Aiming for secured health in future: knockdown to insure it by a Health Insurance

Aiming for secured health in future: knockdown to insure it by a Health Insurance

In this erratic world, one never knows what could happen at any point in time. Due to this uncertainty in life, we should always be prepared for its miseries and disappointments. We are having a sedentary lifestyle which has made health insurance a necessity for us. Among multiple health insurance plans options available in the market, it’s on you how it chooses. 

As we’ve heard, “A Stitch in Time Saves Nine”, the meaning of this age-old proverb is quite literal. It effectively means that we must attend to things well in time so that we can save ourselves a lot of trouble later on if it becomes unmanageable. Moreover, we know that the rise of inflation in medical expenses has reached the heights, it has become mandatory for us to buy health insurance to secure our future. 

Now the questions striking our mind are “What is this health insurance exactly? What   does   it   do  ?   and 

How does it work?   etc.

So here we go with the answers :

Health Insurance:

Health insurance is insurance coverage that covers the whole or a part of the risk of a person sustaining medical expenses. This insurance can reimburse the insured for expenses incurred from illness or injury, or pay any other medical expenses. 

What does Health Insurance do? 

Health insurance covers essential health benefits which are critical to maintaining our health, treating illness, and accidents. It protects us from unexpected and unpredictable high medical costs. The insurance makes sure that the insured has to pay such medical expenses out-of-pocket. The insurer settles the bill directly with the hospital. 

How does Health Insurance exactly work? 

First, we should take proper health insurance according to our requirements.  God forbid but if we ever have a health-related problem in the future, this insurance will come to our great help. It not only helps pay for our health care but also covers services ranging from routine doctor visits to major medical costs from a serious illness or injury. It also covers many preventive services to keep our health secure. 

After thoroughly understanding its necessity, now we’ll need to find a health care provider to buy health insurance which best suits our budget and requirements. So, here we have the analyzed data. 

Over here, we are getting the information regarding various health insurance plans which have been compared so that it becomes convenient for us to choose the right one. 

According to Incurred Claims Ratio, Sum Insured and Pre & Post- hospitalization expenses, the top 10 health care providers, i.e., health insurance plans in India are mentioned below :

1.Essential Privilege Plan :

It is a complete health care offer provided by Universal Sompo. A tremendous Incurred Claims Ratio and amazing offers are owned by the company which is the desire of many families. A wide range of coverage is also provided by this company and it also provides coverage for 91-day old babies. Its family floater plan includes a maximum of six members. 

Benefits and Characteristics:

  • DayCare Procedures
  • Domiciliary Hospitalization
  • Pre-Hospitalization Cover
  • Post-Hospitalization Cover
  • In-Patient Hospitalization
  • Organ Donor Facility
  • Ambulance Cover
  • Child Coverage
  • Vaccination
  • Hospital daily cash
  • Critical illness coverage
  • Sub-limits
  • Bonus
  • Grace period
  • Tax Benefit
  • Pre-Pre-Insurance Health CheckUpCheckUp

Exclusions & Limitations :

  • Hearing Aids
  • Drugs, alcohol and other substance addiction
  • Experimental and unauthorized treatment 
  • Sexual dysfunction
  • Infertility and birth control treatment
  • Self-inflicted Surgery
  • Any injury due to participation in the war
  • Injury is due to illegal or unlawful activity.
  • Mental disorder or psychiatric treatment. 

2.Activ Assure Diamond Plan:

Aditya Birla Health Insurance Company offers The Activ Assure Diamond plan  which provides comprehensive coverage to its policyholder. It is considered to be one of the best health insurance policies in the insurance market. The plan also has a higher sum insured option for its policy buyers. It provides several appreciable facilities and coverage under the plan. 

Benefits and Characteristics:

  • In-patient hospitalization
  • Sum Insured Reinstatement
  • Organ Donor Expenses
  • DayCare Procedures
  • Domiciliary Hospitalization
  • Pre-Hospitalization Cover
  • Post-Hospitalization Cover
  • AYUSH Treatment Cover
  • Daily Allowance
  • Health Coach Facility
  • HealthReturns
  • Second E-Opinion Option
  • Tax Benefit
  • Room Upgrade

Exclusions & Limitations:

  • Genetic disease treatment expenses.
  • Mental disorder treatment.
  • Non-allopathic treatment expenses.
  • Treatment-related to obesity or any of the cosmetic surgeries.
  • Treatment relating to HIV AIDs disease
  • Any self-inflicted injury.
  • Suicidal cases.
  • Injury due to involvement in war activity.
  • Treatment for drug addiction, alcoholism, or another intoxicant.
  • Any medical assistance outside the country.
  • Infertility related treatment.

