Health Insurance

Health insurance is a type of insurance coverage that pays for medical, surgical, and sometimes dental expenses incurred by the insured. Health insurance can reimburse the insured for expenses incurred from illness or injury, or pay the care provider directly.

Why do we need Health Insurance ?

Health risks and uncertainties are a part of life. Health insurance provides people with a much needed financial backup at times of medical emergencies. Health insurance can reimburse the insured for expenses incurred from illness or injury, or pay the care provider directly.

Benefits of Health Insurance

  • Coverage against medical expenses -The main purpose of medical insurance is to receive the best medical care without any strain on your finances. Health insurance plans offer protection against high medical costs. It covers hospitalization expenses, day care procedures, domiciliary expenses, and ambulance charges, besides many others.
  • Coverage against critical illness - Insurance providers nowadays offer critical illness insurance, either as a standalone plan or as a rider. Such an insurance policy provides coverage against life-threatening diseases such as kidney failure, bone marrow transplant, stroke, and loss of limbs, among others.
  • Pre-existing diseases - Coverage for any pre-existing disease is provided to you after a certain waiting period.
  • Tax benefit - Annual premium paid for health coverage are subject to tax exemption u/s 80D of ITA, 1961. Tax exemption ranges from Rs. 25,000 to Rs. 75,000.
  • Cashless claim benefit -Many insurance providers offer cashless claim facility. In such an arrangement, you do not have to make any out-of-pocket payments. The hospitalization expenses are settled between your insurer and the hospital.
  • Other benefits - As an innovative feature, OPD expenses are now covered under few Insurer plans and don’t require hospitalization for minimum 24 hrs to claim reimbursement. Stand alone OPD plans are also available in the market.

How to Choose a Good Health Plan ?

Now, that you have decided to buy a health insurance policy, you need to know how to select a good health insurance plan that will take care of all your needs. Here is a list of benefits any good health insurance plan should offer you –

  • Protection against a large number of critical illnesses.
  • Flexibility to choose your health cover.
  • No increase in premiums during the policy term even if your health condition changes.
  • Long policy term that covers you even in your old age.
  • Large hospital network so that you have easy access to medical treatment.
  • Sum Insured by the policy.
  • Sub-limits (if any) and Waiting Period (for PEDs).

What is difference between mediclaim and health insurance ?

Mediclaim is mainly for covering hospitalisation expenses. A health insurance plan covers hospitalisation expenses, pre-post hospitalisation expenses, ambulance charges, compensation for the lost income, etc. depending on the policy benefits.

Major Key Points of Mediclaim Policy

Medical Expenses incurred in 60 days before the date of admission to the hospital.

Medical Expenses incurred in 90 days after the date of discharge from the hospital.

  • Covers expenses for 540+ Day Care Treatment due to disease/illness/Injury during the policy period taken at a hospital or a Day Care Centre.

Insurance company reimburse every expense occurred while you're staying in single or private room. You can also upgrade your room should there be a need to and is recommended by a treating doctor.

For utilizing ambulance service for transporting insured person to hospital in case of an emergency, coverage limit Rs.5000.

In time of an emergency we believe your focus should be only on your recovery. Hence we take care of those ICU charges that come in your way of getting a quality treatment.

Covers maternity expenses in mediclaim policy subject to a waiting period of continuous coverage under the policy subject to IRDAI portability guidelines.

Covers vaccination expenses for up to one year after the birth of the child subject to a limit of amount.

In case of an emergency or a medical condition that does not allow you to get admitted in a hospital, we provide coverage for medical expenses incurred during your treatment at home for a period exceeding 3 consecutive days. So nothing should delay the treatment you deserve.

Insurance company believes in the old adage that an ounce of prevention is better than a pound of cure. This is why we give an Annual Health Check-up for yourself and all members covered by your policy, including children.

Keep your worries regarding medical expenses outside the door with Automatic Recharge of Sum insured. This additional amount can be used by you for any other ailment or by any other insured member for treatment of any ailment.

Insurance company raises a cheer to good health for every year that you don't claim by increasing your Sum Insured by 10%, up to a maximum of 100% in consecutive 5 years.

Insurance company raises a cheer to good health for every year that you don't claim by increasing your Sum Insured by 10%, up to a maximum of 100% in consecutive 5 years.

Covers Medical and surgical Expenses of the organ donor for harvesting the organ where an Insured Person is the recipient.

Sometimes reassurance works better than the cure itself. Which is why if, at any moment you feel uncertain about your diagnosis, you can opt for a second opinion at no extra cost specially arranged by us.

Insurance Company understands that sometimes non-allopathic treatments may prove to be more effective. Whether it is Ayurveda, Unani, Sidha or Homeopathy, choose the treatment that suits you and we will cover it up to a specified limit and varies according to the plan chosen.

Your family may avoid hospitalization for many years at a stretch. However, you have to be really fortunate to avoid doctor consultation for even a few months. For all the visits for all routine visits to the hospital –Insurance Company give you 1% of your Sum Insured for doctor consultation & diagnostic tests each. This can be availed via a cashless health card and additional premium paid to avail this add- on cover is also applicable for tax benefit under section 80D of IT act.

The right cure may be miles away but never out of your reach with Air Ambulance Cover. For all those times when you might be recommended a treatment which is not in your city of stay.

Once the Insured has completed two years of continuous coverage with the insurance company, they will pay for expenses related to the following dental treatments only subject to an amount of policy.

  • Root Canal Treatment (single or multiple sittings)
  • Tooth extraction(s)
  • Filling