Health Insurance Policies In India

               

health-insurance-policy-in-india

Need of a Health Insurance

Critical illness of self or some loved one in the family becomes a huge burden on the family in the absence of health insurance. A critical illness may even ruin the family as the hospitalization cost and other related expenses soared to the sky nowadays. Therefore, an adequate health insurance coverage for the entire family has become indispensable.

Phenomenal growth of health insurance has been witnessed since 1990. This may be ascribed to the growth of human awareness, spread of education, liberalization of government policies and encouragement by the government by allowing rebate in Income Tax(under section 80D) on premiums paid. India is a fast growing country with a vast population only after China.

India's economy is becoming stronger day after day and its GDP(gross domestic product) is rising fast. More and more available funds in the hands of the Indian people and support by employers and government has led to a massive spread of health insurance policies among Indian population. According to World Bank by 2018 more than 50% of Indian people will have a 'health insurance coverage'.

Various Types of Health Insurance Policy

The controlling authority of insurance sector is IRDA(Insurance regulatory Authority of India). The pioneer in health insurance sector is 'Mediclaim'. In India, health insurance usually covers inpatient hospitalization and expenditure and treatment at specified hospitals within India only and outpatient services are not covered.

Health insurance policies in India flourished only after participation by major private sector companies like Bajaj, HDFC, ICICI, Tata Apollo Munich following permission by the government of India allowing private sector to participate in the insurance segment. There are different types of policies to suit every healthcare need .

Anyone may choose the plan that suits his/her need in the best possible way. The private sector companies offer various types of products - e.g. Cash Less plan, Critical Illness plan, Family Floater plan, Senior Citizen plan etc.

Health insurance plans may be categorized in three categories :

i)Critical Illness Plan : This type of plan covers some specified critical illnesses for instance, cancer, cardiac ailment etc. The cost of treatment of these type of illnesses is very high compared to other medical treatment. The duration of treatment is also very long. This type of policies aim at paying a one time lump sum amount on diagnosis of a critical illness as specified and covered in the policy.  


ii)Hospitalization : Hospitalization plan involves payment of inpatient hospitalization expenses inclusive of cost of medical treatment relating to the disease(x-ray, pathological test, operation cost etc) for the insured subject to a maximum amount as specified in the policy. Under 'floater policy' covering the entire family the insured sum may be availed by any member of the family. Under 'individual health policiy'  the insured amount may be availed on a per member basis.


iii)Hospital Daily Cash Benefit Plan: Hospital daily cash benefit plan takes care
of  'incidental expenses'  during hospital stay. This type of policy pays a daily benefit amount and helps the family to deal with daily expenses.


iv)Top Up Policy : A top up policy is an additional coverage for people who already enjoy an existing individual plan by the employer. The insurer is liable to pay only upto the sum insured for hospitalization. When this limit exceeds the individual has to take care of the additional expenses himself. Here is when a top up policy is of great benefit as it covers the additional expenses. 


How Insurance Companies Bear Cost of Treatment in case of Hospitalization :

• Cashless Facility : Under this facility the insured need not pay the hospital on his/her own and the insurer directly pays to the hospital provided the insured undertakes the treatment only in hospitals approved by the insurer. 

• Reimbursement Facility : Under this facility the insurer reimburses the insured the cost of hospitalization and related medical expenditures at the end of the treatment.