3.Family Health Optima Plan:

Family Health Optima Plan is offered by Star Health Insurance Company. It is a super saver plan, gives coverage to the entire family under a single sum insured. It is also loaded with extra benefits. 

Benefits and Characteristics:

  • Room Rent Facility
  • Sub-limits
  • Ambulance Cover
  • Air Ambulance Cover
  • New Born Baby Cover
  • Organ Donor Expenses
  • Alternative Treatment
  • Bonus
  • Second Medical opinion

Exclusions & Limitations:

  • Frenuloplasty, circumcision & preputial dilation.
  • STD and venereal diseases.
  • Psychiatric treatment.
  • Mental disorder.
  • Congenital anomalies.
  • Treatment with respect to abortion, miscarriage, or other complications.
  • Injury caused by self.
  • Treatment of injury due to war, invasion, enemy attack, etc.
  • Treatment of endocrine diseases.
  • Treatment-related to sleep apnea.
  • Treatment relating to HIV/AIDs.
  • Refractive error correction and Lasik laser expenses. 

4.Care Health Insurance Plan:

Religare Health insurance company offers Care Health Insurance Plan which is one of the best health insurance plans competing in the health insurance market.       Comprehensive coverage is provided to its policyholders by it. It provides both- individual and family floater plans. Several medical facilities are also given to it’s insured. Few of the benefits and features are as follows:-

Benefits and Characteristics:

  • Pre-Hospitalization Cover
  • Post-Hospitalization
  • In-patient Care
  • No Claim Bonus
  • Daycare Treatment
  • AYUSH Treatment Cover
  • Second Opinion Option
  • Daily Cash Facility
  • Ambulance Cover
  • Medical Screening
  • Tax Benefit

Exclusions & Limitations:

  • Treatment of HIV/AIDs.
  • Congenital illness.
  • Infertility and pregnancy termination surgery. 
  • Injury is due to an attempt to suicide or any other self-inflicted wound.
  • Major wounds due to participation in the war, riot, or any unlawful activity.
  • Alcohol or drug abuse.

5.Optima Restore Plan:

HDFC Ergo Health Insurance Company (formerly known as Apollo Munich Health Insurance Company) offers Optima Restore Plan. The policyholders are taken care of and are also rewarded for staying fit by this plan. There is also an option of auto restoration of the sum insured in case it is completely utilized during the policy year.  A free health checkup facility is also available once in a 2-year policy period on the sum insured of Rs. 5 lakhs and once every policy year on the sum insured of Rs.10 Lakhs and above.

Benefits and Characteristics:

  • Pre-hospitalization
  • Post-hospitalization
  • Day Care Procedures
  • Ambulance cover
  • Organ Donor Cover
  • E-Opinion
  • Domiciliary Treatment
  • Daily Cash For Opting shared Accommodation
  • Critical Advantage Rider
  • Discounts
  • In-Patient Hospitalization
  • Pre-Existing Disease Waiting Period

Exclusions & Limitations:

  • There is an exclusion for 2 years for specific diseases like hernia, cataract, joint replacement, hysterectomy, etc.
  • Injury due to participation in war or any defense activity.
  • HIV/AIDs treatment.
  • Any claim except accidental case within the initial waiting period of 30 days. 
  • Injury due to chemical, nuclear or biological weapons.
  • Intoxicant abuse like drugs and alcohol.
  • Congenital diseases.
  • Mental disorder.
  • Cosmetic surgery and weight control treatments. 
  • Non-Allopathic treatment.

6.Health Companion Plan:

Health Companion Plan is offered by Max Bupa Health Insurance Company. A wide range of Sum Insured options is provided for its policyholders. Three variants are available under the plan based on sum insured options and facilities. 

Benefits and Characteristics:

  • Emergency Ambulance
  • Domiciliary Hospitalization
  • Refill of SI
  • Animal Bite Vaccination
  • Pre-hospitalization
  • Post-Hospitalization
  • In-patient Care
  • Waiting Period
  • Living Organ Donor Transplant
  • ICU Cost Cover

Exclusions & Limitations:

  • Puberty and menopause-related disorder.
  • Treatment from the unrecognized health center.
  • Unjustified hospitalization.
  • Permanent neurological disorder.
  • Artificial life maintenance.
  • Cosmetic surgery.
  • Ancillary hospital charges.
  • HIV/AIDs treatment.
  • Hazardous activity.
  • Off-label drug abuse treatment.
  • Obesity treatment.

