Myy Financial Planner

HEALTH INSURANCE

Health insurance is a type of coverage that pays for medical and surgical expenses incurred by the insured individual. It is a contractual agreement between the policyholder (the person who purchases the insurance) and the insurance company (the provider). Health insurance is designed to help individuals and families manage the high costs of medical care by providing financial protection against unexpected medical expenses.

Here are key features and components of Personal Accident Insurance:

HEALTH INSURANCE

Key components of health insurance include:

  1. Premiums:

    • The policyholder pays regular premiums to the insurance provider to maintain health insurance coverage. Premiums can be paid monthly, quarterly, or annually.

  2. Coverage:

    • Health insurance typically covers a wide range of medical expenses, including hospitalization, surgery, prescription medications, preventive care, maternity care, and other healthcare services. The specific coverage details depend on the terms of the insurance policy.

  3. Deductibles:

    • A deductible is the amount that the insured person must pay out of pocket before the insurance coverage kicks in. Higher deductibles often result in lower premium costs.

  4. Co-payments and Co-insurance:

    • Co-payments are fixed amounts that the insured person pays for certain services (e.g., a doctor’s visit), while co-insurance is a percentage of the costs shared between the insured and the insurance company.

  5. Networks:

    • Health insurance plans often have networks of healthcare providers, including hospitals, doctors, and other healthcare facilities. Using providers within the network can result in lower out-of-pocket costs for the insured individual.

  6. Coverage Limits:

    • Some health insurance policies may have limits on certain types of coverage, such as a maximum annual benefit or a limit on specific types of medical procedures.

  7. Preventive Care:

    • Many health insurance plans cover preventive services at no additional cost to the insured person. This can include vaccinations, screenings, and wellness check-ups.

  8. Prescription Drug Coverage:

    • Health insurance plans may include coverage for prescription medications, either through a co-payment structure or co-insurance.

Health insurance is crucial for protecting individuals and families from the financial burden of unexpected medical expenses. It also encourages preventive care and helps improve access to healthcare services. The availability and structure of health insurance can vary by country and region.

Types of Health Insurance:

Individual Health Insurance

Individual Health Insurance is a policy which you may buy to cover you, your spouse, children and parents. This type of insurance policy covers your medical expenses for injury & illnesses related hospitalization, surgery costs, room rent, daycare procedures and more.
Every member covered under the Individual Health Insurance plan will have an Individual Sum Insured. For example, if you take an Individual health policy of 3 lakhs sum insured covering your spouse, 2 kids and yourself, then each person covered will have an individual sum insured of Rs.3 lakhs. Though it makes the premium comparatively higher.
Individuals like you who fall in the age bracket of 18 years to 70 years can choose to buy this plan. The best part of buying an Individual Policy is that it offers individual Sum Insured limit for each covered member.

Family Floater Health Insurance

If you want an affordable health insurance policy for all the members of your family then Family Floater Health Insurance should be your choice. Under a Family Floater Health Insurance, single Sum Insured floats for all the members covered under the policy. A Family Floater Health Insurance Plan is beneficial because the premium is comparatively lower than the Individual Health Insurance policy. This policy can cover yourself, your spouse, children and parents. You should not consider adding members of your family who are above 60 years of age. They are more prone to illness and hence it will impact the premium. If you or the eldest member of your family is below 60 years of age, then you should buy a family floater policy.Benefit of ULIP: Invest money as per your risk appetite. You have the option to invest either in equity, debt or in hybrid funds through the life insurance company with complete transparency.

Group Health Insurance

A Group Health Insurance policy is designed for a group of employees working together. So if you own a start-up or a corporate house, you should buy such plans for your employees. It is a kind of benefit offered to the employees. As an employer, you can buy the cover to boost the rate of employee retention. Group Health Insurance Plan comes with a low cost premium. Some insurance companies allow to refill the sum insured, that too, unlimited times, if it is exhausted. A Group Health Insurance Plan covers you for hospitalization due to accident, illness, critical illness, psychiatric illness, and maternity. Buying a Group Health Insurance policy not only offers coverage to your employees but also enhance the goodwill of your company. A very crucial point here is that the employees are covered only till the time they work with your company.

Senior Citizens Health Insurance

The health insurance policy which is dedicatedly designed for old people above the age of 60 years is called Senior Citizen Health Insurance Plan. If your parents or grandparents are above 60, then this cover is a good choice for you. A Senior Citizen Policy will offer coverage for cost of medicines, hospitalization arising out of accident or illness, pre and post hospitalization and treatment. Along with these, some other benefits like Domiciliary Hospitalization and Psychiatric benefits are also covered. Add-ons like “Zone Upgrade” helps to meet the city-wise price escalation for treatment. Other than this, you can also choose to buy alternative treatment (AYUSH) cover as an addition. Some insurers may ask for a complete body check-up before they sell a Senior Citizen Health Insurance Policy. The maximum entry age limit has been pushed to 70 years of age with lifetime renewability. And, as we know, the senior citizens are more prone to illnesses, these plans are more expensive than other health insurance policies.

Maternity Health Insurance

A Maternity cover can be bought as a rider along with the basic health insurance plan. All the expenses incurred in the prenatal stage, delivery and post-natal stage are covered. Newly married couples or families who are planning a baby in the coming years should buy this policy. It covers for child-delivery (including medically necessary terminations), infertility expenses and coverage for the newborn baby up to its first 90 days. The Maternity Cover has a minimum waiting period of 2 years

Critical Illness Insurance

The occurrence of the lifestyle-related diseases are on the rise. Keeping this in mind, the insurance companies have offered the Critical Illness Policy. Dedicatedly designed for middle-class families, this health plan covers diseases like:

  • Cancer
  • Stroke
  • Kidney Failure
  • Paralysis
  • Coronary Artery Bypass Surgery
  • First heart attack
  • Pulmonary Arterial Hypertension
  • Multiple Sclerosis
  • Aorta Graft Surgery

Getting treatment for these diseases is an expensive affair. Under the Critical Illness Plan as soon as you are diagnosed with the disease, it will pay you a predefined amount irrespective of the actual cost of treatment incurred. Nothing can be a smart move than buying a Critical Illness Policy as it prevents any impact on your savings. The policy has lifetime renewability. If you take the Critical Illness Policy, then you should survive for 30 days after diagnosis of the illness. It will be wise to buy this policy if you have had a family history of some diseases. Other than the lump sum amount, a Critical Illness Policy reimburses you the cost of care and hospitalization expenses. You can also avail the benefit of the complementary health check-ups. But you should remember that once a claim is filed, then the Sum Insured is released in lump sum. After the release of the Sum Insured, the policy terminates.

Top-Up Health Insurance

You can buy a top-up policy if you seek coverage for higher amounts. But such plans come with a “Deductible Clause”. So, in case of a claim the payment will be made over and above a defined limit mentioned in the policy. Like if you have taken a cover for 15 lakhs and it has a deductible of Rs.3 lakhs, then you will have to bear claim up to Rs.3 lakhs. The amount over and above this, will be paid by the insurer. So, if you seek a wider cover over and above your basic health insurance policy, then you can buy this plan. Under the Health Insurance Plans, you also get a Daily Cash Allowance offered by the insurance company. These are daily expenses reimbursed for 30-45 days and are separate from the hospitalization expenses. As the demand for health insurance policies increased, so increased the number of insurance companies and their products. The medical costs are soaring and it is wise to buy either of the policies above.