Health insurance’s importance / Health insurance?



Health insurance’s importance / Health insurance?

Why health insurance is important

Learn why health insurance is important and why you should buy a plan for yourself.


Health insurance is a type of insurance coverage that pays for a person’s medical and surgical costs.
How does Health Insurance work?

Health insurance is an agreement between the insured person and the insurance company. The insurance company agrees to pay for the insured person’s medical bills if they get sick or have an accident that puts them in the hospital. Most insurance companies have deals with the best hospitals so that insured people can get care without having to pay out of pocket. If the insurance company doesn’t have a deal with the hospital, they pay back the costs that the insured had to pay. The government also encourages health insurance by letting people take a tax break for it.


Why health insurance is important

Getting health insurance for yourself and your family is important because medical care, especially in the private sector, can be expensive. A hospital stay can cost a lot of money and throw off your finances. If the person who brings in the money is in the hospital, it will be even harder. All of this can be avoided if you pay a small premium once a year, which would make it easier to deal with medical emergencies. Most of the time, a good health insurance policy will cover the costs of doctor visits, medical tests, ambulance rides, hospital stays, and even some of the costs of recovery after a stay in the hospital.



What’s good about having health insurance

Cashless Treatment: If you have insurance, you can get treatments without having to pay cash because your insurance company works with different hospital networks.
Coverage of costs before and after a hospital stay: Depending on the insurance plan bought, insurance policies also cover costs before and after a hospital stay for up to 60 days.



Charges for Transportation: The insurance policy also covers the amount paid to an ambulance to get the insured to the hospital.



No Claim Bonus (NCB): This is the part of the insurance plan that gives the insured a bonus if they did not make a claim for any treatment in the previous year.
Medical Checkup: There are also options for health checkups in insurance policies. Based on your NCBs, some insurers will also give you a free health checkup.

Why Health Insurance Matters
Room Rent: Depending on how much the insured pays for the premium, the insurance policy may also cover room costs.
Section 80D of the Income Tax Act says that you can deduct the cost of your health insurance premium from your taxes.

How to Choose a Good Insurance Plan

All insurance companies offer the same kind of insurance plan, which makes it hard to choose the best one. So, here are some important things that anyone should think about before buying a plan:

Sum Assured Minimum Entry Age and Clause for Renewal
Room Rent Caps: Who’s Included and Who’s Left Out
The No Claim Bonus and Other Perks

Criteria for eligibility

When getting health insurance in India, people under the age of 45 do not have to go through a mandatory health checkup. They must, however, tell the insurance company about any health problems they already had, like diabetes or high blood pressure. Because of this, people are usually told to get health insurance when they are young so that the premium will be less.
Needed Paperwork When Buying Health Insurance

There are a few things you need to give us, like:

Age proof

Birth certificate, 10th or 12th grade report card, driver’s license, passport, voter ID, etc.

Proof of identity

People can prove their citizenship with a driving license, passport, voter ID, PAN card, or Aadhar card.

Proof of address

The permanent address should be written clearly on the electric bill, phone bill, ration card, driver’s license, and passport.

Some plans call for a medical exam (usually for elder people above the age of 45 years)

Photo for Passport Size

Various kinds of health insurance

Health insurance for one person

This policy covers the costs of medical care and hospital stays for the person who bought it. The cost of this policy is based on how old the insured person is.

Health insurance for the whole family

Under this policy, a person can cover their whole family against multiple diseases with just one plan. Family health plans offer a fixed amount of coverage for everyone in the family. This coverage can be used by everyone in the family or just one person.

Plan for Seniors to Get Health Insurance

This policy is made for people over 60 years old and protects them from health problems that can happen as they get older.

Plan for Insurance of Surgery and Serious Illness

This plan is good for people who need treatment for serious illnesses like kidney failure, paralysis, cancer, heart attack, etc. Since these treatments have very high medical costs, the premiums for these types of policies are also very high.

Plan for Health Insurance for Mothers

This policy pays for things like prenatal and postnatal care, as well as the cost of giving birth. This policy also covers the child for a certain amount of time, which is written into the plan. The costs of an ambulance are also paid for.

Personal Accident Plan

If you have an accident, this policy will pay for your hospital bills. The amount of the premium depends on how much coverage you get.

