessary things. Here are the main inclusions in many health insurance policies.

1) Many medical insurance plans offer coverage for the hospitalisation expenses like room rents, ICU charges, surgery expenses, doctor consultations, etc. incurred on illness, injury or accidents.

2) Many health insurance policies provide coverage for the pre and post-hospitalisation expenses related to in-patient hospitalisation.

3) It is wise to buy health insurance that covers Day Care treatments and procedures. Day Care Treatment costs are included based on the plan.

4) A few health insurance policies offer coverage to the domiciliary treatments taken at home on the advice of the medical practitioner.

5) Some health insurance policies include coverage for the organ harvesting and transplantation expenses if the insured person is the recipient.

6) Many mediclaim plans offer coverage to in-patient hospitalisations due to road traffic accidents.

7) Many plans are available with the AYUSH Coverages like coverage for the alternative systems of medicines like Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy.

8) The expenses incurred for Health check-ups are covered by many health insurance policies. 

9) Automatic Restoration options are when your medical expenses exceed your Sum Insured. This option is available only in some medical insurance plans.

What are the exclusions in the Health Insurance Plans?

There are a few things which most health insurance plans exclude. They are: 

The coverage for any form of self-inflicted injuries will not be there below Medical Insurance policies.

• Many health insurance plans will not offer coverage for the expenses for the treatment of obesity or weight control.
• Most medical insurance policies will not provide coverage for expenses incurred in treatment for cosmetic or plastic surgeries.
• Expenses incurred because of health risks for indulging in hazardous or adventure sports, will not be covered by the Health Insurance policies. 
• Dental treatment or surgery unless necessitated because of the accidental injuries and requiring hospitalisation, will not be covered by the Health Insurance Plans.
• Medical aid costs like cost of spectacles, hearing aids, wheelchairs, walkers and crutches and other similar aids, will not be covered by the health insurance plans.

Steps to Renew Health Insurance Online

Renewing your Health Insurance Online requires only a few steps. Here are the steps to renew Health Insurance Online.

• First click on the Renew tab on the official website.
• Next, type your policy number and your date of birth.
• Now, select your plan type and the preferred Sum Insured. Then choose the option Calculate & Proceed.
• Finally, select your preferred payment method and complete the transaction process.

How to claim Health Insurance?

Here are the steps to claim health insurance:

• Choose a network hospital from the insurance provider's network list. 
• Notify your insurance company about your hospitalization as soon as possible. 
• Get a pre-authorization form from the hospital's TPA desk or your health insurance company. 
• Fill out the form by providing any required documentation and then submitting it to the hospital's TPA desk. 
• Receive treatment at the hospital and pay any hospital bills at discharge. 
• Gather all necessary documents, bills, prescriptions, and discharge summaries. 
• Submit the claim form and supporting documents to your health insurance company as soon as possible. 
• Wait for a decision from your insurance company to review your claim request and either approve or deny it.

Advantages of Buying a Health Insurance Plan

Health insurance plans provides many benefits, according to the plan you buy. Here are the benefits of health insurance plans in India :

1) Pre & Post Hospitalization Expenses
The pre-hospitalization and post-hospitalization expenses are covered up to certain days as specified in the health insurance policy document. Health insurance plans covers the medical expenses that a policyholder may have incurred on an illness before getting hospitalized even the follow-up treatment expenses incurred after being discharged.  
2) Hospitalization Expenses
A health insurance plan offers coverage to the medical expenses incurred on getting admitted to a hospital for above 24 hours. This coverage includes doctor’s fee, room rent, diagnostic test fees,medicine costs,  etc.
3) ICU Charges
A health insurance policy also provide coverage for the cost of availing treatment in an ICU or Intensive Care Unit at the time of hospitalization.
4) Cashless Treatments
Cashless Treatment is a feature of many health insurance plans. Most of the best  health insurance providers in India offer this facility at their network hospitals. As per this benefit, if you get admitted to a network hospital, the hospital bills will be settled by your insurance provider under cashless claims.    
5) Ambulance Charges
It offers the coverage to the cost of ambulance services availed to reach the nearest hospital at the time of a medical emergency.  
6) Maternity Advantage 
Many health insurance companies provide maternity advantages, like pre-natal & post-natal expenses, delivery expenses, medical termination of pregnancy, etc. They provide coverage for the cost of treatment and vaccination of the newborn baby. But, note that all the maternity insurance policies have a waiting period ranging from 3 months to 4 years.
7) Day Care Procedures
It covers the cost of availing day care treatments that need hospitalization of less than 24 hours. 
8) Pre-existing Diseases
A correct health insurance policy offers coverage for pre-existing diseases after you  complete the waiting period. In general, the pre-existing diseases are covered after a waiting period of 2 to 4 years. 
9) AYUSH Treatment
It provides the coverage for the cost of availing medical treatment via the AYUSH system of medicines that includes Homeopathy, Ayurveda, Unani, Siddha and Yoga.
10) Medical Check-ups
Free preventive health check-up facilities are provided by the health insurance companies as per different health insurance companies. This checkup is offered to the insured at regular intervals only based on the policy terms and conditions.

