Health Insurance

Posted in: Insurance | on: June 27, 2011

Health insurance facts fine pointing eligibility criteria, advantages, features, needed documents, types, tax benefits, top insurers particularization and claim process
Health Insurance

Life lasts longer only health is maintained good. Wealth makers enjoy the returns only when the health is better. All individuals are highly prone to the breakdown of health and other problems. We cannot hold the health issues to manage and treat all the time financially. So there is health insurance to provide support during the rise of health risks.

What Is Health Insurance?

It helps for the individuals to meet the 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 hospitalisation. 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 hospitalisation, check ups, room rent. Tax benefits of this insurance are a main feature.

Advantages of Health Insurance

The health insurance cares 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 that providing cashless treatment facility. One can also get the coverage for the preexisting medical conditions. The insurer has vast network of hospitals, so the individual do 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 the adults is 18 years and the maximum is 65 to 70 years depending on the choice of plan. The age limit for children starts from day 91 after birth to 18 years.

Documents to Claim Insurance

The required documents are the photocopy of policy documents of current and previous years, TPA identity copy, consultation bills, details of the prescribed consumed and disposed items, hospitalisation bills, medicine bills, claim for 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. First is the insurer 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 treatment cashless. This requires TPA approval. In the case of not getting TPA approval, reimbursement procedure will be applied.

Types of Health Insurance

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

Individual Health Insurance:

The insured individual undergone major illness, and other severe medical conditions, he 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 the one cover, the medical expenses over any disease or illness of the entire family members will be treated. One of the family member or all of them who are in need of treatment cost can get the amount within the tenure of the policy.

Maternity Health Insurance:

This covers the women during and after her pregnancy. It also covers the new born baby and it's vaccination till the end of the term. Some additional benefits like 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. Rather helping in safeguarding health, 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 check ups, x rays, the other previously checking costs. It is just to ensure our health. It also 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. 22000 per year. If the person is above 60 years then he can save up to Rs. 30000. If the person paying premium for his parents as well as for him then he can get tax benefit up to Rs. 55000 per year.

Star Health Insurance

Star health insurance is one of the best insurance companies. It provides coverage to the family of number four mentioning two children and two adults. It can be renewed long the life that it protects us on our full lifetime. Thirty days before the treatment and sixty days after the treatment will be covered. If there any diseases occurred previously before proceeding the insurance will also 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 allowed once in every four years where no claim is done. 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. And the settlement is made personally not by third parties.

Religare Health Insurance

It is among the top insurers 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 life long coverage offered till the lifetime of the holder. Before thirty days of hospitalization and sixty days after are covered by this health insurance. Room rent coverage up to 1% of the amount ranges 3 to 4 lakhs. Above 5 lakhs coverage, room rent is calculated based on private room rent. Only after 4 years, it is covered if there any pre existing disease. 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 whole family health insurance enable 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 also available. It does not provide facility of loans and surrender value in this insurance. Death benefit is available only if the policy holder has chosen a special rider. Major surgeries, hospitalisation, ambulance costs are covered in this. Hospitalisation cover ranges from Rs. 1000 to Rs. 4000 and the major surgeries cover ranges from Rs. 1 lakh to Rs. 4 lakhs. Minimum age for entering the insurance is 18 years for the adults and 91 days for the 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.  


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darade kishore - Oct 4, 2011

my sun education policy