7. My Health SurakshaPlan:

HDFC Ergo Health Insurance Company has offered one of the best health insurance plans as always and one of those is my: Health Suraksha. The plan covers the insured in all possible ways and easily fits the budget as well. It covers the insured, their family as well as their newly born baby.  Few of the details of the plan which can help us make better decisions are as follows:-

Benefits and Characteristics:

  • Regain Benefit
  • Pre-Hospitalization
  • Post-Hospitalization
  • Enhanced Cumulative bonus
  • Organ donor
  • Newborn Baby Cover
  • Emergency ambulance
  • Renewal Benefits
  • Second E-Opinion

Exclusions & Limitations:

  • HIV/AIDs related treatment.
  • Cases related to intoxicating substance abuse like drugs and alcoholism.
  • Injury due to unlawful activity.
  • Any type of cosmetic surgery.
  • Any claim within the initial 30 days of buying the policy except accidental cases.
  • Self-inflicted injury and suicidal cases.
  • Any injury due to involvement in war activity.
  • Any treatment relating to weight control.

8. Prohealth Plus Plan:

The ManipalCigna Health Insurance Company has launched the Prohealth Plus Plan. Being a self-sufficient health insurance plan it provides comprehensive coverage. It covers both types of policyholders- who are residing within the country and outside the country in case of an emergency. The benefits of this plan are as follows:-

Benefits and Characteristics:

  • Restoration Of Sum Insured
  • Worldwide Emergency Cover
  • Newborn baby cover
  • Maternity Expenses
  • Free Health Checkup
  • First Year Vaccination Cover
  • Cumulative Bonus
  • Expert Opinion
  • Family Floater Limit
  • Mandatory Co-payment
  • Portability Option
  • Pre-Hospitalization
  • Post-Hospitalization
  • Income Tax Exemption
  • Free-look Period
  • Waiting period

Exclusions & Limitations:

  • Behavioral problems including attention deficit hyperactive disorder (ADHD).
  • Dyslexia
  • Expenses relating artificial life support including a life support machine used in the procedure.
  • Birth control treatments and contraceptive supplies expenses.
  • Routine medical checkup of eye and ear.
  • Circumcision unless the disease requires surgery.
  • Cosmetic surgery.
  • Laser surgery of the eye.
  • Syphilis, genital warts, gonorrhea, genital herpes, chlamydia, etc.
  • Weight loss treatment.

9.Senior Citizen Red Carpet  Plan:

Senior Citizen Red Carpet Plan is one of the best plans offered to Senior Citizens by Star Health Insurance Company. We know that Medical issues are common with the growing age, so it is really necessary to have a plan that can provide us medical coverage and cut down on the medical expenses in old age. This plan has proved to be of great help to elderly people with the choice of good Sum Insured options. The benefits and features of the plan have been mentioned below. 

Benefits and Characteristics:

  • Pre-Hospitalization Cover
  • Post-Hospitalization Cover
  • In-Patient Hospitalization
  • ICU Charges
  • Pre-insurance Medical Screening
  • Co-payment
  • Health checkup
  • Sub-limits

Exclusions & Limitations:

  • Nutritional deficiency state.
  • Congenital external condition.
  • Run-down condition or rest cure.
  • All types of cosmetic surgery.
  • Dental treatment.
  • Plastic surgery.
  • Sexually transmitted diseases.
  • Venereal diseases.
  • Intentional self-injury.
  • Convalescence. 
  • Inoculation or vaccination. 
  • Intentional self-injury.
  • Treatment of subfertility assisted conception and other related complications of the same.

10.Lifeline Supreme Plan:

Royal Sundaram health insurance company offers the Lifeline Supreme Plan. The plan is counted to be one of the best coverage providers. Comprehensive coverage is provided to both individuals and families. Several add on facilities are also provided under the plan. A few of the benefits and features have been mentioned below. 

Benefits and Characteristics:

  • Ambulance cover
  • Daycare Treatment
  • NCB
  • Re-load Of Sum
  • Free Health Checkup
  • Vaccination in Case Of Animal Bite
  • Worldwide Emergency
  • Second Opinion
  • Newborn Baby Cover
  • Maternity benefit
  • Vaccination Cover for New Born baby
  • Pre-Existing Disease Waiting Period

Exclusions & Limitations:

  • Treatment at an unrecognized health center.
  • Congenital diseases.
  • Dental/oral treatment.
  • Psychosomatic condition.
  • Obesity treatment.
  • Addictive condition and disorder.
  • Healthy hydros.
  • Unrelated diagnostics.
  • Injury in conflict and disaster.
  • Sleep disorder.
  • Psychosomatic condition.
  • Reproductive disorder treatment.
  • Drugs and dressing for OPD treatment.
  • Unprescribed X-ray.

These are the top 10 health insurance companies providing the best health insurance for all of us. 

This is the era of erratic as there are so many threats to our lives. It is thus of paramount importance that the people should be acknowledged on the issues of medical care. We should have health insurance as it is the need of the hour if we have to safeguard our future. 

Medical help is one of the greatest help one could get as it requires both financial and moral support. 

