New Age Comprehensive Health Insurance Plans

Medical advancement has improved the quality of the healthcare facilities, but on the other side, it has also given rise to medical inflation. Hospitalization, treatment costs, and medicines costs are skyrocketing, and if any medical emergency occurs, it can drain all your money. Therefore, to protect yourself and your loved ones from financial distress during medical emergencies, you need a health insurance plan. Below are its benefits:

Hassle-free cashless hospitalization at the time of emergencies.

• Coverage for pre and post-hospitalization expenses.
• Cover Day Care Treatment such as dialysis, chemotherapy, cataract, stone surgery and more.
• Provide domiciliary hospitalization if beds are not available in the network hospitals.
• Covered ambulance expenses.
• Free annual health check-ups for members insured.
• Lessen the financial burden.
• Quick assistance at the time of emergency.

Health Insurance covers your pre and post hospitalization expenses along with your diagnosis, medicine, and treatment expenses. It can be a cashless or reimbursement facility. In a cashless facility, we pay your bills directly to the hospital, once you submit all the required documents to our claim management team. Under reimbursement, we give you the amount you incur on your hospitalization and treatment after you submit your medical bills to us. The medical treatment costs can burn a hole in your pockets and drain all your savings. So, investing in good health insurance is a wise decision you can take to secure yours and your family's future.

When you buy a health insurance policy for yourself, it is an individual health insurance policy. Under this policy, only one insured individual is entitled to get the policy benefits. Whereas, when you cover your family members such as a spouse, dependent parents or children under one policy, it is known as a family health insurance policy. Under this policy, all insured members can avail of the policy benefits.

Filing medical insurance claims is no longer a daunting task. Read the below steps and get it done easily:

Claim Process for Cashless Hospitalization

• Get the health insurance policy claim form from the insurance help-desk of the network hospital and fill all the required details.
• Collate all the medical bills, diagnosis and doctor's prescription.
• Submit all the required documents along with health insurance policy claim to your insurance company.
• Once your documents will be verified by the insurer you will receive an approval letter from the side of the claim management team.
• Query might be raised from the claim management team.

After approval, your hospitalization expenses will be borne by the insurer directly to the respective hospital.

Claim Process for Reimbursement

• Fill health insurance claim reimbursement form and attach all the required documents along with the form.
• Submit the form and the required documents to the insurer. Claim management team may raise the query.
• Once they cross-check and verify the documents you will get an approval letter from the claim management team.
• After approval, your hospitalization expenses will reimburse you by the insurer up to the sum insured.

Yes, you can buy medical insurance immediately from us. We have only 30 days waiting period. It means you have to wait only for 30 days for any illness other than injury to avail the benefits of the policy.

Network hospitals are partnered with us. These hospitals are well-renowned for healthcare services and have trained medical professionals. You can get the claim under health insurance policy only when you are admitted to any of our network hospitals. We provide you with the list of network hospitals at the time of purchasing insurance cover. Non-network hospitals do not have tie-ups with us, and you are not entitled to get any claim if you get admitted to any of the non-network hospitals.

It's easy to calculate the premium for a health insurance policy. You can use our online premium calculator available on our website. However, the amount may vary according to age, pre-existing disease, income, and a number of family members need to cover. If you already have any pre-existing disease then, in that case, your premium will be higher than those who don't have. Further, it will also help you to prepare your budget and invest in the policy that will be cost-effective and gives you more coverage.

No Claim Bonus or NCB is a reward that you get from us under your health insurance policy for not claiming during your policy tenure. It is the bonus amount that gets accumulated to the sum insured for every claim-free year. It is a double bonus you can avail of on your health insurance policy. For instance, we offer a 10% increase in the medical insurance policy sum insured for every claim-free year, with no change in premium. So, a policy with a sum insured of Rs.5 lakh will get an extended cover of Rs.50, 000 in the following year at the same premium. In a claim-free third year, another 10% extra cover on will be added in the base sum insured, taking the total to Rs.6 lakh. A maximum bonus of up to 50% is permissible. In the case of a health insurance claim, the accumulated bonus is reduced by 10%. It makes you strong to face any medical emergency in the future.

Group health insurance is designed to protect the employees of any corporation or institution. It offers sum insured options from 50 thousand to 10 lakhs with different family definitions. It also provides additional benefits like wellness initiatives, complementary annual health check-ups, etc. However, individual health insurance is for a single person, and only one individual insured can avail of its benefits.

Premium is the amount that you have to pay to us against the sum insured. You will be glad to know that you can easily claim tax benefits on the medical insurance policy premium. Under Section 80 D of the Income Tax Act, the premium paid for the health insurance policy for self, your dependent parents, spouse, and children are exempt from tax. You can claim Rs.25000 for individual and family health insurance and up to Rs.30000 for senior citizens per year.

Deductible in health insurance means the amount that you have to pay to us before we start paying your claims. Therefore, we are liable to pay your claim amount only if it exceeds the deductible. For instance, if the deductible of your policy is Rs.20, 000, and the claim by the insured is Rs.30, 000, then we pay you Rs.10, 000. However, if the claim amount is less than the deductible, then we are not liable to pay any amount. The higher your medical insurance premium, the lower is your deductible.

