Save tax up to ₹75,000~ u/s 80D
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Save tax up to ₹75,000~ u/s 80D
Health insurance coverage helps you stay covered in medical emergencies that might require hospitalisation, doctor consultations, diagnostic tests, etc. This guide explains everything you must know about health insurance policies.
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A health insurance policy is a type of agreement between a policyholder and an insurer to help pay for healthcare costs. Under the insurance coverage, the insured pays a premium amount, and the insurer helps pay for healthcare expenses when incurred.
Health insurance plans protect individuals from medical bills and ensure access to essential treatments. Plans vary in coverage and services, such as wellness programs.
There are several types of health insurance coverage based on the type of coverage they offer. Mentioned-below are a few.
Covers a single person up to the sum insured, which is the maximum amount the insurer will pay for the individual's medical expenses.
Covers immediate family members in one policy. All the insured members can utilise the sum insured, which serves as a pool, as per their needs. The number of members that can be insured in family health insurance may vary from plan to plan.
Senior Citizen Health Insurance is an insurance coverage designed for those over 60, with benefits tailored for older people.
A Maternity insurance plan covers medical expenses during pregnancy, including prenatal, postnatal care, delivery, and often newborn care.
This indemnity-based insurance coverage offers financial aid for medical expenses incurred to treat a list of pre-defined critical illnesses.
It is an insurance policy that offers additional coverage to your existing health coverage and works on the principle of a deductible.
Health insurance supports you and your family in managing health challenges. Key benefits include:
A medical insurance coverage significantly reduces medical costs for surgery, hospitalisation, and emergencies, preventing financial strain from unexpected bills.
An individual with a health insurance coverage can access quality healthcare services when needed, minimising waiting times and ensuring they receive timely care.
Provides reassurance knowing you're covered in medical crises, reducing financial stress and allowing focus on recovery.
Policyholders receive access to a vast network of hospitals, professionals, and experts. This network enables policyholders to receive care from respected and experienced professionals, fostering improved health management and treatment effects.
Many plans include coverage for health screenings, vaccinations, and check-ups, promoting early detection and prevention.
Family members are usually covered in a health insurance coverage that ensures they can receive the same protection. This enables them to preserve the family's wellness and health without worrying about financial obligations.
Health insurance is essential in accessing medical care without financial worry. It enables proactive health management and early intervention. Here's why it's necessary:
A health insurance plan enables policyholders to alleviate the risk of unforeseen and increased healthcare expenses, delivering security from economic lapses.
It becomes easier for the policyholder to care for chronic conditions and access expert consultations.
The policyholders receive improved insight and understanding of their health, promoting better lifestyle choices.
A health insurance plan fosters financial stability and lowers financial apprehension, contributing to a productive workforce.
Ensures access to immediate care during medical emergencies, preventing treatment delays.
Medical expenses can quickly drain your savings, especially with rising healthcare costs. Hence, you require a protective shield- an insurance coverage. Health insurance reimburses expenses, protecting your finances and providing peace of mind.
Today, considering that we are exposed to new health risks, it is sensible to take vital steps to safeguard our finances by getting health insurance. Having a financial backup that will protect a family during any unforeseen medical emergency is of utmost necessity to help you bear the burden of rising medical expenses. Health insurance fulfils this objective best by giving comprehensive financial protection against various medical expenses, including hefty hospital bills.
Health insurance is more comprehensive than mediclaim. The costs covered will include medication, diagnostics tests, consultation fees for pre and post-hospitalization, ambulance cover, and daycare treatment. Simply put, it provides well-rounded health protection and financial security, often including extra benefits like annual check-ups and no-claim bonuses.
A policyholder can avail of coverage benefits by paying the health insurance premium regularly. The premium amount is calculated by considering several factors, such as the insured's age, type of coverage opted for, sum insured, pre-existing conditions, and policy tenure.
The insured also has the advantage of continuing the same policy and availing its benefits through timely policy renewals.
We all look for ways to save and invest wisely. Health insurance is a valuable investment, safeguarding your and your family's well-being against rising healthcare costs.
Here are some reasons you need health insurance:
Medical inflation is growing faster than overall inflation, and quality medical care is now more expensive than expected. Investing in health insurance now protects you from potentially exorbitant costs in the future.
Illnesses affect people of all ages. Today's fast-paced lifestyle and environmental factors increase health risks. Insurance provides a safety net, ensuring access to quality medical care.
Cashless hospitalisation gives you access to immediate treatment at a network hospital. You can choose any network hospital empanelled with us, according to your locality and convenience. Network hospitals are well-facilitated and have highly experienced medical professionals.
Your pre- and post-hospitalization medical expenses are reimbursed up to the insured sum. You must submit your medical bills 30 days before hospitalisation and 60 days after discharge from the hospital to get the reimbursement. With the right medical insurance cover, you get your money back and do not need to pay hefty medical bills from your pocket.
