How Do Health Insurance Companies Work in India?

Given the increase in the number of lifestyle-related diseases in India, the demand for health cover has increased. Medical inflation is on the rise too. Individuals have therefore realized the importance of investing in medical policies. Such an insurance policy offers coverage against expenses in the event of hospitalization.

Numerous insurance providers offer health policies coupled with the best features and benefits to meet this rising demand.

How Do Health Insurance Companies Work in India? 1

Types of health insurance policies

In India, there are numerous types of health insurance plans available in the market. Following are the five most common types of medical policies.

  1. Indemnity plans

Such a health cover provides reimbursement of hospitalization-related expenses. You may submit all the necessary bills to your insurer, and the insurer is liable to cover these costs up to the sum assured limit.

2. Cashless plans

As the name suggests, cashless plans prevent out-of-pocket expenses. The insurer will settle the bill directly with the hospital. However, it is important to note that you have to be admitted at any of the insurer’s network hospitals to avail of the cashless facility.

3. Family floater plans

These plans are exclusively designed for those who wish to cover their loved ones under a single plan. Therefore, you may seek health cover for yourself, your spouse, dependent children, parents, and parents-in-law under a single plan.

4. Top-up plans

To enhance the level of coverage of your existing plan, you may opt for a top-up plan. Such plans help you when your medical expenses are higher than the sum insured amount of your basic health insurance plan.

5. Daily hospital cash plans

Irrespective of the actual hospitalization expenses, you are entitled to receive a fixed amount of money each day you are hospitalized. This amount may be used to cover costs such as physiotherapy, admission fees, and the cost of travel of accompanying family members, among others.

Benefits of health cover

The advantages of investing in a health cover are many. Following are three major benefits of doing so.

6. Financial security

In case you are not covered under a health plan, you are required to withstand the worst of rising medical inflation. You are required to pay a large sum towards your medical bills, thus resulting in a financial strain. A health insurance plan, therefore, provides much-needed financial protection during medical emergencies.

7. High quality of treatment

By purchasing an adequate coverage amount, you may visit the best specialists and doctors. You may also receive the best treatment at the hospital specialized in your disease.

8. Tax benefits

You may reduce your tax liability by claiming a deduction on the premium paid towards your health plan. You may seek a tax benefit of up to INR 25000 under Section 80D of the Income Tax Act, 1961. Senior citizens may enjoy a higher tax benefit of INR 50,000, according to the latest Union Budget.

The process of seeking a claim

Quite contrary to the popular misconception that making a health case you are admitted at any of the non-network hospitals, you are firstly required to pay the hospitalization expenses. You may then submit a reimbursement claim, along with all the original documents. The insurance provider will then assess the request and reimburse the amount after successfully verifying all the documents.

Alternatively, you may make a cashless health insurance claim if you choose to be admitted to any hospital in the insurer’s network. Here, you have to display the health insurance card and submit the duly filled preauthorization form. These documents are forwarded to the insurance company, and upon successful approval, the hospital receives a go-ahead for your treatment.

Mediclaim policies offer complete safety for you and your family during times you need it the most. With numerous options available in the Indian market, you may analyze such plans’ features and benefits. You may then zero down to the plan best suited to your needs. You may either buy health insurance online or visit your nearest branch to enjoy the benefits of such a plan.

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