Health Plan Linked to Unit

These plans are unique because they let you save money and get insurance at the same time. This policy helps you build up a fund that you can use to pay for costs that your insurance policy doesn’t cover.
Some of the Indian health insurance plans

Health insurance from Max Bupa
HDFC So Insurance for Health
Health insurance from Bharti Axa
SBI Insurance for Health
Health insurance from L&T
Health insurance from Bajaj Allianz
Health insurance from Apollo Munich
Health insurance for everyone

Health insurance with tax breaks

Section 80D lets you claim the amount you pay for health insurance premiums as a tax break. You can get 25,000 a year to pay for your own health insurance. If you also pay the premiums for your parents’ health insurance, you can also get up to 30,000 back. If you don’t have a life, it doesn’t matter how much money you make. Think about yourself, your loved ones, and how important life is. You already know how important and helpful it is to have health insurance. If you haven’t already, start one.
How to File a Health Insurance Claim

With health insurance, you can get the best medical care without having to worry about the huge bills you’ll have to pay when you get out. So, knowing how to file a claim is an important piece of information that the insured person should always be aware of. When making a claim on health insurance, there are two main types of claims that a person can choose from:

Cashless Claim Process Claim Process for Reimbursement

When the insured person gives their health insurance information to the hospital, they can start getting treatment. When the patient leaves the hospital, the bills will be sent to the health insurance company that was chosen. The company will then review the costs and pay the hospital what it is still owed. Since the payments are made by the hospital and insurance company, the insured doesn’t have to do anything. During the reimbursement claim process, an insured person who is admitted to a certain hospital pays for all of their care until they are released.

Once the insurance company has paid for the costs of treatment and hospitalization, the person must file a claim for reimbursement with that insurance company. The person with health insurance will have to show the original bills from the hospital in order to get their money back. The insurance company will look over the claim and then decide whether or not to pay it. The claim will be paid to the policyholder if the insurance company agrees. If the claim is denied, the insurance company will let the person who made it know.
Healthcare Plans by the Indian government

The central and state governments of India have started many medical insurance plans to improve health care and make it easier for the poor to get it. Here is a list of government-run health insurance programs:


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Health insurance’s importance / Health insurance?


Why Getting Health Insurance Is So Important
Learn the reasons why you should invest in a health insurance coverage for yourself and why health insurance is so important.



An individual who is covered by health insurance is able to make claims against the policy for reimbursement of the costs of medical care and surgical procedures.
What does it mean to have health insurance?

The contract that constitutes health insurance is an agreement in which the insurance company undertakes to undertake a guarantee of compensation for medical expenses in the event that the insured suffers from an illness or is involved in an accident that results in the insured being hospitalized. In most cases, insurance firms have established working relationships with major hospitals in order to be able to offer cashless treatment options to their insured clients. In the event that the insurance company does not have any business relationships with the hospital, they will pay back the cost of the insured person’s expenses. A tax break for people who have health insurance is another way the government encourages people to purchase it.
The Significance of Having Health Insurance

Because of the high cost of medical care, it is vital to purchase a health insurance policy for yourself and your family. This is especially true for care received in the private sector. A stay in the hospital can put a significant dent in your finances and disrupt your budget. If the person who brings in the money is currently confined to a hospital bed, things will become even more difficult. All of this can be avoided by just paying a little premium on a yearly basis, which would reduce the amount of anxiety you feel in the event of a medical emergency. In most cases, the costs of doctor consultation fees, the costs of medical tests, the charges imposed by an ambulance service, the costs of hospitalization, and even the costs of post-hospitalization recovery, at least to some extent, are covered by a solid health insurance policy.


Advantages of Purchasing a Health Insurance Plan for One’s Family


Cashless Treatment: If you have health insurance, you may be able to receive cashless treatments because your insurance provider may work in conjunction with a number of different hospital networks.
Coverage of costs incurred before to and following hospitalization An insurance policy may, depending on the insurance plan(s) selected, extend coverage for costs incurred prior to and following hospitalization for a period of up to sixty days.
Charges for Transportation The insurance coverage will also reimburse any money that was paid to an ambulance service for the purpose of transporting the covered person.
No-Claim Bonus (NCB): This is the bonus component that is paid to the insured person if the insured person does not submit a claim for any treatment during the preceding calendar year.
Medical Checkups Many insurance policies also include coverage for medical checkups as an option. On the basis of your prior NCBs, several insurance companies will also give you with a free health assessment.
Room Rent: Depending on the premium that is being paid by the insured, insurance policies also cover room expenses such as room rent.
The premiums that are paid for health insurance are deductible from your taxable income under section 80D of the Income Tax Act.