Besides one’s family medical history, a sedentary lifestyle, unhealthy eating habits, lack of physical exercise, and pollution together become risk factors for critical illnesses, including cancer. These illnesses require regular medication, treatments, and chemotherapies. An exclusive health insurance policy will help you manage the recurring medical expenses due to ongoing treatments of such diseases.
Annual health check-ups and diagnosis costs are skyrocketing. Under a health insurance plan, you and your loved ones can avail of annual health check-ups on a cashless basis. It saves you a bunch of money on diagnosis and tests every year. With regular check-ups, you can keep track of your and your family's health, detect any hidden ailments, and nip them in the bud before they become serious.
Under Section 80D of the Income Tax Act, you can also avail of tax benefits. For the premium you pay towards a health insurance policy for yourself, dependent senior citizen parents, children, and spouse, you can get a tax deduction up to Rs.75,000. However, the taxable amount is subject to your income and age. It also reduces your taxable income, which reflects less tax liability.
Here are the steps that might assist a policyholder to choose the right health insurance plan in India:
Health insurance coverage has made it possible for people to remain financially protected by the healthcare expenses to a considerable extent. However, for many, the challenge lies in deciding on the right plan. You may have questions like what health insurance covers, what does not, or which is the best health insurance plan for a family. Every such question is worth asking, and finding answers is vital to help make the right decision.
Pre-existing diseases refer to diseases, illnesses, or injury or related condition(s) for which medical advice was received/ or diagnosed by a medical practitioner within 36 months before the policy's effective date issued by the insurer or its reinstatement.
Some health plans cover pre-existing diseases, such as diabetes or hypertension. Still, there would be a waiting period when the insured person must wait to claim the treatment of such diseases. Thus, before opting for health coverage, find out if it covers pre-existing diseases and, if yes, what the waiting period is. You can ensure you get access to medical treatment without any delays by opting for a policy with a lower waiting period.
Disclosing your complete medical history when buying a policy is necessary to avoid negative implications later. Not specifying your pre-existing condition can lead to claim rejection in cases involving treating such conditions.
A health insurance plan gives you comprehensive protection when you face the brunt of medical emergencies or even in case of planned medical treatments due to an illness. The covers one gets will depend on the type of policy, but broadly, health insurance provides the following benefits:
To understand this, you must read about the exclusions mentioned in your policy document. Exclusions refer to scenarios and expenses for which a policyholder is not eligible to get a claim under the health policy. However, there may be conditions that may not be covered temporarily. That is, they would be covered after a certain waiting period.
Examples of some expenses and medical conditions that are permanently excluded from policy coverage include:
To process your cashless claim under the medical insurance coverage, you must present your health card and identity proof at the network hospital and submit the duly filled pre-authorization form at the hospital insurance/TPA desk as part of the claim settlement procedures. The details required include contact information, policy number, past medical history, proposed line of treatment, estimated expenses, duration of therapy, etc.
In case of a reimbursement claim, you must submit the claim form giving vital details, including the insured's name, contact information, policy number, and details about the ailment or accident, and furnish documents such as identity proofs, hospital bills, etc.
Your claim under your health insurance policy may get rejected for several reasons. One of them is not disclosing facts about your medical history, predominantly pre-existing ailments. Other reasons include mentioning incorrect facts, claims made during the waiting period, and specific coverage not given as per the policy terms or expenses, say for room rent, that exceeds the sub-limit specified in policy details. Moreover, it is also essential to renew health plans on a timely basis to avoid health insurance claim rejection.
If you want comprehensive coverage for all your medical expenses, browse and select a suitable health insurance policy for your family from Care Health Insurance.
The sum insured refers to the maximum payout an insurer is liable to pay an insured in case of an unforeseen medical emergency or planned medical treatment. It is based on the principle of indemnity; the health insurance policy will cover the expenses an insured incurs up to the sum insured.
Pre-existing diseases refer to diseases, illnesses, or injury or related condition(s) for which medical advice was received/ or was diagnosed by a medical practitioner within 48 months before the policy's effective date issued by the insurer or its reinstatement.
The waiting period refers to policyholders waiting before claiming certain medical expenses or treatments. In health insurance plans, there are three types of waiting periods, namely:
Network hospitals or healthcare providers empanelled with an insurance company to provide cashless medical treatment facilities to the policyholders.
A No-Claim Bonus is a reward that many health insurance plans provide if the insured spends a claim-free year. It refers to a bonus amount, in the form of an increased sum insured by a specified percentage, that a policyholder is entitled to receive under a health insurance plan for not claiming during the policy tenure.
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Disclaimer: Plan features, benefits, coverage, and underwriting of claims are subject to policy terms and conditions. Please refer to the brochure, sales prospectus, and policy documents carefully.
~Tax benefit is subject to changes in tax laws. Standard T&C Apply
**Number of Claims Settled as of Dec'24
^10% discount is applicable for a 3-year policy
^^Number of Cashless Healthcare Providers as of Feb 2025
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