Benefits of Health Insurance: 8 Reasons Why You Need It

Health Insurance is a crucial financial tool that covers a range of medical expenses and treatment. It protects you and your family against high medical costs, ensuring access to necessary medical care when you need it. Buying Health Insurance is a simple proposition: you pay a small premium to an insurance company, which then makes good any costs that arise if you get hospitalised subject to the maximum promised and the conditions outlined in the policy. Also read: What is a Health Insurance Policy?

In an age where medical costs are soaring, Health Insurance coverage is a no-brainer. Here are a few reasons why:

Financial protection

A Health Insurance policy helps you cope with the financial burden of hospitalisation. When insured, your policy covers all planned and unplanned hospitalisation expenses and other related costs.

Access to quality healthcare

The hospital network under your Health Insurance plan ensures you can select the best hospital and access timely and quality medical care. It includes access to specialists, diagnostic tests, and specialised treatments that may be expensive or inaccessible.

Tax friendliness

Any amount you pay as Health Insurance premium is tax deductible. If your annual salary is ₹ 9.5 lakhs, and you pay ₹ 50,000 as a premium, your taxable salary will be ₹ 9 lakhs.The maximum deduction limit is up to ₹ 25,000 per year if you are below 60 years of age. If you are above 60 years, the limit increases to ₹ 50,000. You can even claim additional deductions of up to ₹ 25,000 if you pay premiums for your parents below 60. If your parents are above 60, the limit increases to ₹ 50,000.

OPD treatment

Some Health Insurance plans cover outpatient department (OPD) treatment, including fees for doctor's consultations, follow-ups, and prescribed medications. However, this benefit may require an additional premium.

Free annual check-ups

Complimentary annual check-ups provided by many Health Insurance plans allow you to access health assessments, preventive screenings, and diagnostic tests every year and help you in the early detection of potential health issues.

Preventive care and wellness

Many Health Insurance plans cover preventive services such as vaccinations, health screenings, and wellness programs. The measures promote early detection and prevention of illnesses, leading to better health outcomes and reduced medical costs in the long run.

Family coverage

Health coverage often provides options for family coverage, ensuring your loved ones are protected. It includes coverage for your spouse, children, and dependents, providing comprehensive medical benefits for your family.

Peace of mind:

Health Insurance offers peace of mind, knowing you have protection against unforeseen medical emergencies. It allows you to focus on your health and well-being without stressing over the financial consequences of medical treatments.Read the terms of your plan thoroughly to understand the benefits of Health Insurance. It offers essential benefits that help you manage medical expenses and access quality care, making it indispensable coverage against rising medical expenses. Overall, Health Insurance is a vital tool that provides financial security and access to quality treatment and promotes preventive measures, ensuring you and your family can prioritise your health and well-being.

Hospitalisation expenses

Health Insurance typically covers expenses related to your hospitalisation, including room charges, nursing charges, doctor's fees, surgical procedures, anaesthesia, and operation theatre charges.

Pre-and post-hospitalisation expenses

Many policies cover medical expenses incurred before and after hospitalisation, including diagnostic tests, medications, follow-up consultations, and rehabilitation services.

Daycare procedures

Health Insurance often includes coverage for specific daycare procedures that don't require 24-hour hospitalisation, such as cataract surgery, chemotherapy, dialysis, and certain surgeries.

Ambulance charges

Some policies cover road ambulance services, including transportation to the hospital in emergencies.

Pre-existing conditions (during the waiting period)

Your policy may cover pre-existing conditions , but they may have a waiting period before the coverage becomes effective.

Maternity benefits

Certain Health Insurance plans offer maternity coverage, including expenses related to prenatal care, delivery, and postnatal care. However, the benefits may have waiting periods and specific limitations. Also read: Health Insurance Cancellation Policy - All You Need To Know

Cosmetic Procedures

Health Insurance rarely covers cosmetic procedures or surgeries done specifically for aesthetic purposes.

Experimental and unproven treatments

Treatments considered experimental or not medically proven are not covered.

Non-medical expenses

Expenses that are not directly related to medical treatment, such as personal comfort items, telephone charges, and television fees, are usually not covered.

Certain high-cost medications

Some high-cost medications, such as drugs for lifestyle enhancement or non-life-threatening conditions, may be excluded from coverage.

Self-inflicted injuries

Injuries resulting from self-inflicted harm or attempted suicide are not covered.It is important to review your Health Insurance policy's specific terms and conditions to understand the inclusions, exclusions, waiting periods, and coverage limitations.

Health Insurance policies in India are evolving to cater to your individual needs, providing customised coverage options. Regardless of your age, health status, or marital status, knowing about the benefits of health insurance available for everyone is essential.

