Health Insurance & Its Many Types in India

Introduction

There are a variety of health insurance plans offered in India. These plans can be broadly classified into indemnity and fixed benefit plans. Indemnity plans provide insurance benefits up to a predetermined limit. The insurance provider can reimburse you or enable you to avail of cashless treatment. A fixed benefits plan provides a definite amount of money when a claim is made as a result of specific health issues.

Popular Types of Insurance Policies

In India, different types of health insurance policies are available and you should decide carefully based on your needs. The right insurance policy will provide the most financial support you need.

● Individual Health Insurance

Individual health insurance is the most straightforward insurance plan suitable for a single person. The insured person will be compensated for medical expenses for illnesses covered by the plan.

Coverage includes hospitalisation expenses, surgical costs and other medical expenditures up to the insured limit. Premium is usually calculated based on the age and medical history of the insurer. At an added cost, an individual can also extend coverage for spouse, children and parents under the same plan.

● Family Floater Health Insurance

Family health insurance is a single insurance plan for everyone in the family. The insurer has to pay the premium while everyone in the family, including children and elders, will be covered for medical expenses.

Even if more than one person is affected by the illness, you can claim insurance for all until the limit is reached. As the age of insured people influences premium calculations, the cost of adding members over 60 years of age is higher but as they are more prone to illness and other medical problems, it is advisable to have them covered.

● Group Health Insurance

Companies usually purchase group health insurance to provide insurance for their employees. As an insured member under group health insurance, you may be eligible to include your family members under the same plan. Basic coverage is usually free for employees in the group.

Some perks include maternity coverage, outpatient treatments, annual health check-ups, diagnostic tests coverage, etc.

● Senior Citizen Health Insurance

Senior citizen health insurance is available for seniors older than 65. The premium for senior citizen health insurance is usually higher because of the increased medical risks.

Coverage usually includes both pre and post-hospitalisation expenditure. Some policies also cover domiciliary expenses and psychiatric treatments.

● Maternity Health Insurance

Maternity health insurance is usually purchased as an add-on and a basic insurance policy. This type of insurance covers prenatal, delivery and postnatal expenses. It is best to purchase this plan when you start planning for a family.

There is usually a waiting period before you can make a claim. Furthermore, some insurance providers also cover new-born expenses shortly after delivery.

● Critical Illness Insurance

Critical illness insurance is a lifesaver for those diagnosed with critical illnesses such as cardiac problems, kidney failure, stroke, cancer, paralysis, etc. The insurance provider pays a lump-sum amount as a one-time payment at the time of claim. The policy is terminated after the lump-sum payment. There is also a renewability feature with this policy.

● Top-Up Health Insurance

Top-up health insurance is usually purchased for additional coverage apart from the health insurance plan. The top-up plan activates automatically when you have exhausted the maximum claim amount for your base insurance plan.

● Hospital Daily Cash

The hospital daily cash plan covers hospitalisation expenses when the insured person gets hospitalised. However, hospitalisation charges vary widely depending on the treatment. Usually, individuals can get a cash benefit set by the coverage amount.

● Disease-Specific Health Insurance

After the widespread global pandemic, insurance providers now offer disease-specific health insurance plans for those affected with diseases like COVID-19. Such an insurance policy covers specific diseases and provides coverage based on the conditions.

● Personal Accident Insurance

A personal accident insurance plan explicitly covers expenses for treating injuries caused by a personal accident. The injured person may become disabled or die, and the insurance offers some solace to the family. The victim's family gets a lump-sum payment when the claim is made.

How to Choose a Health Insurance Plan?

With numerous options available, you must compare multiple insurance plans and choose one that best suits your requirements. Some of the factors to consider are:

Deductibles – Insurance plans require the insured to pay the deductibles first and the insurance provider will cover only the rest.

Family Size – Family health insurance plans are cheaper than individual plans but the premium will increase for bigger families.

Age – Almost all insurance plans consider the insured's age while calculating premiums. Generally, you can get lower premiums when you are young.

Medical Conditions – Medical conditions of everyone covered in the policy play a significant role in the premium calculations. When you have pre-diagnosed medical conditions, the premium will usually be higher.

Coverage and exclusions – The coverage offered by the insurance policy determines when you will be compensated. With more exclusions, your chances of making a claim reduce.

Waiting period – Many insurance policies require you to wait for a certain amount of time before you can enjoy the benefits of the policy.

Hospital network coverage – Always choose an insurance policy that has the most comprehensive hospital coverage.

Conclusion

Health insurance policies empower you to get the proper treatment for different types of critical illnesses without spending much money out of your pocket.

When you or your loved ones suffer from a life-threatening disease, the increasing cost of healthcare facilities should not stop you from getting the treatment. So, choosing the right plan is crucial to maximising benefits.