How to Determine Which Insurance Policy Is Best for You

Due to the fact that every insurance business offers the same basic form of insurance plan, it might be challenging to choose the greatest insurance coverage. Because of this, the following are some of the most significant considerations that should be given to any person prior to the purchase of any plans:

The Sum Assured Minimum Entry Age clause also includes a renewability provision.
The Inclusions and Exclusions of Rent Caps for Rooms
Bonus for Not Filing a Claim Other Perks

The Criteria for Eligibility

When applying for medical insurance in India, individuals who are less than 45 years old are exempt from having to submit to a mandated physical examination. On the other hand, they are obligated to come clean about any pre-existing diseases, such as diabetes or hypertension. It is therefore typically recommended that one should purchase health insurance when they are still young in order to take advantage of lower premiums.
When Purchasing a Health Insurance Policy, You Will Need These Documents

You will be need to furnish a few papers, including the following:

Age proof

Any one of the following: a birth certificate, a tenth or twelfth grade report card, a driver’s license, a passport, or a voter identification card.

Proof of one’s identity

Driving License, Passport, Voter ID, PAN Card, and Aadhar Card are all examples of documents that can be used to demonstrate citizenship.

Evidence of address

Invoices for utilities like electricity and telephone service, ration cards, driver’s licenses, and passports must to make note of the permanent address.

A physical examination may be required by certain policies (usually for elder people above the age of 45 years)

Passport Size Photo

Different Categories of Health Insurance

Insurance for an Individual Patient

The individual who has purchased this policy is responsible for paying their own medical bills and any costs associated with being hospitalized. The amount of the premium for this coverage is based on the age of the insured person.

Family Health Insurance Plan

One person can purchase this insurance coverage and protect their entire family from a number of diseases under the umbrella of a single premium payment. The family health plan provides a predetermined amount of coverage that is guaranteed to each member of the family. This coverage can be utilized by any individual member of the family or by the entire family as a whole.

Plan for Senior Citizens to Acquire Health Insurance

Protecting those over the age of 60 from the health risks that come with advancing age is the goal of this particular insurance plan, which is geared specifically toward senior adults.

Plan for Insurance Coverage of Surgical Procedures and Serious Illnesses

This plan is appropriate for the insured person who needs care for a serious illness, such as kidney failure, paralysis, cancer, heart attack, or any of the other conditions listed below. Because of the extremely high cost of these procedures, the premiums that are charged for the insurance policies that cover them are likewise quite expensive.

Plan for Health Coverage During Pregnancy

This coverage takes care of costs associated with newborn babies, including prenatal and postoperative care, as well as child birth charges. Additionally, the newborn is protected under this policy for a predetermined amount of time, which is specified in the plan. The expenditures of an ambulance ride are also covered.

Personal Accident Plan

In the event of an accident, this policy will cover the costs associated with hospitalization. The total amount of protection purchased will determine the total cost of the premium.

Plan of Care Linked to the Unit

The provision of insurance and savings opportunities under the same roof is a feature that is exclusive to these plans. This policy assists in the accumulation of a corpus, which can afterwards be utilized to fulfill any expenses that are not covered by the insurance policy.
The following are examples of health insurance policies available in India:

Health insurance provided by Max Bupa.
HDFC Health insurance provided by Ergo
Health insurance provided by Bharti Axa
Health insurance provided by SBI
Health insurance provided by L&T
Health insurance provided by Bajaj Allianz
Health insurance provided by Apollo Munich.
Insurance Programs on a National Scale

