Which Health Insurance Policy You Should Buy?

The cost of health care in today’s world is increasing at a crazy rate while one’s earnings do not seem to match up that level. And, get yourself with regular health checkups. A patient looking forward to getting better health check-ups which should not be any longer as expected. A comprehensive health insurance comes packed with some of the best features. Understanding the following features makes purchasing medical insurance policy easy:

    • Cashless Treatment: Every medical insurance organization has tie-ups with various nursing homes across the country or ’impaneled hospital’. If you are admitted, you don’t need to pay anything. You only need to mention your policy number on the document which may be given by the hospital, and everything else will be taken care of by the hospital and your insurer company. This type of plan is mostly preferred because there is no stress of claim resolution and arranging documentation. However, if your expenses go beyond the sub-limit specified by the insurance cover or marked as not covered by the provider, then they have to settle it directly with the hospital. Another important thing to remember is that cashless Mediclaim is not available if one gets treatment in a hospital that is not part of the hospital network of a provider.
    • Pre and Post Hospitalization: This feature of a health insurance policy takes care of both pre and post hospitalization fee over a time of 30 to 60 days, depending on the plan purchased. It takes into account costs incurred during a certain number of days such as both prior to and post-hospitalization for a specified period from the date of discharge from the hospital which is part of the claim, provided the expenditures are related to the disease/sickness.
    • Ambulance Fee: The person is free from the burden of transportation fee, as it is borne by the firm. This is one of the best add-on benefits and you should opt for it while purchasing the insurance for anyone.
    • No Claim Bonus: NCB (or No Claim Bonus) is an advantage provided if the person does not file a claim for any treatment in the previous year. The advantage could be in any form, either as an increment in the sum assured or as a discount in the cost. You can avail this advantage on renewal.
    • Medical Check- Up: A Medical plan entitles the insured to receive regular medical check-ups. A free full body check-up is provided by some of the insurers, provided you have a good history of no claim bonus.
    • Room Rent include in Your Health Insurance Sub-limits: A health insurance policy may have various sub-limits associated with it; room rent is one of those sub-limits. General Insurance Companies provide you with coverage max up to sum assured. However, they can deliberately trim down their liability of insurance payment by introducing the sub-limit clause in the coverage for the first steps of room rent. A sub-limit on room rent in case of hospitalization works on per day basis. For example, the insurance policy cover room rent of hospital of Rs.3000 and the actual rent of room is Rs.5000 and the balance of Rs.2000 would be paid by you from your own pocket and it also depends on the type of room is available, a single room or on a sharing basis. Everything else is calculated proportionately.
    • Co-Payment: According to this feature, you can lower the health insurance cost. Medical insurance plans offer co-payment option that pre-defines the voluntary deductibles to be borne by the firm. So, in the event of medication, some amount is paid by the customer and the rest by the provider. It is a cost-sharing requirement under a health policy, which states that the organization or the person will bear a certain share (in percentage) of the total admissible cost. However, the co-payment option does not have any effect on the sum assured. It allows you to reduce your premium to a certain extent (subject to the insurer and insurance policy).
    • Tax Benefits of Health Insurance: Health insurance policies entitle you to receive tax benefits under section 80D of income tax act, 1961. The premiums you pay towards insurance plans for yourself or your family members get you a tax rebate, irrespective of whether they are dependent on you or not. The tax benefit offered, with respect to the premiums of the insurance, is subject to the age of the person and there is a cap available of maximum benefit that can be availed to the insurance holder. You can save tax up to Rs. 25, 000 in taxes a year unless your age is above 60 years. If your age is above 60 years, then this cap of maximum tax benefit increases to Rs. 30, 000. If you are paying the insurance premiums for your parents as well as of your own, then you are eligible for tax exemption of up to Rs. 55, 000 a year under section 80D, provided your parents are senior citizens.
    • Health Insurance by Employer: More than 80% of employers in today’s age provide health coverage for their employees. The health insurance which is offered by an employer to covers the hospitalization expenses of the employee and his/her family including spouse he/she has their, children or parents included. It is a wise decision to opt for medical claim offered by your company as you won’t need to pay the premium. This comes under a group health insurance policy and the premium is paid by the employer, basis the group size and benefit opted. However, sometime you might feel that your employers medical policy is not sufficient to fulfill your medical needs or what to do if change your job? You’re no more a member of this plan once you leave the job. Hereby, it is necessary to understand the policy terms thoroughly. You can communicate with the HR department regarding whats covered and what not in your health insurance. Mostly we observed employees are more than satisfied with their company providing health insurance, only to find out later that the plan is not sufficient. So, before its too late, take your call!
    • Third Party Administrators: The TPA concept is the brainchild of Insurance Regulatory and Development Authority of India (IRDA), to assist both the insured and the insurer. While it benefits the insurer by reducing their overheads or administrative costs, fake claims and claim ratios, the insured can avail the benefit of improved and fast healthcare services.TPAs are the important players in the sector of health insurance. It excels the capacity to handle all or a portion of the claims related to medical claim insurance. They have tie-ups with the health insurer or self-insuring companies to manage services such as premium collection, enrollment, claim settlement or other administrative services. Often hospitals or organizations outsource health-related responsibilities to a TPA to lower the burden. In this, an employer may prefer to provide the health care expenses to its employees via a TPA to manage various aspects of employer-funded healthcare policy.