Riders

Health Insurance companies offer various riders such as Critical Illness coverage, accident cover, and maternity cover. While the riders increase the policy premium, they expand your coverage and provide additional benefits.

No Claim Bonus

One of the best benefits of being insured is the no-claim bonus, which rewards you with a discount on your premium for every claim-free year. It incentivises maintaining good health and avoiding unnecessary claims.

Lifetime renewability

Your insurance company offers policy renewability throughout your lifetime with no age restrictions. Paying the premiums on time and ensuring the timely renewal of your Health Insurance policy is essential.

Restoring sum assured

Insurance companies can restore your coverage amount when you have utilised the entire sum assured for medical treatment. It is essential to understand the policy terms regarding coverage restoration.

Benefits on deductibles

Deductibles are the amount a policyholder pays before the insurance provider covers the claim. They may include individual and family deductibles in the plan. Look for benefits in your health insurance plan that do not require payment of deductibles, such as coverage for doctor's visits.

Daycare treatment

Domiciliary hospitalisation refers to receiving medical treatment at home under medical advice and supervision. It is applicable when a hospital room is unavailable or due to the patient's weak condition. Familiarise yourself with the ailments covered, the limitations of availing of the medical insurance benefit, and other policy terms related to home treatment.

Daily cash allowance

In case of hospitalisation of you or your family member, the insurance company may offer a daily cash allowance to cover expenses like food and hospital visits. The insurer determines the allowance duration, which is not applicable after hospital discharge.

Attendant allowance

Some insurance companies may offer a provision for covering the expenses of an attendant or a person responsible for taking care of you. It provides an allowance to cover your attendant's expenses, including food and refreshments.

• Assess your healthcare needs and medical history
• Compare coverage, benefits, and network hospitals of different policies
• Choose an adequate sum insured and consider waiting periods
• Check for co-payment and sub-limits
• Compare premiums and claim settlement ratio
• Read customer reviews for customer service feedback
• Understand policy exclusions and limitations
• Consider add-on riders for enhanced coverage

• Government-issued photo ID, such as an Aadhaar card, passport, voter ID, or driving license, for identity proof and address.
• Usually, two recent passport-sized photographs are required.
• Birth certificate, school leaving certificate, passport, or any government-issued document that mentions your date of birth.
• Permanent Account Number (PAN) card is required for tax purposes, as insurance premiums are eligible for tax benefits under Section 80D .
• Medical reports may be required for underwriting purposes, especially for senior citizens or those with pre-existing conditions, medical reports may be required for underwriting purposes.
• You need to fill out the proposal form provided by the insurance company when opting for Health Insurance.
• In certain cases, the insurance company may require income proof to assess your eligibility, especially for high-sum insured amounts.
• Provide your bank account details for premium payments and claim settlements through electronic transfers.
• You may also be required to mention details of the nominee who will receive the policy benefits in case of your unfortunate demise.

Also Read: Can I Port My Health Insurance Policy?

• Inform the insurance company about the hospitalisation or medical treatment for which you seek coverage.
• You may need to show your Health Insurance Card or policy details at a network hospital to avail cashless claim facility.
• Fill out the claim form provided by your insurer and attach all the relevant documents.
• Submit the claim form to your insurer within the specified time frame.
• The insurance company will review your claim application and the supporting documents.
• Once the claim is processed and approved, the insurance company will settle the claim amount. The insurer will pay the hospital if it's a cashless claim. You will receive the approved claim amount in their bank account with reimbursement.
• You can contact the insurance company's grievance redressal cell if there are any disputes or issues regarding the claim settlement. If the matter does not get resolved, you can escalate it to the Insurance Ombudsman or seek legal recourse.

Also Read: Learn Why Health Insurance Claims Get Denied

• Health Insurance protects against high medical costs and unexpected medical expenses, reducing the burden on you and your family.
• Health Insurance ensures access to a network of hospitals, enabling you to receive timely and quality medical care, including specialists, diagnostic tests, and treatments.
• Many Health Insurance plans cover preventive services and wellness programs, promoting early detection, preventive care, and overall well-being.
• Having Health Insurance offers peace of mind, knowing that you are protected against unforeseen medical emergencies and can focus on your health without worrying about financial implications.
• One benefit of having Health Insurance is family coverage, extending protection to your loved ones and ensuring comprehensive medical benefits for your family.
• Health Insurance may offer tax advantages, allowing you to claim deductions on premiums paid, reducing your overall tax liability.
• You need to understand the exclusions and limitations of coverage, including specific treatments, pre-existing conditions, and non-medical expenses, to make informed decisions about your Health Insurance plan.