Tax Breaks for People Who Have Health Insurance

The amount of money you put toward your health insurance premium that you can deduct from your taxable income thanks to Section 80D. You are eligible to receive 25,000 per year toward the premiums of a health insurance policy for yourself. You are eligible to receive a tax credit of up to 30,000 for the cost of the same thing if you pay the premiums for your parents’ health insurance policy as well. If you don’t have a life outside of work, it doesn’t matter how much money you make. Think about the importance of life, as well as yourself and your family, right now. You are aware of the significance of having health insurance as well as its many advantages. If you don’t already have one, you should create one.
The Procedure for Filing a Health Insurance Claim

Having health insurance enables you to receive the very finest medical care without having to stress about the enormous financial burden that will be your responsibility once you are released from the hospital. Therefore, the insured person should always be aware of the process for filing a claim, since this is a vital piece of information that they should be aware of at all times. When filing a claim for health insurance, an individual often has the option to pick between two primary categories of claims, which are as follows:


Claim Procedure for Cashless Payments and Claim Procedure for Reimbursement of Payments

After the insured person gives the relevant hospital with information regarding their health insurance, the individual will start receiving treatment at the facility. After the patient is discharged, the hospital will send their medical costs to the health insurance company that was previously designated. After that, the corporation will conduct an investigation into the costs and settle the overdue payment owed to the hospital. Because the payments are handled directly between the hospital and the insurance company, the process is straightforward and uncomplicated for the policyholder. When filing a claim for reimbursement, the insured person who has been admitted to a particular hospital is the one who is responsible for paying for the whole course of treatment until they are discharged.

After the insurance provider has paid for the costs of treatment and hospitalization that have been incurred, the policyholder is required to submit a claim for reimbursement to the specific insurance company. When submitting a claim for payment, the covered person will be required to present the health insurance company with the hospital’s original bills. After conducting an investigation into the claim, the insurance provider will determine whether or not to pay it. The policyholder will be notified of the claim as soon as it has been approved by the insurance company. In the event that the claim is denied, the insurance company is obligated to convey this information to the policyholder.
Initiatives taken by the Government of India to Improve Healthcare


The central and state governments of India have both initiated a variety of health insurance programs in an effort to expand access to quality medical treatment for economically disadvantaged members of the population. The following is a list of the various health insurance programs that are offered by the government:

The Rashtriya Swasthya Bima Yojana, often known as RSBY, is a program that was initiated by the Ministry of Labor and Employment with the intention of providing families living below the poverty line with access to medical insurance. Beneficiaries of this program are eligible to get a health benefits cover of up to Rs. 30,000 as part of the program. There is a registration fee of Rs 30 that must be paid.

Pradhan The Mantri Suraksha Bima Yojana is a program that is being run by the government with the goal of increasing accessibility to insurance, particularly for economically disadvantaged segments of society. This plan offers reasonable rates as well as financial support to the surviving members of the insured person’s family.
The Central Government Health Scheme, sometimes known as the CGHS, was launched in the year 1954. The employees of the central government, as well as their pensioners and dependents, can take advantage of the facility’s complete medical care services.

Aam Aadmi Bima Yojana, also known as AABY, is a social security program that was initiated in 2017 with the goal of providing rural landless individuals with access to medical care services. The system will provide protection for the family’s primary wage earner as well as any other member of the family who does so (AABY). It is recommended that the beneficiary be between the ages of 18 and 59. The beneficiary’s dependents will get Rs. 30,000 at the beneficiary’s death due to natural causes, Rs. 75,000 upon the beneficiary’s death due to an accident or permanent disability, and Rs. 37,500 upon the beneficiary’s partial disability.

This program, known as the Janashree Bima Yojana (JBY), was initiated in August in the year 2000. People living below the poverty line (BPL) are the focus of this program, which provides benefits to members of 45 different occupational categories.

Employment State Insurance Scheme (ESIS): This is a social security project with the goal of providing socio-economic protection to members of the working class and their families. The plan guarantees that each participant and each member of their family will receive comprehensive medical care on day one.

The Universal Health Insurance Scheme, also known as UHIS, is a program that has been adopted by public sector insurance companies in India to help enhance the quality of healthcare that is available to low-income households. Beneficiaries are eligible to get a reimbursement of up to Rs. 30,000 for medical expenditures and up to Rs. 25,000 for accidental death insurance. This plan’s insurance premium is Rs. 200 per individual, Rs. 300 for a family of five, and Rs. 400 for a family of seven members.



Health insurance’s importance / Health insurance?

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