Health Insurance

Posted in: Insurance | on: June 27, 2011

Life lasts longer only if health is maintained good. Wealth makers can enjoy money as long as they are hale and hearty. Almost all individuals are highly prone to the breakdown of health and other problems. It is impossible to manage health issues all time financially. To get rid of such problems, health insurance provides financial support for the treatment of the individual.

What Is Health Insurance?

It helps for the individuals to meet high cost health issues financially that relatively satisfy the cost of medical expenses and other expenses related to health.

Features of Health Insurance

One of the key features of health insurance is the cashless treatment and financial protection before and after hospitalization. One can go cashless for the treatment that only the policy number is needed. This type of insurance comes with ambulance charge coverage, cost coverage for before and after hospitalization, checkups, room rent. The significant feature of this insurance are tax benefits.

Advantages of Health Insurance

The health insurance cares for the entire family of the individual with the flexibility of extending the number of members. It protects the senior citizens, pregnant women to a large extent by providing cashless treatment facility. One can also get the coverage for the pre-existing medical conditions. The insurer has vast network of hospitals, so the individual need not wander for the right hospital to avail the benefit.

Health Insurance Eligibility Criteria

All the individuals and the family members are eligible for the insurance. The minimum age limit for adults is 18 years and the maximum is 65 to 70 years depending upon the choice of plan. The age limit for children starts from day 91 after birth to 18 years.

Documents to Claim Insurance

The documents required to claim insurance are the photocopy of policy documents of current and previous years, TPA identity copy, consultation bills, details of the prescribed, consumed and disposed items, hospitalization bills, medicine bills, claim form with the policy holder signature, other TPA documents if needed and the investigation report.

How Long The Claim Settlement Takes?

The claim will be settled on two types. In the first type, the insured should manage all the medicinal cost then approach the insurer for the reimbursement. Secondly the policy holder shall use the health card at the hospital, thereby can get cashless treatment. This requires TPA approval. In case of not getting TPA approval, reimbursement procedure will be applied.

Types of Health Insurance

Health insurers provide various types of health insurances. There are individual or family health insurance plans, preventive health insurance plans, maternity, surgical, senior citizen health insurances available. Let's see each one in detail.

Individual Health Insurance:

The insured individual who has undergone major illness, and other severe medical conditions, can avail the benefit of this type of insurance for the hospital needs. The amount is calculated based on the age of the individual. The insured amount will be settled in separate.

Family Health Insurance:

Under this one cover, the medical expenses over any disease or illness of the entire family members will be treated. One of the family members or all of them who need treatment cost can get the amount within the tenure of the policy.

Maternity Health Insurance:

This covers women during and after her pregnancy. It also covers the new born baby and its vaccination till the end of the term. Some additional benefits include that it covers the transportation cost of the pregnancy.

Senior Citizen Health Insurance:

This covers the medical expenses of senior citizens after the age of 60 years.

Unit Linked Health Insurance:

It is a recent insurance plan comes with investment. Not only does it help in safeguarding health, but also it helps for the additional expenses that are not provided by the health insurance. Health, age and the gender of the individual determines the coverage amount.

Preventive Health Insurance:

Preventive health insurance defines the coverage for the practices of checkups, X-rays, and other previously checking costs. It is just to ensure our health. Also, it covers the cost of consultation with doctors.

Tax Benefits

The policy holder can avail the tax benefits depending on the age. If the person is below 60 years and paying premium, then he can save up to Rs. 22,000 per year. If the person is above 60 years, then he can save up to Rs. 30,000. If the person paying premium for his parents as well as for him, then he can get tax benefit up to Rs. 55,000 per year.

Star Health Insurance

Star health insurance is one of the best insurance companies. It provides coverage to the family of four in number, mentioning two children and two adults. It can be renewed life long, that it protects us throughout our lifetime. Thirty days before the treatment and sixty days after the treatment will be covered. Diseases occurred previously before proceeding the insurance will also be taken but only after four years of post apply. Room rent costs also covered with the maximum pay of Rs. 4000 per day or 2% of the assured amount. Health checkups come under the coverage can allowance in every four years where there are no claims. There exists bonus of 5% to 100% for the claim free years calculated from the sum assured. It has a vast network of hospitals to get the benefits. The settlement is made only personally and not by any third parties.

Religare Health Insurance

It is among the top insurers which provides health insurance and other products. It covers up to six members of a family including two adults and coverage will be renewed lifelong. It is a lifelong coverage offered till the lifetime of the holder. Before thirty days of hospitalization and sixty days after hospitalization are covered by this health insurance. Room rent coverage up to 1% of the amount ranges 3 to 4 lakhs. For above 5 lakhs coverage, room rent is calculated based on private room rent. If there is any pre-existing disease, it will be covered only after four years. One can avail medical treatment all over the world. About 50% to 150% will be given as no claim bonus. If the assured amount is cleared, then it will be summed again.

LIC Health Insurance

LIC Jeevan Arogya is a whole family health insurance which enables the policy holder to add new family member during the term. This policy provides cover for the individual's parents, spouse, parents-in-law and children. The coverage amount will be increased over the years and convenient premium payment is also available. It does not provide any facility for loans and surrender value in this insurance. Death benefit is available only if the policy holder has chosen a special rider. Major surgeries, hospitalization, ambulance costs are covered in this. Hospitalization cover ranges from Rs. 1000 to Rs. 4000 and the major surgeries cover range from Rs. 1 lakh to Rs. 4 lakhs. Minimum age for entering the insurance is 18 years for adults and 91 days for children. Maximum age for entering the insurance is 65 for policy holder or spouse and 75 years for his parents. The age at maturity will be 80 years. There are exclusions for any previously existing conditions, suicides, plastic and beauty surgery, self-harming injuries, drugs, pregnancy and childbirth conditions.


6 - 5 =

darade kishore - Oct 4, 2011

my sun education policy