Health Insurance

What is Health Insurance?

Health insurance plan or policy is also called a medical insurance policy. Top health insurance companies in India offer medical insurance plans that cover injuries, illnesses, and other situations.

Various types of health insurance policies are available, from basic hospitalization insurance to comprehensive policies with extra benefits such as preventive medical health care.

Do you know?

According to Forbes Health Insurance Statistics – 2024

  • In 2021, only around 37% of the Indian population had health insurance coverage.
  • This translates to nearly 400 million people in India lacking health insurance.
  • While estimates suggest 70% of the population could have public or private health insurance, a significant portion remains uncovered. This represents over 40 crore individuals, or 30% of the population, without health insurance.

If you are among the 40 crore people without health insurance then our team can help you to choose the best health insurance plans that provide financial security for your family.

Types of Health Insurance Plans in India:

There are different types of health insurance plans available in India. An individual health insurance policy covers only one person, while a family floater policy covers the entire family for one premium. When you’re diagnosed with a serious illness, such as cancer or a heart attack, critical illness insurance gives you a lump-sum payment.

Family health insurance plans in India include insurance for the whole family under the same insurance policy. In most cases, the policyholder are the spouse, and any children who are dependent on them.

  • Coverage for the primary insured, spouse, and dependent children
  • Daycare procedures, hospitalization, and surgical expenses
  • Pre-/post-hospitalization expenses are included in maternity benefits

Group health insurance policy covers a group of people, usually employees, members of an organization, or members of society. Health insurance plans for groups are usually more affordable than individual plans as they are spread over more people.

  • Coverage for a group of people under a single policy
  • Typically offered by employers to their employees
  • Often includes medical, dental, and vision coverage

The individual health insurance plans available in India protect individuals from a wide range of health-related expenses. The plans cover medical treatments, hospitalizations, and other aspects of healthcare.

  • Personalized coverage based on individual needs
  • Prescription drugs, hospitalization, and medical expenses covered
  • Different deductibles, copays, and coverage limits are available

Senior citizen health insurance policy is designed to cover the healthcare needs of individuals over 60 years of age. These insurance plans cover a variety of health expenses, customized for seniors’ needs.

  • Coverage for individuals over a certain age (60-65 years)
  • Treatments for age-related illnesses and pre-existing conditions
  • Premiums and coverage options vary according to health and age

How To Choose Best Health Insurance Plan In India

The best health insurance plan for your needs is determined by several factors. Several factors need to be considered:

  • Ensure that the plan covers hospital visits, medicine, and doctor’s visits.
  • Pay attention to the monthly premium and the deductible and copay you have to pay when receiving care (premium and copay).
  • To save money, look for doctors and hospitals in your plan’s network.
  • Look into the plan’s coverage limits, like not covering certain conditions.
  • Learn how to make a claim and how long it takes for payments to be made.
  • Find out if the insurance company has good customer service when you need it.
  • Take advantage of extra benefits such as wellness programs and discounts.
  • Check what other people have said about the insurance company.

Factors Affecting Health Insurance Premiums In India

Health insurance premiums in India are influenced by a number of factors. In order to obtain an affordable insurance policy, older individuals must pay higher premiums because older individuals are more prone to health problems. A higher coverage amount results in higher premiums, as does the sum insured.

  • Age: Older people might pay more because they need more medical care.
  • Health: You could pay a higher premium if you are not healthy or have a medical condition.
  • Lifestyle: If you smoke or drink heavily, or if you are very overweight, your insurance premium will rise.
  • Coverage: A higher level of coverage will cost you more.
  • Plan type: Costs can vary between plans (such as individual and family plans).
  • Location: There are different costs in different locations.
  • Claims: The premium you pay might be higher if you have filed claims before.
  • Hospitals: You may need to pay more if you can use a certain hospital under some insurance plans.
  • Policy length: Policies that are longer may be more expensive.

What Is The Best Way To Save Tax With Health Insurance?

  • If you are under 60 years of age, you may be able to claim a tax exemption on health insurance premiums up to ₹25,000.
  • There is a maximum tax deduction of ₹50,000 for seniors on their insurance premiums.
  • There is a maximum deduction of ₹50,000 if both individuals and parents under 60 pay the premium.
  • In the case of a premium paid by an individual and a family under 60 years of age, but parents over 60 years of age, the maximum deduction is ₹75,000.
  • The maximum deduction for both individuals and parents over 60 years is ₹1 lakh.
  • Health check-ups for preventive purposes are eligible for an additional deduction of ₹5,000. As long as the deduction does not exceed ₹25,000 or ₹50,000, based on the individual’s health insurance policy, the deduction cannot exceed the maximum deduction threshold.
  • A deduction for these expenses is allowed under the Income Tax Act, 1961 section 80D.

What Is The Eligibility Criteria For Health Insurance?

Health insurance is only available to people who meet certain requirements. There are several factors to consider, such as how old you are, where you live, and whether you have any existing health problems. You must check what the rules are before you apply to different insurance companies and plans.

Some of the Requirements are:

  • An applicant for health insurance must be over 21 years old.
  • For a family floater policy, the minimum age for a child to be covered is 3 months.
  • Two adults and two children are the maximum size allowed under the family floater policy.
  • If you are 56 years or older, you will need to undergo a medical check-up in a designated center. The eligibility for health insurance depends on your medical condition and pre-existing illnesses.

What Is The Ideal Health Insurance Coverage?

It is recommended that people buy health insurance plans with at least half their annual income as a sum insured. To protect against medical inflation, experts recommend purchasing a medical insurance policy that covers a minimum of 10 lakhs.

Those who purchase health insurance should have coverage that is tailored to their medical needs and circumstances. Medical insurance coverage amounts are largely determined by three factors:

  1. Residence city (i.e. tier-1, tier-2 or tier-3)
  2. Insurance policyholder’s age or stage of life
  3. Future hospitalization expenses (considering medical inflation)

 

Health Insurance Policy- Types An ideal amount of health insurance coverage
City
Tier-1 Tier-2 Tier-3
Individual Health Insurance Plan ₹10 lakh & above ₹5-10 lakh ₹5 lakh
Family Floater Health Insurance Plan ₹30 lakh & above ₹20 lakh & above ₹10 lakh & above
Senior Citizen Health Insurance Plan ₹20 lakh & above ₹15 lakh & above ₹10 lakh & above

 

*Disclaimer: The above sum insured is a guide and may differ according to age and medical condition.

There is also the option of purchasing a “1 crore” health insurance policy, which has become extremely affordable lately. Having a $1 crore health insurance policy can be helpful in cases of long-term illness or for treatments abroad. A premium of ₹1500 more will secure health coverage of up to ₹ 1 crore.

 

It is also possible to buy a base policy with a low sum insured and then buy a top-up policy with a high sum insured, which is an affordable option.

Documents Required for Health Insurance

Check out the KYC documents required for buying or renewing health insurance in India. Be prepared with your health insurance documents before you purchase or renew it.

  • Aadhaar Card
  • Driving License
  • Passport
  • Voter ID Card
  • Letter by the National Population Register with demographic details
  • Ration Card

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