Eligibility to Avail a Health Insurance Plan 

The eligibility criteria needed to buy a health insurance plan depends on a several factors like the policyholder age, pre-existing diseases, etc. In many health insurance plans, the following eligibility criteria must be met :

Age Criteria - The minimum age criteria for adults and children differs, and it can range from 18-65 years and 90 days to 25 years respectively. The actual age can differ from one medical insurance policy to another.

Pre-medical Screening - Pre-medical examination is needed for applicants mostly above the age of 45 years or 55 years. But, many senior citizen health plans need pre-medical tests prior to the policy issuance.

Pre-existing Diseases Disclosure - Any pre-existing illness is covered following the completion of the waiting period i.e. 2-4 years. Many health insurers enquire the applicant if they are facing any medical conditions such as cardiovascular diseases, kidney problems, high blood pressure, diabetes,  etc., during the time of buying a health insurance policy. If you are an alcoholic, then you need to tell it to the insurance company. Do tell or it may create problems at the time of claim settlement or might even result in the rejection of your claims. As per these criteria, the insurance company provides medical coverage to the applicant.

How to compare Health Insurances? 

Comparing health insurance policies is not simple by seeing the features. You have to see at the insurers, their antecedents, the price at which they market their policy and the use case. Only after you see these factors, you can compare the policy. Here are those factors : 

• Coverage: Compare the inclusions and exclusions in different plans. 
• Sum insured: See for the maximum amount, the insurer will pay for hospitalization. 
• Waiting period: The time period you must wait prior to you can file a claim. 
• Co-pay clause: Check if you have to contribute towards the claim settlement. 
• Sub-limits: See if there are any limits on some coverages. 
• Network hospitals: See if the insurer has a big list of hospitals that come under their network.   
• Room rent limit: See for the maximum amount you can claim for a hospital room. 
• Extra Advantages: Check if the policy provides free health check-ups, wellness programs, or telemedicine services.  
• No claim bonus: See if the policy provides a bonus, if you don't make a claim. 
• Discounts: Check if the health insurance policy provides discounts on the first few premiums.

How does a health insurance differ from a medical insurance?

Both the health insurance and medical insurance have similarities as well as differences. Here is the comparison between health insurance and medical insurance.

 
Need For Comparing Health Insurance Plans Online

There are many benefits of comparing health insurance plans online. The following are some of the major advantages of comparing and buying a health insurance plan online :

• Convenience in buying health insurance : While you compare different health insurance plans online, that will be both time-saving and convenient. You no need to  meet the agents for comparison and select the best plans. 
• Easier tasks: Many tasks, like health insurance plans renewal, premium payments etc., are also easier online. 
• Get access to correct information: Health insurance provides easier access to all medical insurance plans available in the market. Through this, it protects the buyers from dealing with insurance agents who might offer unreliable and biased details to attain their goals.
• Identify a Policy having Suitable Premiums: If a person chooses to buy a health plan online, he/she will compare the premiums of various policies and then buy the one that suits the budget. 
• No Brokerage fees: No brokerage fees are levied, when a person compares and buy a policy online. Hence, the buyer ends saving certain amount of money.  
• Availability of Provider/Plan Reviews: You can compare the Claim Settlement Ratio and customer reviews online,then you can check an insurance company’s capability that meets your claim requests.

