What is Health Insurance ?

Health insurance policy is essential because the cost of hospital treatments are rising day by day. If an accident or critical illness happens to you, it will cause a huge financial burden on you and your family. Truth is that whether your trip to hospital is planned or unplanned, it is sure to cost you heavily.                                  Health insurance policy is a product that protects you against the financial implications of a wide variety of health related expenses, ranging from those caused by minor illnesses and injuries to critical diseases. Therefore, health insurance plans serve as a protective financial shield for you should you be faced with a major medical expense.

Why Do I Need Health Insurance

  • Rising medical costs.
  • Changing lifestyle.
  • Pandemic kind of situations.
  • Food habits and stress.
  • Provides cashless treatment.
  • Covers Pre-hospitalisation and Post-hospitalisation expenses.
  • Can includes a cover for Pre-existing diseases.
  • Critical illness.
  • Tax saving.

Benefits of Health Insurance

  • Cashless treatment across India at major hospitals.
  • Free health check-ups.
  • Life long renewability.
  • Tax benefits for propose of the policy.
  • Cumulative bonus increases your coverage.
  • Various add-on coverages like Top-up, daily hospital cash, personal accidental, critical care etc. can be opted.

Types of Health Insurance Plans

Health insurance in India is the one that can adequately fulfill your specific financial needs. To be able to make an decision before purchasing, you must know the many types of health insurance plans, commonly required are:

Individual Health Insurance

Top-Up Insurance

Family Floater Health Insurance

Critical Illness Benefit

Group Health Cover

Who Must and Can Buy Health Insurance Plans ?

Purchasing a health insurance policy for yourself and your loved ones is a crucial financial decision. Resorting to medical insurance has become a necessity because of how expensive medical care is, especially in today’s fast-paced lifestyle-driven world.                                                              Therefore, if you are a salaried or self-employed individual who has dependents to take care of, you must invest in a health insurance policy. Furthermore, buying the health insurance plan becomes essential if:

  • You wish that you and your family remains protected during any medical crisis.
  • You wish to maximize your tax savings.
  • You are a resident Indian national.

Factors Affecting Your Health Insurance Premium

The fast-paced lifestyle that we live today, with so many stressors around us, some unhealthy habits that we adopt might become a roadblock in availing a good health insurance policy. The cost of health insurance plans and the premium amount paid varies significantly for insurers and the insured based on several factors:

Pre-Existing Diseases

Before buying a health insurance policy, if any person is diagnosed with an ailment, his premium amounts will be higher and requires a set waiting period to avail claims against treatment of such diseases or even are excluded for lifetime due to severity of the ailment.

Gender Impact

Gender is another factor that can impact premium rates for insurance policies. Typically, women have a longer lifespan than men which makes the premium rates comparatively lower for them.

Age

An individual of a certain higher age, they become susceptible to age-related diseases and medical supervision that adds up to the cost of your health insurance plan.

Smoking Status

Your smoking status makes for a huge contributing factor that affects your premium amount as regular smokers are more prone to health diseases and conditions like lung cancer, heart diseases, respiratory disease and more. This vulnerability to a range of ailments affects your health insurance premium amount and you are required to pay a higher price.

Exclusions in Health Insurance Policy

Health insurance policy offer coverage which varies from one insurer to insurer. But, there are few common which are not covered by health policy. Following is some of the most common health insurance plan exclusions you should be aware of:

  • Waiting period for pre-existing diseases, you need to wait for a particular pre-defined time period for the known illness.
  • Critical illnesses for pre-existing diseases is subject to a waiting period or completely excluded, which can vary from one insurance company to another.
  • Most of health insurance polices cover maternity expenses and maternity related treatment after a waiting period of 1-4 years. Maternity related expenses such as childbirth, prenatal and postnatal care, newborn baby cover etc. has waiting or permanent exclusion.
  • Cosmetic treatments, plastic surgery, body enhancements or contouring are usually not covered.
  • Under most of the insurance policies, Dental procedures are not covered unless the need for dental treatment arises out of accidental injuries.
  • Self-inflicted injuries or any sort of injuries or illnesses that occur due to attempted suicide are not covered.
  • Treatment out of India or by an under-qualified medical professional.
  • Pre-existing condition: Defined as a cancer condition (primary or metastatic); pre-cancerous condition or related condition(s) for which the insured had symptoms or was diagnosed earlier or got medical treatment prior to the date on which the policy was issued.
  • Sexually Transmitted Diseases AIDS or HIV.
  • Intoxication by alcohol or narcotics or drugs.
  • Congenital diseases, Nuclear, biological or chemical contamination (NBC).
  • Note: The Health Insurance exclusions mentioned above can vary from one insurer to another. It is recommended to check for all the health insurance inclusion and exclusion before choosing the best health insurance plan in India.

Alcoholism

Any Individual with regular and extreme drinking habits may have to pay higher premiums to get financial security. This is because excessive drinking has been linked to cases of renal and liver disease, high blood pressure, and other serious health issues.

Family Medical History

Few individuals have a medical history of certain diseases that are passed on to new generations. Such pre-dispositions put some people at a greater risk for diseases. This is also a factor that affects your health insurance premiums.

Occupation

Individuals exposed to a stressful or dangerous working environment have higher chances of developing a disease or illness. In case your occupation makes you susceptible to accidents, it can affect your premium rates.

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Pinakin Insurance Solutions LLP
Office A-14, Privia Business Center, Next to PCMC RTO office, Moshi, Pune-412105.