“Health is wealth” - It is not merely a saying but also a fact that constantly reminds us to prioritise our health. Additionally, the rising healthcare cost is restricting access to quality healthcare when required for a sizable chunk of the population.
At this point, health insurance becomes a quintessential financial tool that helps in getting quality treatment without worrying about the hefty medical expenses.
By offering necessary financial coverage during health-related emergencies, health insurance allows you to avail the best possible medical treatment without pushing yourself into debt.
In this comprehensive guide, we will discuss what is health insurance, how it works and why you should purchase it, along with other important information.
Health Insurance Meaning: What is Health Insurance?
Health Insurance, also known as medical insurance, is a contract between an individual (you) and an insurance company. Under this contract, the insurer agrees to cover all or some portion of the medical expenses incurred by you in exchange for a regular premium.
These medical expenses usually include hospitalisation, medicine costs, doctor consultation fees, surgical procedures and much more as per the health insurance policy's terms and conditions.
The financial coverage or sum assured or coverage is pre-decided by you and your insurer.
Let’s understand what is health insurance with the help of an example.
Suppose you are a perfectly healthy and active individual. One fine day, you start feeling pain in your chest, and the doctor prescribes immediate cardiac surgery, which can cost around ₹10 lakhs.
If you don’t have a health insurance policy, you have to pay this hefty amount out of your pocket, which can impose an additional financial burden. However, if you have a health insurance plan, a big portion of the medical cost will be covered by your insurer.
How Does a Health Insurance Policy Work?
The working of a health insurance policy is simple. Here is a brief overview of how it works:
Step 1: Purchase a Health Insurance Plan
First and foremost, you purchase a suitable health insurance plan based on your coverage requirements and budget. For this, you need to pay a nominal policy maintenance fee known as the insurance premium.
Step 2: Occurrence of Medical Emergency
A health insurance plan comes with a tenure, which is usually one year. Suppose you encounter an unprecedented medical emergency during your policy period.
After experiencing the medical emergency, you file a claim to your insurance provider regarding the expenses incurred in the treatment of your medical emergency.
Your health insurance company settles the expenses as per the policy terms and conditions.
Types of Health Insurance Plans
Individual Health Insurance:
Individual health insurance is one of the most common types of health insurance available in the country. It is designed to meet the coverage requirements of a single person and offers coverage for all unforeseen medical needs, including emergency hospitalisation, outpatient treatment, daycare procedures, and more.
One of the primary
benefits of individual health insurance is that it provides dedicated coverage to your unique requirements.
Family Health Insurance:
As the name suggests, family health insurance plans are designed to offer financial coverage to a family rather than an individual.
You can purchase a single family insurance policy to cover yourself, your spouse, your parents and dependent children.
The main benefit of family floater plans is that they are easy to manage and often cost-effective, as you don’t have to purchase individual policies for each family member.
Senior Citizen Health Insurance:
These plans offer specialised coverage based on the varying needs and healthcare requirements of aged individuals.
They often come with additional benefits like domiciliary hospitalisation, preventative care, wellness programs, etc.
International Health Insurance :
International health insurance plans provide you with international coverage with benefits like worldwide hospitalisation to ensure you stay protected regardless of where you are.
With our international health plans, you can get coverage for emergency and planned hospitalisation within the country.
Top-up Health Insurance :
Top-up health insurance plans are another popular type of insurance that acts as a backup to your existing health insurance policy.
In other words, these plans offer additional coverage if you end up exhausting the maximum limit of your existing health insurance plan.
Critical Illness Health Insurance :
Critical illness insurance is a type of health insurance policy designed to offer coverage for life-threatening medical conditions such as cancer, kidney failure, cardiac issues, and so on.
Unlike other plans,
critical illness insurance plans offer a one-time lump sum amount as soon as a critical issue is diagnosed. This amount helps cover the hefty treatment cost.
Accidental Health Insurance :
Accidental health insurance plans offer coverage for medical expenses arising from injuries or health issues caused by an unforeseen accident.
With our Accidental Health Insurance, you get benefits such as hospitalisation, total loss or disability benefits, accidental death coverage, and more.
Group Health Insurance :
Group health insurance plans are designed to cater to the insurance needs of a group of individuals.
These are usually purchased by employers and group leaders to cover all the members of the organisation.
The benefits and sum insured for group insurance plans are shared among all the group members.
Important Features of Health Insurance Plans
Sum Insured :
Sum insured is the highest amount you can claim after facing a medical emergency included in your health insurance policy.
In simple words, it is the maximum claim limit of your insurance plan. The value of the sum insured is decided by you at the time of buying a policy.
