Reatil Health Insurance

Health emergencies do not come with a prior notice. With sedentary lifestyles more and more people are becoming prone to lifestyle diseases in India. With the increased demand for quality healthcare services, medical treatment has now become quite expensive, especially in the private hospitals. And without insurance the hospital bills are enough to drain one’s savings.

Health Insurance is a type of insurance that offers coverage to the policy holder for medical expenses in case of a health emergency. A health insurance plan chosen by the insured provides coverage for different expenses including surgical expenses, day-care expenses, and critical illness etc.

Types of Reatil Health Insurance Plans

To ensure that the health insurance plan meets your insurance needs, it is important to know the different types of health insurance plans, to decide the right policy.

Individual Health Plan

Individual health insurance plans offer insurance protection with benefits such as cashless hospitalisation, reimbursement, compensation for expenses incurred on pre and post hospitalization expenses, coverage for domiciliary treatment and many more. Individual health plans come with add-on covers as well to enhance the basic health insurance coverage, at a minimal premium.

Family Health Plan

Family health insurance offers insurance coverage to entire family against a single premium. Under this health plan, a defined sum insured is divided among the policy members equally, which can be availed either by one or all members of a family for one or more claims during the tenure of the policy. With a family health plan, almost all the family members can be added under a single health insurance premium.

Senior Citizen Health Plan

Senior Citizen health insurance plans offer insurance coverage to the age group between 60 and above. The health insurance plan covers hospitalisation expenses including in-patient expenses, OPD expenses, Daycare procedures, pre, and post-hospitalisation expenses along with tax deduction benefit u/s 80 D.

Critical Illness Plan

Critical illness health insurance plans offer a lump sum amount in case the insured is diagnosed with a critical illness such as kidney failure, paralysis, cancer, heart attack, etc. Usually brought as a standalone policy or as a rider, the sum insured is pre-defined, where the insured has to survive a particular survival period after being diagnosed to avail the policy benefits.

Covid Health Plans

Post COVID-19 outbreak, the IRDAI has also launched two Coronavirus specific health insurance plans i.e. Corona Kavach health plan and Corona Rakshak health insurance plan. Corona kavach is a family floater plan while Corona Rakshak is an individual coverage based plan. Both the polices cover COVID-19 hospitalization expenses, including the cost of consumable items like masks, gloves, PPE kits, oximeters, ventilators, etc. that make the major portion of the hospital bills. If someone has a health insurance policy then also any of these coronavirus health insurance policies can be purchased to ensure safety of your loved ones during the ongoing pandemic.

Maternity Health Plans

The maternity health insurance plans offer coverage for maternity expenses incurred during both pre and post-natal care, child delivery (normal or cesarean). Some providers also include expenses incurred on vaccination of newborn babies in a maternity health insurance plan. The list of coverage also includes the transportation fee for ferrying the mom-to-be to the nearest network hospital of her choice.

Personal Accident Insurance

Personal Accident Insurance is a rider cover that offers insurance coverage in case of an accident leading to disability or death. The policy coverage includes hospitalization and bears the medical outlay in the event of an accident. A fixed monetary benefit is offered in case of an unfortunate event leading to loss of income.

Key Benefits of Health Insurance

Comprehensive health insurance plans come packed with features that can assist a person in managing expenses associated with medical emergencies and also with preventive health care check-ups.

Cashless Medical Treatment
Pre and Post Hospitalisation

This feature of a health insurance policy takes care of expenses incurred on both pre and post-hospitalisation. It takes into account the costs incurred during a certain number of days both prior to and post hospitalization as part of the claim, provided the expenditures are related to the covered disease/illness.

Ambulance Fee

Once hospitalized the person is free from the burden of transportation fees as it is borne by the insurer.

No Claim Bonus

NCB (or No Claim Bonus) is a bonus provided to the insured if no claim has been filed for any treatment in the previous policy year. The reward can be offered either as an increment in the sum assured or as a discount on the premium cost. You can avail this advantage on policy renewal.

Medical Check-Up Facility

A medical plan entitles the insured to receive regular medical check-ups. A free check-up facility is provided by some insurers, or you can get it as an add-on benefit.

Room Rent

Medical insurance plans offer a co-payment option that pre-defines the voluntary deductibles, which have to be borne by the insured. So, in the event of a medical exigency, some amount is paid by the insured and the rest, by the provider. According to this feature, you can lower the cost of your health insurance.

Tax Benefits
  • Health insurance plans entitle you to receive tax benefits under section 80D of the Income Tax Act, 1961. The premium you pay towards health insurance plans for yourself or your family members, get you a tax rebate, irrespective of whether they are dependent on you or not.

    The tax deduction offered, with respect to the premium, is subjected to the age of the insured and the maximum tax deduction limit that is available. You can save up to a maximum of Rs. 25, 000 in a financial year if you are below the age of 60 years. If your age is above 60 years, then this cap of maximum tax benefit increases to Rs. 50,000.

    *Tax Benefits are subject to changes
Pre Existing Disease:

After 2-4 years of policy inception, various policies begin considering pre-existing diseases, e.g. diabetes, hypertension, etc., for claims. Coverage for pre-existing diseases is offered for specific illness (es) that the insured had before purchasing the policy.

Preventive Health Check Ups
  • Insurance companies have preventive health care check-ups that take care of you before you fall sick. Preventive care, such as regular health check-ups, concession in X-ray fees, consultation fees, etc., is offered under some health insurance plans. By offering various healthcare provisions, this type of plan benefit aims at keeping you healthy. Preventive care is medical care rendered not for a specific complaint but for prevention and early-detection of ailments.

What Should You Consider Before Buying a Health Insurance Plan?

  • Duly filled claim form.
  • Original bills, receipts and discharge certificate/card from the Hospital/ Medical Practitioner. (Self attested copies of bills, receipts and Hospital discharge summary can be provided for Critical Illness or Hospital Cash claim)
  • Original bills from chemists supported by proper prescription.
  • Original consultation notes and/or investigation test reports and payment receipts supported by prescription. (Self attested copies of bills, receipts and Hospital discharge summary can be provided for Critical Illness or Hospital Cash claim)
  • Medical Practitioner's referral letter advising Hospitalisation in non-accident cases.
  • Details of any other insurance policy that may respond to the claim.
  • First Information Report (FIR) & Panchnama/Medico Legal Certificate for medico-legal cases. (If Applicable).