Why Should You Buy a Health Insurance Plan?

There are many reasons why health insurance plans has to be bought. Here are the reasons to buy a health insurance plan :

• Provide Good Quality Medical Treatment - Health Insurance Plan helps afford the best quality medical treatment, so that you can concentrate on getting the treatment and speedy recovery. 
• Meets Sudden Medical Inflation - A health insurance policy can help you pay your medical bills, like pre and post-hospitalization expenses, in the presence and also in the future inspite of the rising medical costs.
• Helps in fighting against varying lifestyle Diseases - Health insurance permits you to pay for the long-term treatment of lifestyle diseases such as heart ailments, cancer,  etc., those that are arising have been on the rise with the changing lifestyles.
• Protect Your Savings - The health insurance helps save your hard-earned savings by covering your medical expenses so that you can get the needed treatment without have to worry about any financial worries.
• Get Cashless Hospitalization Facility - The health insurance permits you to get a cashless hospitalization facility at any of the network hospitals listed by your insurance provider. You can get cashless Hospitalization Facility through raising a cashless claim. 
• Get Tax Benefits - It enables you to save the tax on the health insurance premium that you pay below the section 80D of the Income Tax Act. This helps for better financial planning. 
• Provides Peace of Mind - It permits you to get medical treatment with peace, as you do not have to get stressed about paying huge hospital bills.

Myths about Health Insurance

There are many myths that has spread about the health insurance. So, it is necessary to be aware of it, before you buy a health insurance policy. Here are some of the myths about health insurance :

1) Health Insurance I bought Will Cover All My Medical Expenses
All the health insurance plans will have a set of exclusions/limitations, according to the IRDAI regulations. So, it is necessary to check all the policy information and the coverage offered by your insurer. You will get only the expenses that are covered in the policy and only up to the sum insured limit.

2) No Need Medical Insurance as I Am Healthy
There may be many unexpected circumstances, such as the seasonal illnesses, like dengue, malaria, or an accident, that can hit anyone anytime, inspite of being healthy. Using the medical insurance, you can avail financial help to pay for the expensive hospitalization costs. 

3) There is No Need to Declare My Pre-existing Diseases
Insufficient information or non-disclosure of pre-existing diseases can result in the rejection of the claim and can result in the  policy cancellation. So, it is a must to declare all your pre-existing diseases in the proposal form while you buy a health insurance policy.  

4) Smokers Cannot Buy a Health Insurance Policy
Many people think that the smokers cannot buy a health insurance policy. However,  there are some health insurance companies that provide medical insurance coverage for smokers as well. As smokers and alcohol consumers have risks they must have to undergo a pre-medical examination and pay a higher premium to avail the health insurance coverage.

5) I Am Already Covered Below a Group or Corporate Health Insurance Plan
Many people depend on the health insurance policies offered by their employer. But, it is needed to know that a group health insurance policy have several number of limitations. In many cases, the sum insured will not be sufficient, or it will not cover health insurance to all your family members or in some cases it will not cover the critical illnesses. The health insurance coverage tends to stop as soon as you quit your job. So, availing a health insurance coverage after retirement or quitting the job can be hard and it is expensive. 

6) Medical Insurance Will Only Offer Coverage for the Hospitalization Expenses
There are health insurance plans that do not have a cap on the period of hospitalization, although many health insurance policies offer coverage to the medical expenses for hospitalization of above 24 hours. Most of the insurers cover day care procedures, in which hospitalization of at least 24 hours is not needed. This includes  varicose veins surgery, cataract surgery, and similar other medical procedures. Also, many health insurance plans now cover OPD treatments that do not need any hospitalization at all. 

Here, we are proud to announce that our Star Health Insurance has 14,000+ hospitals across India and it has one of the highest  claim settlement ratio.

Star Health offers wide-ranging health insurance policies that provide coverage for cashless hospitalisation, pre-existing diseases, critical illness, etc., with a comprehensive network of hospitals.

Our health insurance information page serves as a tool to provide key insights on the relevant details that policyholder require to choose the right medical insurance plan for their needs.