Cashless Hospitalisation:
Cashless hospitalisation is one of the most important health insurance features that allows you to get cashless treatment at any healthcare facility of your choice.
While you can avail of cashless hospitalisation across any hospital in the country, getting it at a network hospital allows additional perks like quality treatment, quick settlement, minimum out-of-pocket expenses and more.
Insurance Premiums :
Premium is the amount of money you pay to the insurance company to maintain your coverage. Depending on your preferences, it can be paid in monthly instalments or one-time yearly payments.
Please note that the premiums are not fixed. They vary from one policyholder to another based on individual coverage needs, type of policy, age of insured, chosen deductibles, copayment percentage and so on.
Claims Settlement Ratio:
It is another key feature of health insurance plans. It refers to the ratio of settled claims to the total number of claim requests received by the insurance company.
A higher claims settlement ratio reflects an efficient claims settlement process, whereas a lower CSR reflects the opposite.
Add-ons :
Add-ons or riders are insurance products designed to enhance the coverage of health insurance plans. They can be purchased along with a policy to receive additional benefits.
Some of the most popular health insurance add-ons in India are maternity cover, critical illness cover, wellness programs, alternative treatment coverage, etc.
What are the Benefits of Health Insurance?
Financial Protection:
Health insurance costs in India are increasing rapidly, making quality healthcare unaffordable for individuals. By offering the required financial coverage, a health insurance policy allows you to get the best treatment without burning holes in your pockets.
Access to Quality Healthcare :
Besides financial coverage, health insurance plans also let you avail quality treatment at network facilities. From hospitalisation and routine check-ups to in-patient/out-patient care and preventative treatment, you can avail all these benefits at the network facilities of your insurance provider.
Preventative Care :
Prevention is far better than cure. Following this principle, the best health insurance plans offer preventative care through services like routine check-ups, medical screenings, vaccinations, and more.
Additional Coverage via Add-ons :
By purchasing certain add-ons, you can make your health insurance plan even more comprehensive. For instance, by purchasing a maternity cover, you can enjoy coverage for medical expenses related to childbirth. These include prenatal and postnatal care, newborn care, etc.
COVID-19 Coverage:
Everyone knows the havoc caused by the deadly coronavirus. A health insurance plan covers other medical expenses and offers extensive coverage for the prevention and treatment of COVID-19. This includes emergency hospitalisation, vaccinations, screenings, and more.
Alternate Treatment:
The best health insurance plans like ours, come with coverage for various alternate treatments such as naturopathy, ayurveda, etc. making sure you get the best results possible.
Why Do You Need Health Insurance?
According to the World Bank report, approximately
49% of Indians pay for their health expenses out of their pocket.
Not to mention, India has the highest healthcare expenditure in Asia, which reflects the skyrocketing cost of healthcare services.
However, increasing out-of-pocket expenses are not the only reason to consider investing in a healthcare plan. There are many other reasons to invest in medical insurance plans now.
Changing Lifestyles:
We are living a fast-paced life with busy schedules and little to no time to focus on our health and well-being. This, in turn, has taken a huge toll on our mental and physical health.
At this point, having health insurance becomes indispensable knowing the increased health uncertainties and financial burden attached to them.
Mitigate Rising Medical Cost :
Rising healthcare cost is a major reason why people think twice before prioritising their health. Even if they do, they have to face exorbitant healthcare charges that push them into significant debts.
On the contrary, dealing with medical expenses becomes easier with health insurance as your insurance company takes the responsibility of sharing a considerable portion of your unforeseen expenses.
Reduce Out-of-Pocket Expenses :
Getting quality treatment is one thing, and paying the hefty bills from your pocket is another. Health insurance helps you reduce your out-of-pocket health expenses by covering a significant chunk of your emergency medical spending.
It helps in minimising the financial burden and accessing quality healthcare promptly.
Tax Savings:
Besides the above-mentioned benefits, investing in medical insurance plans can also help you increase your tax savings.
As per Section 80D of the Indian Income Tax Act, you can avail of up to ₹1 lakh tax deductions on premiums paid towards health insurance purchased for yourself, your spouse, dependent children, or your parents.
Peace of Mind :
Last but not least, having health insurance is like having someone you can financially rely on during your medical crisis.
It provides you with the peace of mind you deserve and lets you live your life without constantly worrying about unseen scenarios.
How to Buy Health Insurance Online?
Here is how you can purchase health insurance from Reliance General Insurance:
Step 1: Visit our
Health Insurance page.