It is therefore imperative that as we enter the Millenium, we replace the structure with a more humane, objective, forward-looking system. Where there is more stress on Health and Life. 

The Key Benefits Of Cashless Health Insurance Plans

Cashless Health Insurance Plans

In this time of inflation, it is impossible to deal with the increasing medical expenses. Your whole life investment will fall less if someone in your family is diagnosed with an unexpected medical emergency. This will protect you and your family from the financial crisis. Insurance companies came up with a cashless insurance facility for the comfort of customers. With cashless health insurance plans, you can take treatment at a network hospital without paying a penny from your pocket. The entire medical expenses including cost of medicine, surgery, room rent, transportation, and many other expenses will be paid by the insurance company. All the prominent insurance companies have their network hospitals spread all over the country.

Generally, hospitals take higher charges from customers who don’t have insurance. Insurance company tie-up with major hospitals to negotiate treatment prices. Then the hospital authorities directly contact the insurance company to provide benefits of health insurance plans to the customers.

  • Optimum coverage options:

    Low immunity and hectic lifestyle have made us more prone to diseases. Health emergencies are mostly unpredicted and misfortunate for a family. Health insurance provides complete support to your financial needs at the time of hospitalization. With a cashless health insurance plan, you can take treatment without thinking of the expenses. A comprehensive health insurance policy will cover all major and minor expenses.

  1. Pre & post hospitalization cost coverage:

    Health insurance plans provide coverage for both pre & post-hospitalization expenses. Every insurance company has their timelines according to which they will cover those expenses.

  2. Transportation expenses:

    If the doctor suggested shifting you from one hospital to another then the ambulance charges will be borne by the insurance company. Similarly, when you take an ambulance to go to the hospital that too will be covered by the insurance provider. 

  3. No Claim Bonus:

    The customer will get an attractive reward from the insurance company in the form of no claim bonus. If the customer does not make a claim in a year then he/she can claim for NCB to reduce his premium. 

  4. Medical Check-up:

    Along with all the hospitalization fees, a health insurance company will also pay for medical check-ups. Apart from this, some insurance companies provide full-body check-ups once a year for their valued customer.

  5. Room rent:

    You can avail of a private room in all hospitals depending on the opted sum insured.

  6. Organ donor expenses:

    A health insurance company will ensure that you don’t have to pay the expenses of organ transplantation. Some insurance policies also cover the donor expenses along with the insured person.

  7. Domiciliary treatment:

    If you are not in the condition to go to the hospital then you can also take treatment at your home. A medical supervisor will always be there with you to treat you while taking domiciliary treatment.

  • More advantages for young buyers:

    Customers can take additional benefits from an insurance policy if they opt for it at a young age. You don’t have to serve for a waiting period at a young age. Also, the risk of claim rejections is null at a young age.

  • Financial safety:

    The cost of medical treatments is increasing with time and our body is getting weaker. If you will take treatment of any disease after 5 years then the expenses will rise 5 times. So, a health insurance policy will protect you from paying high treatment costs. All the unexpected medical expenses will be paid by the insurance company if you purchase a cashless health insurance plan now. Also, your savings will be stored safely and you can use it for some other work.

  • Income tax benefit:

    As per Section 80D of the Income Tax Act, individuals less than 60 years of age can make a claim for insurance premium paid by them. You will also get Income tax benefits on purchasing a health insurance plan for your family. You will get less deduction in income tax bills by purchasing a health insurance policy now.

  • Additional coverage for extra security:

    All the government and non-government organizations provide health insurance benefits for their employees. It is not necessary that you will remain with the same job for your entire life. The sum insured provided by the organizations is not sufficient for a family. So, having a separate cashless health insurance plan for your family will provide extra protection

Apart from this, there are certain hospitals that do not tie-up with the insurance companies hence not provide cashless treatment. In that case, you have to pay the expenses from your pocket but later you can reimburse this with the insurance company.

Process of making claims in the network hospitals

Taking cashless treatment at the network hospitals in not less than a relief. You just have to follow a simple process to make a successful claim.

  • In the case of planned hospitalization, you have to inform the insurance company about a health emergency.
  • You have to contact the third-party administrative after getting admitted to the hospital. They will check your cashless card and verify the details.
  • TPA will provide you an authorization form that will be duly filled and signed by the consulting doctors.
  • Submit that form to the third party administration. He will validate the form and process it further to the insurance company.
  • The insurance company will approve the claim based on the validation and the details provided by the TPA.

Normally, it will take 6 hours to make a cashless claim for planned hospitalization. But in case of an immediate medical emergency, the insurance company will take up to a week to process the claim. In certain cases, the customer has to pay from their pocket first and can reimburse it later. In case of emergency hospitalization, you have to inform the insurance company within 24 hours of getting admitted.

I Hope, it helps you. Stay in touch with us, keep visiting.