Health Insurance


Healthcare is very expensive and only health insurance overcomes this obstacle to make you free of anxiety about your health. It gives your much needed financial relief.
Generally, hypothecation is allowed on assets and protection. Insurance is the just the way reimbursement of expenses that policyholder have incurred.
Just give a request letter mentioning the new address to the insurance company on plain paper and insurer will the endorsement and provide a copy of the same to you.
Health insurance is a long term plan and hence, you need to consider many factors such as maximum renewal age of the plan, 1st & 2nd year exclusions, daycare treatment / procedures covered, pre-existing coverage, per illness limit (if any), sublimits (if any), 30 days exclusions, diabetes and hypertension loading, next renewal premium, cashless facility, portability and add-on covers, top up covers while selecting the healthcare plan.
Many insurance companies do not provide cover for maternity and related conditions but some insurance company in India like Max Bupa, Apollo Munich provide cover for maternity after specified waiting periods generally two to four years.
Yes. Each insurance company will pay its proportions of the medical expenses.
Yes, each insurer will pay its mentioned proportion of the loss, compensation, liability, expenses or costs.
When the sum insured is increased by a certain percentage for every zero-claim year. Here, you have to take note that the insurance policy should be renewed without interruption to enjoy the cumulative bonus.
It is a card which customer will get along with the health policy and this card is similar to an identity card. It would entitle policyholder to take benefit of cashless hospitalization facility at any of network hospitals. On this card, contact details and the contact numbers of the TPA are mentioned. Customer can contact on these numbers for clarifications, queries and assistance during medical emergencies. But, customer has to show his health card at the time of admission into the hospital.
Generally, insurance brokers or agents will send you a renewal notice to inform you that your health insurance policy is about to expire. But, customer still has the initial responsibility to renew this plan.
Under cashless hospitalization, the patient does not need to pay the hospitalization bills at the time of discharge from hospital because medical expenses are paid by your health insurance company.
Policyholder can make any number of claims during the policy term. However, the sum insured is the maximum limit under the policy.
Premium paid under the health policy is exempted from Income Tax under section 80D of the Income Tax Act up to Rs 15,000 for individual covering his family and dependent children. If the proposer intends to insure his parents under medical insurance, he is eligible for a deduction of another Rs 15,000 under section 80D. If the age of parent to be covered is above 65 years, then the deduction available is Rs 20,000 under section 80D.
Hospitalization expenses for a least period of 24 hours. But, in case of treatments like chemotherapy, dialysis, Eye surgery, radiotherapy, lithotripsy, dental surgery, D & C taken in nursing home or hospitals and Tonsillectomy, the 24 hours time limit is not applicable.
Below are some of the general exclusions under mediclaim policy: Pre-existing diseases such as any condition, injury or ailment or related conditions for which policyholder had signs or symptoms and / or was diagnosed or / and get medical help / treatment within 48 months prior to his / her health insurance plan with the insurer. Pre-existing diseases will be covered after a maximum of four years since the inception of the policy. Any disease that contracted during the first 30 days of inception of insurance plan except in case of injury resulting out of accident is also not included in the policy. Some specific diseases like hernia, cataract, sinusitis and piles etc are excluded as well for certain period in case contracted or manifested during the policy term. Diseases or injuries directly or indirectly attributable to war, invasion, war like operations and act of foreign enemy. Cosmetic or aesthetic treatment unless leading out of accident. Expenses of contact lenses, hearing aids and spectacles are also excluded Dental treatment or surgery of any kind unless requiring hospitalization Charges incurred at nursing home or hospital primarily for x-ray, diagnostic or laboratory examinations, without any treatment. Pregnancy and child birth related diseases Intentional self-injury or injury under influence of drugs, alcohol etc Diseases like AIDS or HIV Expenses on tonics and vitamins unless mentioning as a part of treatment for injury or disease and certified by the attending physician. General debility, congenital external diseases, anomalies, run-down condition or test cure and convalescence
During the policy term, the medical bills of certain diseases like piles, cataract, hernia, benign prosthetic hypertrophy, sinusitis, fibromioma or hysterectomy for specific period are not payable if manifested and / or contracted during the policy period.
Donor expenses are all hospitalization bills incurred by the donor for donating an organ (without including the cost of the organ) to the policyholder during the process of an organ transplant.
Any condition, injury or ailment or other related conditions for which policyholder has symptoms and / or was diagnosed and / or received medical treatment or medical help within 48 months before issuing his or her policy with the insurer. Pre-existing diseases will be covered after a maximum period of four years since the inception of the insurance policy.
Relevant medical costs incurred before and after hospitalization for certain days or up to a certain amount. These expenses are related to the treatment of the disease for which the policyholder is hospitalized.
Domiciliary hospitalization means medical treatment for a period over three days for such illness / injury / disease in which person needs treatment and care both at a hospital or nursing home but actually taken whilst confined at home in India under any of the following circumstances: Patient is not in a position to take him to the hospital or nursing home OR Patient cannot be moved to nursing home or hospital due to lack of accommodation therein.
Hospitalization expenses are covered boarding expenses, room rent, nursing expenses, and fees of consultants, anesthetists, surgeon, specialists & medical practitioner. Also, it covers the cost of diagnostic tests, anesthesia, oxygen, blood, medicines, organs, dialysis, radiotherapy, chemotherapy, operation theatre charges and appliances such as artificial limbs & pacemaker.
Family Floater plan is the single policy which takes care of the hospitalization costs of your whole family. It pays medical expenses of all the family members during accidents, surgeries and sudden illness.
Yes, medical checkup is mandatory before buying a new health insurance policy for customers above the age of 50 years. Medical test is not necessary only for senior citizen policy provided to people between 60 years to 69 years.
A hospital which has a contract with the insurance company for offering cashless treatment facility is called as a ‘Network Hospital’. This facility is offered only at the network hospitals. On the other hand, non-network hospitals are those with whom insurer do not have any contract and any insured person seeking medical help in such hospitals will have to pay for his medical treatments and later claim according to the reimbursement process.
No, medical tests don’t get covered unless and until it is highly needed.
TPA is an abbreviation of Third Party Administrator. It’s a Mediator between insurer and insured. Insurance agency hires or appoints this TPA for claim settlement process.
Yes, sometimes you may be rejected the coverage over small medications. In such cases, your doctor can fight for you and lodge a formal complain to state Medicare office or State Board that regulates health insurance plans, as these insurer respects the State Board.
No, it does not. You won’t get paid; if you choose hospital other than the hospital list provided by your insurer.