health insurance policy feature and condition

OVERVIEW:

  • Health insurance is a type of insurance service, in which anyone can employ their medical and surgical expenses. Various types of financial institutions have different schemes for them. Mainly, this insurance helps the customer in the payment of hospitalization, ambulance, nursing care, surgery, medical bills etc. During the accident or any disease. To get all these benefits, only one and only work has to be done ,that according to your income. Health insurance is purchased. The insurance company plays all these responsibilities very well. Certain insurance plans also pay for health checkups from time to time.

Every person want to know that

  • What you will get in health policy ?
  • What is the health insurance policy and condition ?
  • What is the futures if we take health insurance policy ?

we will tell you everything

 FEATURE OF health insurance policy

Cashless facility

  • This facility is only available at the network hospitals mentioned in the list provided by your insurance company.
  • Insurance companies tie up with hospitals in different parts of the country .And form a network of such hospitals which offer cashless hospitalization benefits to the policy holder.
  • In case of emergency hospitalization or planned hospitalization. The policy holder has to approach one of the network hospitals.
  • At the time of hospitalization, the policy holder is required to fill up, pre-authorization form for availing this facility. And this form is submitted to the Third Party Administrator  as appointed by the insurance provider.
  • Once the TPA (Third Party Administrator)approves the form, the patient becomes eligible for availing the cashless facility.
  • Cashless facility cannot be availed at hospitals which are not part of the network of hospitals.

Online features

The biggest thing is that health insurance can now be bought online, which was previously bought by an agent. One benefit from online .online is that beyond the breathtaking point of the customer agent, living on the realm of life will know all the information related to the insurance themselves and choose the right insurance for themselves.

Various Premium Payments

Many insurance companies in India offer the same types of facilities, but among them some companies, such as Bharti Axa and Star Health Insurance, also carry many types of ‘zone based premium’. These premiums vary for different cities and metros. It is generally seen that the health insurance of metropolis is more valuable than the general cities’ insurances

Renewal Service:

Unlike the old insurance system, many health related insurances of instant time have started coming in a more intuitive and flexible form. The old insurance system had a maximum age limit, but the service of instant health insurance is free from this condition, and the client can renew this plan anytime during its lifetime.

Help in OPD expense

Whereas a hospitalized person can insure after 24 hours in traditional insurance, some health insurance companies are also offering instant support. Under this facility, health insurance companies offer all OPD expenses of the customer. This time, ICICI and Star Health Care are offering these facilities

 

HOW MANY TYPE OF HEALTH POLICY  CLICK HERE

 

health insurance policy and condition

 Tax benefits for Health Insurance policy

  • There are various benefits provided to the policy holder under Section 80D of the Income Tax Act.
  • This section of the Income Tax Act is different from Section 80C which is applicable to life insurance wherein other forms of investments/expenditure also qualify for the deduction.
  • If a taxpayer buys a Health Insurance policy, then under Section 80D deduction is available up to Rs 25,000 for insurance of self, spouse and dependent children.
  • If the individual or spouse happens to be more than 60 years of old, the deduction available is Rs 30,000.
  • Additional deduction for insurance of parents  available is up to the extent of Rs 25,000 if they are less than 60 year old and Rs 30,000 if they are more than 60 year old.
  • For super senior citizens who are uninsured, therapeutic consumption acquired up to Rs 30,000 will be permitted as a conclusion under Section 80D.
  • Therefore, the maximum deduction available under this section is to the extent of Rs 60,000.

CONDITION OF health insurance policy

health policy cover

A health policy covers pre- and post-hospitalization expenses.

In addition to hospitalization, some specific policies offer number of additional benefits like maternity and newborn coverage, day care procedures for specific procedures, pre and post-hospitalization care, and other benefits.

A critical illness plan provides a fixed amount to the insured in case of diagnosis of a specified illness or on undergoing a specified procedure.

Health Insurance premium

  • Age plays a major role that determines the premium of the policy.
  • The older you are, the higher will be the premium because you are more prone to illnesses when you are old.
  • Previous medical history is another major factor that determines the premium.
  • If no prior medical history exists, the premium will automatically be lower.
  • Claim-free years can also be a factor in determining the cost of the premium as it might benefit you with certain discounts.

health insurance policy and condition

What does the policy not cover

  1. It is very important to read the policy document before purchasing any type of health insurance policy from an agent of the insurance provider.
  2. It helps understand what is not covered in the policy being bought. Some policies don’t cover pre=existing diseases.
  3. There are policies which exclude certain diseases from the first year of coverage and impose a waiting period. Hence, it is very important to understand policy terms and conditions.
  4. There can be some other exclusion like purchase of spectacles, contact lenses, hearing aids, dental treatment or dental surgery unless hospitalization is required.
  5. The other things which may be excluded are use of intoxicating drugs/alcohol, aids, expenses for diagnosis, x-ray or laboratory tests not consistent with the disease requiring hospitalization, treatment relating to pregnancy or child birth including cesarean section, neuropathology treatment.

 Pre existing condition in Health Insurance

  • it is possible a person suffers from an ailment before a policy is bought.
  • Pre=existing condition is broadly defined as a condition or a disease which existed before the Health Insurance policy is bought.
  • Most Health Insurance providers do not cover pre=existing conditions for a period of 4 years from purchase of the first policy.

Can the policy expire if it is not renewed on time

  • There is a grace period of 15 days available to pay the premium, from the date of expiry of the policy.
  • However, coverage would not be available for the period for which no premium is received by the insurance company.
  • The policy will become nonexistent if the premium is not paid within the specified grace period.

 

SOME QUESTION AND ANSWER FOR  HEALTH INSURANCE POLICY

 

Can a policy be transferred from one insurance provider to another provider without losing the benefits.

ANS:

  • Yes! The Insurance Regulatory and Development Authority, the regulatory body looking after the insurance sector  has issued a circular which directs insurance companies to allow transfer from one insurance company to another and from one plan to another, without making the insured lose the renewal credits for pre-existing conditions, enjoyed in the previous policy.However, this credit will be limited to the Sum Insured under the previous health insurance policy .

What  is Health insurance policy Term ‘Waiting Period”‘ for claims under a policy

ANS:

  • When you  for a new policy, there will be a waiting period of 30 days from the date of inception of the policy.
  • Any type of hospitalization  whether planned or emergency  will not be covered by the insurance provider during the span of this waiting period.
  • However, this is not applicable for any emergency hospitalization occurring due to an accident.
  • This waiting period will not be applicable for subsequent policies under renewal.

What happens to the policy coverage after a claim is filed

ANS:

  • This means that whatever claim you have received, that amount will be deducted from the sum insured for the remaining period of the policy.

What is the maximum number of claims allowed over a year

ANS:

  • Health insurance policy holder can claim any number of claims under a policy, within a year.But the claim amount cannot exceed the maximum amount for which the policy has been insured under health insurance policy .

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