Step 2: Enter your name, mobile number and pin code and click on “Get Prices”
Step 3: Enter and verify the OTP sent to your mobile number.
Step 4: Follow the instructions to choose a plan and make the payment.
Step 5: Once payment is done, your policy documents will be sent to the registered contact details.
Tips to Purchase the Best Health Insurance Plan in India
Determine Your Requirements :
Health insurance requirements differ for everyone. They vary based on numerous factors such as age, income, location, medical status, and so on.
For instance, a young individual may require less coverage as compared to an ageing individual. This is why the most crucial tip to buy the best health insurance plan is to outline your unique health coverage requirements.
With this approach, you will be able to buy the best plan that not only meets your financial needs but also matches your budget.
Compare Multiple Plans :
Purchasing the best health insurance scheme can be challenging, given the wide range of available options.
The right approach is to compare multiple plans based on your specific needs and budget to choose the best one.
When doing so, pay special attention to factors like type of coverage, premiums, claims settlement ratio, sum insured, customer reviews, etc.
Decide on Premiums :
Health insurance premiums are a key factor to consider when purchasing a suitable policy. They are the amount you pay to your insurer for maintaining your coverage.
It is like a subscription fee you need to pay at regular intervals during your policy tenure. While health insurance is essential, it should not add to your financial burden.
Thus, select a reasonable premium amount that justifies the coverage you are getting.
Consider Additional Benefits :
When selecting the best health insurance plan for yourself and your family, pay close attention to additional benefits such as no-claims bonuses, add-on availability, automatic renewals, and so on.
Evaluate Inclusions and Exclusions :
Before finalising a policy, consider evaluating its inclusions and exclusions to ensure that it covers all potential health scenarios.
Opt for Higher Claims Settlement Ratio :
The higher the claims settlement ratio, the better the chances of a stress-free settlement of your claims. Always go for an insurance provider with the highest claims settlement ratio.
Examine Customer Reviews :
Customer reviews and testimonials truly reflect an insurance provider's capabilities. So, review the reviews of existing policyholders to decide if a policy is worth buying.
Conclusion
Health insurance is a quintessential financial management tool that allows you to avail quality treatment and timely medical care without worrying about the resulting cost. By purchasing a health insurance plan for yourself and your family, you can ensure a safe and stressful life while making health and well-being your priority.
For these reasons, purchase health insurance at the earliest to avail all the benefits we have discussed.
At Reliance General Insurance, we provide insurance plans that stand out for providing comprehensive coverage at premiums starting as low as ₹243 per month.
In addition, we offer a 100% claims settlement ratio and benefits like cashless hospitalisation, an extensive list of inclusions and exclusions, no-claim bonuses, and more.
Get your quote today!
Frequently Asked Questions
1. What is the right age to buy health insurance plans?
There is no such thing as the right age to buy health insurance. You should buy a policy as soon as possible after completing the minimum age requirement of 18 years. The reason behind this is simple: health emergencies are inevitable.
They can strike anyone regardless of their age, health status, or gender. Moreover, you can enjoy multiple benefits by purchasing your health insurance early. These include low premiums, no pre-medical checkups, etc.
2. Should I buy an individual or family floater health insurance?
Individual health insurance offers coverage only to the policyholder, i.e. you. On the other hand, a family floater plan can offer coverage to your entire family, including yourself, your spouse, dependent children and parents.
It is more cost-effective and convenient as you can insure all your family members under one plan instead of purchasing individual policies for each member.
3. I am covered under a group insurance policy provided by my employer. Should I still buy another health insurance plan?
The extent of coverage offered by group health inside the plan is limited as the benefits are shared
among multiple members. Thus, it is recommended to purchase an individual health insurance policy for dedicated and tailored coverage as per your demands.
4. What kind of medical expenses are covered by health insurance plans in India?
The best medical insurance policies offer coverage for the following medical expenses. It is advisable to check these benefits when buying a plan for yourself or your family.
Pre and post-hospitalisation
Hospital room rent
Surgical cost
Pharmacy cost
Doctor consultation fees
Ambulance cost
Daycare cost
ICU rent
Preventive care (routine check-ups, vaccinations, etc.)
Critical illness coverage
Note that these insurance benefits can vary depending on your plan and insurance provider. It is always recommended to confirm the same before making a final decision.
5. What if I don’t need to make a claim during a policy year? Does it mean my money is wasted?
No. Not making an insurance claim does not mean the waste of your money. If you don't make any claim during your policy year, you become eligible for a No-claim Bonus.
This benefit allows you to enjoy discounted premiums on your policy renewal. In other terms, you can enjoy comprehensive coverage at a low premium cost.
