Benefits & Features of Health Insurance Policies

The cost of healthcare in the modern days is increasing at a high pace while one’s income does not seem to match up that level. Regular health check-ups are getting out of one’s range of affordability since multiple expenses of thousands are common in such scenarios. A patient looking forward to availing frequent health check-ups is no longer expected, whereas a health insurance policy easily covers all such expenses with assured benefits. A comprehensive health plan comes packed with features. Let us understand these features in detail so that buying a healthy policy becomes easy.

• Cashless treatment - Ev
• ery health insurance company or its Third Party Administrator has tie-ups with a network of hospitals and nursing homes called a ‘network hospital’ or ‘empanelled hospital’. If you get admitted in these hospitals, you don’t need to pay anything. Just tell your policy number and rest everything will be taken care by the hospital and the health insurance company. This type of plan is the most preferred because there is no stress of claim reimbursement and arranging documentation. However, expenses beyond limits or sub-limits allowed by the insurance policy or expenses not covered under the policy have to be settled by the insured directly with the hospital. Another important thing to remember is that cashless Mediclaim treatment or cashless facility is not available if one gets treatment in a hospital that is not part of the network.
• Pre and Post Hospitalization - This feature of health insurance policy takes care of both pre and post hospitalization charges for a period of 30 to 60 days depending on the plan purchased. It takes into account expenses incurred during a certain number of days prior to hospitalisation and post hospitalisation for a specified period from the date of discharge as part of the claim, provided the expenses are related to the disease/sickness.
• Ambulance charges - The policy holder is free from burden of transportation or ambulance charges as it is paid by the insurer. This is a add-on benefit and you should have opted for it while purchasing.
• No Claim Bonus - NCB or No Claim Bonus is a benefit provided if the insured does not claim for any treatment in the previous year. Benefit could be in any form, either an increment in the sum assured or a discount in premium. You can avail this benefit on renewal.
• Medical Check- Up - Health insurance policy entitles the policyholder to receive regular medical check-ups. Free check up is provided by few insurers provided you have a good history of no claim bonus.
• Tax Benefits - According to India’s tax system if you are paying a premium amount then you are liable to get tax rebate under section 80D of Income Tax Act for a maximum value of Rs.25000 for Indians in the age group of 18 to 50 years and Rs.30000 for senior citizens.
• Co-Payment - According to this feature you can lower the health insurance premium amount. Medical insurance plans offers co-payment option wherein there is a pre-defined amount of voluntary deductibles mentioned in the policy to be paid by the insured. So in case of a treatment, some amount is paid by the insured and rest by the insurer. It is a cost-sharing requirement under a health insurance policy that provides that the policyholder/insured will bear a specified percentage of the admissible costs. A co-payment does not reduce the sum insured.
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• Health Insurance Portability - Health insurance portability gives freedom to the policyholder to switch from one health insurance company to another without losing continuity benefits with respect to pre-existing diseases, waiting period and other time bound exclusions earned in the previous policies. Health insurance portability is subject to continuous insurance coverage in the previous years. Those covered under employer group health insurance or family floater policies can also make use of health insurance portability to port to an individual health cover. For this, they have to first switch to a plan offered by their existing health insurance company and after a year, they are allowed to switch to an insurer of their choice. Health insurance portability has come as a breather for policyholders who were trying to change their insurance company but were unable to do so earlier. With health insurance portability, they can now try out the policies they prefer with the insurance companies they prefer.