It has been rightly said that necessity is the mother of invention. This also applies to health insurance. The deteriorating lifestyle and rising cost of healthcare in India have paved the way for health insurance services. This need has further exacerbated the fact that unlike the West, the social security system is non-existent in India. Governments have made all provisions to withdraw taxes from citizens at all possible points but when it comes to health care and social security, it has done nothing.
Thus, it is the responsibility of the citizen to protect themselves. But it is not easy to get the right health insurance policy. There are more than two dozen general insurance companies offering various types of health insurance plans in India. Many times, people buy health insurance plans that are not relevant to them and which do not help them in times of need.
Therefore, it is of vital importance that you understand the nuances of 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 mainly to provide you coverage against hospitalization and critical illnesses. Most plans cover this. However, there are many schemes, which do not cover certain types of health diseases. For example, you can find many mediclaim plans that do not cover issues related to blood pressure and diabetes.
Coverage may also vary. For example, not every plan covers post-hospital expenses. In some, the coverage period can be as large as 45 days and in some the duration can be as short as one week.
It is your responsibility to investigate these matters. If you are relying on an insurance agent who is following you, it can cost you dearly at later dates. Agents are interested in making sales and commissions. They can show their concern and offer you the best plans, but they can be very different realities. So, just take care of these aspects.
The growth of the health insurance industry in India has prompted insurance companies to introduce comprehensive schemes. A wide range of riders are also available at your disposal. Thus, if you buy a standard policy, you can add riders who can provide you cover against many other risks such as permanent disability benefits, diabetes coverage, and more.
Do they cover pre-existing conditions?
Most mediclaim schemes in India do not cover pre-existing conditions, unless specified. Do not believe this matter. If you are looking for coverage against an already existing medical condition, make it clear in the first instance. You can compare health insurance plans online and consult customer service center through online chat option or telephone call.
There are plans that cover pre-existing diseases on certain conditions. Generally, there is a pre-specified period under which pre-existing conditions are covered. The cost of such schemes is inherently higher than standard ones.
Can multiple family members be covered under one scheme?
Yes it’s possible. You can simply opt for a family floater plan and cover your family members under one plan. These schemes have innumerable benefits. If you go for different health insurance plans for different family members, the premium is slightly higher, but significantly lower. The collective cost for various schemes is very high.
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 coverage limit and the other member falls ill. There are solutions to these situations.
You can top-up the coverage limit during the policy term. Of course, you need to pay some additional premium to get extended coverage.
Can you switch from one health insurance plan to another?
Portability is not limited to the telecom sector alone. The Insurance Regulatory and Development Authority of India (IRDAI) has made portability possible in the health insurance sector.
If, for any reason, you wish to change your health insurance services company, you can file an application for a switch. Health insurance is provided by general insurance companies, so far and they cannot deny your claim for portability.
They may try to retain you but in the end, making the final decision is your priority. If you come across any issue related to your health insurance plan, you can file a complaint in IRDAI’s online consumer grievance redressal system. It is surprisingly efficient and you can expect action within a period of 15–45 days.
However, IRDAI has taken stringent steps to protect consumer rights and there is every possibility that your complaints are resolved by the insurance company in the first phase and you do not need to contact IRDAI in that case.
What about tax exemption?
In the current fiscal year ending in March 2015, you can claim tax deduction up to the limit of Rs 15,000 towards payment of health insurance premium under Section 80D of the Income Tax Act. This limit has been fixed at Rs 25,000 per year from the next financial year.