Health insurance cover is the most crucial to have especially at this point of time when the entire world is experiencing the wrath of Coronavirus. In the modern era of inflation, it becomes imperative to seek out a decent health insurance cover especially if you wish to safeguard yourself as well as your loved ones from falling prey to skyrocketing healthcare expenses. Apart from providing you with adequate peace of mind, it also offers the best chance of recovering back both physically and financially if anything unfortunate happens.
Getting a health protection as early as possible is becoming extremely important as once you succumb to issues such as diabetes or blood pressure, your insurance cost starts getting high while the coverage gets low. Today we are going to take you through the most important considerations which can help you in choosing the right cover.
The emphasis on importance of having the right and adequate health insurance plan is never enough.
There is always a lot of confusion about which health insurance plan is best and which one suits our needs. The major reason for this confusion is diversity of features among different insurance providers and their products. There are so many things and fine print that one needs to check before buying a health insurance plan.
Let us start with the very basics.
Types of Health plans
So there are two types of health insurance plans available in the market. These are:-
- Indemnity Plans
- Benefit plans
Let us discuss each of these two in detail : –
- Indemnity plans
Indemnity means to make good the loss. The objective of this type of plan is that it makes sure that you do not have to spend on the medical treatments from your own funds. This plan ensures this by two ways :-
- Reimbursement -It reimburses the cost of medical treatment in a hospital. Reimbursement means first you need to pay all the expenses incurred in the hospital and after showing proof of the expenses by way of bills etc, the insurance company reimburses you.
- Cashless treatment – This is the most common one and you might already be aware of this. Here, you don’t have to pay anything from your pocket; the bills of the hospitals are directly paid by the insurance company through TPAs. This facility is available to all the network hospitals of the insurance provider.
I would say almost all the times, the hospital near you will be covered in a list of network hospital and you can avail the cash less facility. However, if not then you can opt for reimbursement. So it is always better to check the list of network hospitals before buying an insurance policy.
For example, if a policyholder chooses a sum insured amount of Rs.4 lakhs and is presented with a hospitalization bill amounting to Rs.1.5 lakhs, the insurance company will pay out Rs.1.5 lakhs to the policyholder. This is what happens in indemnity based plan.
I hope you are now clear with indemnity pans. In short, this plan settles the claim based on your expenses incurred either by reimbursement or cashless. This claim cannot exceed your sum insured. These plans also cover a wide range of treatments and illnesses and cover the actual amount of the hospital bill.
On the other hand, benefit plans pays out a fixed amount to the insured on diagnose of a particular disease for which he is insured irrespective of the expenses incurred or about to incur. This means you can spend this amount received from insurance company however you want and not necessarily the hospital expenses.
When a person is diagnosed with a critical illness, not only he incurs the hospitalization expenses but also suffer by loss of income owing to inability to work. The benefit plans gives you the flexibility to use the money as you want.
For example, if a policyholder chooses a sum insured amount of Rs.4 lakhs and is diagnosed with a critical illness then insurance company pays you the entire sum insured of 4 lakhs. Doctor’s certificate and report is required to prove diagnosis. Now even if the he is presented with a hospitalization bill amounting to Rs.1.5 lakhs, the insurance company will pay out entire Rs.4 lakhs to the policyholder. This is what happens in benefit based plan.
Now based on the above two types, let us see the different types of health insurance plans available in the market:-
- Comprehensive health insurance Plan – It is a Indemnity based plan which is available as individual plan as well as family floater. These are offered by general / health insurance companies only.
- Critical Illness Plan – It is a benefit based plan which is available only for individuals not as family floater. There are some plans which are comprehensive which covers a number of critical illnesses and there are plans which cover only one particular critical illness like cancer. Also, note that these plans are often offered as a rider as well. Thus, it is offered by both life and general insurance companies.
- Corona Specific Plans
IRDAI had recently mandated insurance companies to offer short-term health plans that will cover hospitalisation expenses related to the treatment of COVID-19. This will assist individuals buy specific health cover for meeting hospital costs due to coronavirus.
There are two such plans – Cororna Kavatch and Corona Rakshak. Both of these policies are short term health insurance plans meant for Covid-19 related hospital expenses. One of the major benefit of these policies is that your no claim bonus of existing comprehensive cover will not be impacted due to COVID-19 claims.
- Corona kavatch – It is an indemnity plan offered by general and health insurers only. Minimum cover – 50,000, Maximum Cover -5 lacs. It is available in both individual and family floater Option. You can get to add hospital daily cash of 0.5% of SA per day
- Corona Rakshak – It is a benefit plan offered by both life and general insurers. Minimum cover – 50,000, Maximum Cover -2.5 lacs. It is available as only individual plan. It requires an hospitalization of 72 hours.
It is suggested to not buy corona specific in place of comprehensive cover but rather it should be like a supplementary cover. It is recommended that one should have a comprehensive indemnity based cover with a benefit based cover as well. Both the plans have their own unique features.
Stay safe and be insured.