DIt is the period until which you have to wait before the health insurance coverage comes into effect. You will get all the benefits after the completion of the waiting period. We have a 30 days waiting period for a health insurance plan. It is also known as the elimination period.

We take 15 days after receiving the required documents from you to process your health insurance claim. However, it can take a long time depending on the verification process conducted by our claim management team.

Below is a list of the documents you required for medical insurance claims:

• Duly complied and signed claim form.
• Doctor's prescription and referral letter.
• Diagnostic tests and reports.
• Original bills, receipts and discharge papers from the hospitalization.
• Original bills from pharmacy/chemists.
• Provide the Police Report or FIR if personal accident.
• Post-mortem report. Death certificate.
• Policy details including number, name of the policyholder, nature of the illness, address and other required information.

You can get the tax benefits from health insurance under the following:

Tax benefit on Premium You can claim Rs.25000 for individual and family health insurance and up to Rs.30000 for senior citizens per year.

Tax Reduction on Health Check-Ups: According to Mediclaim Section 80D, you can avail tax reduction on annual health checkups up to Rs.80000.

Tax Deduction on Single Premium Health Policies: On a lump-sum premium paid in a single year for a health policy valid for more than one year you can claim a deduction up to Rs.50000.

If you don't pay your health insurance policy premium on the due date, then we will give you a grace period immediately following the premium due date. It is 90 days extra time given to you to make the payment. If you still do not make the payment during the grace period, then no coverage will be provided for that particular period.

Yes, you can increase your health insurance cover during renewal. If required, we have to review your health, claims history, age, etc. before increasing your cover. You have to pay an extra premium as per the cover you want to add in your medical insurance policy to avail of more benefits.

There are various reasons for medical insurance claim rejection. If your insurance claim got rejected, follow the below steps:

• Check the reason for claim rejection from Claim Management Team.
• See your health insurance claim form again and make sure that you have given the right name and policy number.
• Make sure you have provided all the required information to avoid system error due to insufficient information.
• Check all the documents attached with the medical insurance claim form.
• Write a letter to Claim Management Team informing them the genuine reason for filing the claim.
• Contact to Ombudsman for settlement.

Sum Insured means the amount specified in the policy certificate, which represents the company's maximum, total, and cumulative liability against the insured person. All claims arising under the health insurance policy shall not exceed more than the Sum Insured.

No, you cannot have multiple health insurance plans for yourself. You can buy it for yourself, spouse, dependent parents, and children. You cannot claim two policies at the same time.

Yes, medical insurance premium increases with age. With the increase in age, the probability of health problems also rises; thus the premium amount also goes up.

Keeping in mind the day-to-day lifestyle, eating habits, pollution, and stress level, it's better to stay financially protected. These days a plethora of health insurance plans are available, but you should wisely pick the one that best suits your needs. Here you can consider below points while looking for a health insurance plan:

• Look for Maximum Coverage
• Amount of Premium
• Check Exclusions
• Ask For Waiting Period
• Check the Sub-Limits
• Check the Age

You can pay health insurance premiums via cheque, net banking, debit card, credit card, and payment wallets.

No, you cannot include your elderly parents on your medical insurance policy. Instead, you can buy health insurance for parents for them.

Yes, you can get a medical insurance policy if you are over 65. You can opt for Senior Citizen health insurance that has a 20% co-payment clause. It covers pre and post hospitalization expenses and also provides the facility of cashless hospitalization at an affordable premium.

You can increase the sum insured in my health insurance at the time of policy renewal. Policyholders have the option to increase the sum insured after certain medical tests and a revision of the claim history. But it can't be increased further if the existing sum has already met the sum insured limit of your policy.

Pre Hospitalization: expenses that are incurred before you get admitted to the hospital for further treatment are known as pre-hospitalization expenses. Following are the admissible pre-hospitalization expenses:

• Medical Tests such as blood, sugar, BP, and urine test ultrasound and x-rays.
• Medicines
• Vaccinations
• Doctor's Consultation Fees.

Post Hospitalization: Expenses that are incurred after you admitted to the hospital for your further treatment are known as post-hospitalization expenses. Following are the admissible post-hospitalization expenses:

• PET SCAN, MRI, Kidney Functioning Test, ECG, Endoscopy, Angiography and other.
• Advance medicines.
• Advance Vaccinations.
• Dialysis, Surgery, Organ Replacement and Physiotherapy, Daycare treatment, Chemotherapy Doctor's Consultation Fees.

Under the cashless health insurance facility, you do not need to pay a single penny out of your pocket in case of hospitalization. All the medical, surgical, and treatment bills, will be directly paid by us to the network hospital. These are the hospitals that have tie-ups with us, and you are eligible for cashless hospitalization here only.

A pre-existing condition in a health insurance policy means any health issue that the individual has been facing before purchasing health insurance. The pre-existing conditions include all health issues ranging from high blood pressure, thyroid, diabetes, asthma, etc.

Smoking increases health risk, that's why we charge a higher health insurance premium, to mitigate the risks associated with it. We conduct medical tests to detect regular smokers and determine the premiums for coverage accordingly.