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What is Health Insurance and its Importance

7 Reasons Why Health Insurance is Important


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The healthcare sector in India has made great progress over the years with the country, today, being the preferred choice for those seeking advanced diagnostic services. Quality of medical care has improved greatly as scientists have found cures for many serious diseases. Despite these positive developments, access to quality healthcare continues to be expensive for people, especially middle-class families.

Below, we address some commonly asked questions buyers ask about health insurance.

What is Health Insurance?

Health insurance is an insurance cover for health-related expenses offered by a health insurance company to an individual or a group of individuals. Health insurance provides comprehensive coverage for medical exigencies beyond hospitalization, for instance, OPD expenses, ambulance costs, etc.

Why is Health Insurance Important?

Youth is a wonderful phase of life where the josh is high, and you fly on the top of the sky. Your health is at its best, so what is the use to invest in health insurance policy right now? Remember, humans, are not immune to ailments and uncertainties. You cannot even imagine how a medical crisis can wipes out your health and happiness. Since healthcare costs have become expensive, they can eat all your money and savings if you do not have adequate health insurance. Here, we walk you through the importance of health insurance policy and why it is a one-stop solution to all the health concerns.

Immediate Treatment

With comprehensive health cover, you get immediate treatment. During medical exigency, you can be admitted to any of the network hospitals. You are not required to wait, and full fill cash deposit formalities. Your treatment gets started right after you inform the help desk in the hospital. Later, after submitting all the required documents, your health insurance provider pays all your bills directly to the hospital, subject to policy terms and conditions.

Reimbursement of Pre and Post Hospitalization Medical Expenses

Your pre and post hospitalization medical expenses get reimbursed up to the sum insured by the insurer. You are required to submit your medical bills of 30 days prior to hospitalisation and 60 days after discharge from 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.

Treatment in Network Hospitals

Network hospitals have tie-ups with insurance providers, and you can choose any network hospital of the insurer according to your locality and convenience. These hospitals are well-facilitated and have highly experienced medical professionals. You do not need to wander from one hospital to another during an emergency. You can easily get admitted here and file for the claim.

Bear Recurring Costs

A sedentary lifestyle, unhealthy eating habits, no physical exercise, and pollution together causes critical illnesses. These illnesses require regular medication, treatments, and chemotherapies. An exclusive health insurance policy bears the recurring medical costs that occur due to on-going treatments of such diseases. Therefore, it ensures the best possible treatment in the present and even after your retirement.

Annual Health Check-Ups

Annual health check-ups and diagnosis costs are skyrocketing. Under the health insurance plan, you and your loved ones get annual health check-ups on cashless basis. It saves your bunch of money on diagnosis and tests every year. With regular check-ups, you can keep track of your and your family's health.

Tax Benefits

Under section 80 D, you can avail of tax benefits as well. Premiums paid for health insurance for self, dependent parents, children, and spouse get the tax exemption up to Rs.75, 000. However, the taxable amount is subjected to your income and age. It also reduces your taxable income, which reflects less tax liability.

Peaceful Life

With the right health insurance cover, you do not need to worry about on-going medical treatment costs after retirement. You can save your money on buying a home, children's education, and their marriage. While your health insurance plan takes care of your healthcare needs for a peaceful life.

Buying health insurance has made it possible for people to minimize healthcare expenses to a huge extent. However, for many, the challenge lies in deciding the right plan. As a buyer, you may have several questions like what does health insurance cover, what does it not cover or which is the best health insurance plan for family. Every such question is worth asking and finding answers to all of them is important to help make the right decision.

What is Pre-Existing Disease? Will My Health Policy Cover the Same?

Pre-existing disease refers to the medical condition, an ailment or an injury for which an individual showed signs or symptoms/was diagnosed for, prior to purchasing a medical insurance policy. Since the chances of availing medical treatment are higher in such cases, it becomes difficult to get suitable health policies.

However, there are health plans that cover pre-existing diseases, for example, diabetes or hypertension, but there would be a waiting period that the insured person must go through in order to make a claim for the treatment of such diseases. Before buying a policy, you should find out if it covers pre-existing diseases and if, yes, what the waiting period is.

It is also necessary to disclose your complete medical history to avoid negative implications later on. That is, if you do not inform your insurer about your pre-existing diseases, it can lead to rejection of your insurance claim in the cases involving treatment of such conditions.

What Does Health Insurance Cover?

This is the question that many buyers ask, and should ask, their insurer at the time of buying a health policy. The answer will depend on the type of policy you have opted for. Commonly, health insurance covers expenses involving hospitalization, pre and post hospitalization medical expenses, medications and diagnostic tests, etc. It is, therefore, advised to read the policy details thoroughly.

What Does Health Insurance Not Cover?

To understand this, you must read about the exclusions mentioned in your policy document. 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 conditions that are permanently excluded from policy coverage include intentional self-inflicted injuries, substance abuse, etc.

What are the Details Required for Making a Claim?

For processing your insurance claim, your insurer may require vital details such as the name of the insured person, contact information, policy number mentioned on the health card and details about the ailment or accident. To support your claim, you will need to furnish documents such as identity proofs, hospital bills, etc. In case of cashless treatment, you also need a pre-authorization form containing information like past medical history, proposed line of treatment, estimated expenses, duration of treatment, etc. It has to be submitted to the hospital insurance desk as part of the claim settlement procedures.

Can My Claim Get Rejected? If Yes, Under What Conditions?

Yes, the claim made by you under your health insurance policy may get rejected due to a number of reasons. One of them is not disclosing facts about your medical history, especially pre-existing ailments. Other reasons include mentioning incorrect facts, claims made during the waiting period, specific coverage not given as per the policy terms or when expenses, say for room-rent, exceed 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 are looking for comprehensive coverage for all your medical expenses, browse and select a suitable health insurance policy for your family from Religare Health Insurance.

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