Key Reasons: The Importance of Health Insurance
- Medical Costs Are Rising Rapidly
- Even minor treatments can cost ₹50,000–₹1 lakh.
- Health inflation in India is ~14% annually.
- Protects Your Savings
- Prevents you from breaking your FD or selling investments in emergencies.
- Covers Expensive Hospitalization
- Cashless treatment in major hospitals.
- Covers room rent, ICU, surgeries, diagnostics, etc.
- Access to Better Healthcare
- You don’t have to compromise on treatment due to cost concerns.
- Tax Benefits (Under Section 80D)
- Save up to ₹25,000 (₹50,000 for senior citizens) on tax.
- Peace of Mind
- Removes financial stress during health crises.
- Covers the Whole Family
- Family floater plans make it affordable to insure everyone.
- Early Purchase = Lower Premium
- Younger people get higher coverage at cheaper prices.
How to Select the Right Health Insurance Policy
- Sum Insured Should Be at Least ₹5–10 Lakh
- Consider city-based costs and family size.
- Opt for Cashless Network Hospitals
- Check if your preferred hospital is covered.
- Family Floater vs. Individual Plan
- For 3–4 people, family floater is cost-effective.
- Watch Out for Waiting Periods
- Especially for maternity and pre-existing conditions.
- Check Room Rent Limits & Sub-Limits
- Avoid plans that limit room types or treatments.
- Look for Useful Add-Ons
- Day care, maternity, critical illness, top-up plans.
- Compare Premium vs. Features
- Cheapest isn’t always best — look for value.
- Trusted Insurer with Good Claim Settlement Ratio
- Go for insurers with a ratio of 95%+.
- Understand Co-payment Clauses
- Clarify if you need to pay a percentage of the claim amount.
- Verify List of Diseases Covered & Exclusions
- Be aware of what's covered from day one and what's not.
Frequently Asked Questions (FAQs)
Q1: I’m young and healthy. Should I still buy health insurance?
A: Yes. Buying early gets you lower premiums, zero waiting period later for many conditions, and lifelong protection. Accidents and illnesses can happen at any age.
Q2: What if I already have corporate health insurance?
A: You should still consider a personal policy. Corporate cover ends when you leave the job, and may not be sufficient for your family's needs.
Q3: What is a ‘waiting period’?
A: It’s the time (usually ranging from 30 days for illnesses, 2–4 years for specific conditions or pre-existing diseases) before certain illnesses or pre-existing diseases are covered by the policy.
Q4: Can I cover my parents in my policy?
A: Yes, many family floater plans allow this. However, it’s often better to buy a separate senior citizen plan for them as their health risks are different and it can make your premium very high.
Q5: Is OPD (doctor visits) covered?
A: Most regular health insurance plans in India focus on hospitalization expenses and don’t cover OPD (Outpatient Department) visits unless you opt for a specific plan or an add-on that includes OPD benefits.
Q6: What happens if I don’t claim in a year?
A: Many policies offer a ‘No-Claim Bonus’ (NCB). This can be an increase in your sum insured or a discount on your renewal premium for every claim-free year, up to a certain limit.
Q7: What is Co-pay in health insurance?
A: Co-payment (or co-pay) is a clause where you agree to pay a fixed percentage of the admissible claim amount, and the insurer pays the rest. For example, a 10% co-pay on a ₹1 lakh bill means you pay ₹10,000 and the insurer pays ₹90,000. This often reduces your premium.
Q8: Should I opt for Critical Illness cover separately?
A: A critical illness rider or a standalone policy can be beneficial. It provides a lump sum amount on diagnosis of listed critical illnesses, which can cover treatment costs, loss of income, or lifestyle changes. This is different from regular health insurance that typically reimburses hospitalization expenses.
Q9: Are all diseases covered from Day 1?
A: No. Apart from accidental hospitalization, most policies have an initial waiting period (e.g., 30 days) for any illness. Pre-existing diseases usually have a waiting period of 2–4 years. Some specific ailments like hernia, piles, cataracts, etc., might also have a 1-2 year waiting period.