What is Health Insurance?
Health Insurance is a type of insurance that covers your hospitalization expenses in the following situations:
a. In case of a sudden illness
b. In case of an accident
c. In case of any surgery, which is required in respect of any disease which has arisen during the policy period.
What are the benefits of buying a Health Insurance policy?
The basic benefits of buying a Health Insurance policy are:
a. Reimbursement for Hospitalization due to illness / disease / surgery.
b. Reimbursement for Domicilary Hospitalization expenses in lieu of Hospitalization.
c. Pre-hospitalization expenses
d. Post-hospitalization expenses
e. Ambulance charges
I am already covered under the Group Health Insurance Policy provided by my employer. Do I still need Health Insurance?
Well, it depends. If you plan to stay with the company forever, it may be ok. However, when you leave the company, your cover expires and you will have to buy a new policy. This may have implication. For example, any existing disease may not be covered if you go for a new policy. Considering this, you may consider buying an additional policy which will increase your coverage amount as well as come handy if you ever decide to leave the company.
Can a person get claim from his own company or spouse company if they both are covered under group insurance policy by respective companies?
Yes, if both husband and wife are covered from their respective employer, they can claim from insurance provided to them by either of the companies, but not both the companies.
What is Domiciliary Hospitalization?
Domiciliary (Home) Hospitalization means medical treatment for a period exceeding three days for such illness/disease/injury which in the normal course would require care and treatment at a Hospital/Nursing Home but actually taken at home under any of the following circumstances:
i) The condition of the patient is such that he/she cannot be removed to the Hospital/Nursing Home, or
ii) The patient cannot be removed to Hospital/Nursing Home for lack of accomodation therein.
What is Cashless facility?
Cashless facility is the benefiit of health insurance in which you will be able to avail the hospital services without making any advance payments. Hospital should be one out of the list of empanelled hospitals with the respective health insurance company.
How to avail the benefit of Cashless facility?
You can avail the benefit of cashless facility through a health card provided to you by the TPA (Third Party Administrator) of your health insurance company.
What is the method to inform the TPA in case emergency for Hospitalization arises?
You can contact your TPA for assistance at any time by calling on the helpline numbers provided to you on your health card.
How can I cover myself for medical expenses incurred during my trip outside India?
For this you need to buy a Foreign Travel Insurance Plan.
Can I take more than one health insurance policy? How will I make a claim in that scenario?
Yes, you can take multiple health insurance policies from the same company or different companies. In that case, you can make a claim either under any one policy or split the claim between the policies in proportion of the sum assured availed.
Will the premium amount remain constant throughout the policy period?
The premiums charged by the health insurance company is usually the same for specific age group. The premium usually remains constant as long as you are in the same age bracket. But once you shift from one age bracket to another, the premium will increase.
What is critical illness insurance?
This policy pays an amount equal to the sum insured upon first diagnosis of a critical illness covered under the policy. It pays the whole sum assured at the point of diagnosis, irrespective of actual cost incurred on treatment.
What are the critical illnesses that are covered in the Critical Illness insurance?
Generally, the following critical illnesses are covered :- cancer, multiple sclerosis, coma, heart attack, bypass surgery, stroke, paralysis, kidney failure, major organ transplant, etc. However, the same may differ from insurer to insurer.
Why to buy Critical Illness insurance if I have a Health Insurance cover?
A basic health insurance policy generally pays only for hospitalization bills. However the amount of health cover may not be enough for treatment if you are diagonised of a critical illness. It may also lead to loss of income, change in lifestyle and permanent disability. To help you combat these, the critical illness insurance plan pay you lumpsum money to meet your large medical cost as well as meet your day to day expenses.
Does the Critical Illness policy cover hospitalization expenses or provide any cashless benefit?
There is no hospitalization expenses or cashless benefit under Critical Illness policy. The insured is paid an amount equal to the sum insured at the time of diagnosis of a critical illness.
Is there any Health Check-up required for taking a Critical Illness insurance?
Yes, depending on your age, plan, sum assured and other factors, the insurer company may require you to undergo a medical check.
What is a “Top-up” Health Insurance policy?
A “Top-up” health policy is an additional coverage for a person/family already having an existing health insurance. It is for reimbursement of expenditure which arises out of beyond a threshold limit of the existing cover. Reimbursement can be one time hospitalisation or recurring during a policy term.
What is No Claim Bonus?
No-claim bonus (NCB) is a discount in premium offered by health insurance companies if a Policy holder has not made a single claim during the term of the health insurance policy.
What is Co-pay in Health Insurance?
Health insurance co-pay refers to an arrangement in which the policyholder will need to pay a portion of the medical expenses on their own and the insurance company will pay the remaining amount.
What is a network hospital?
Network Hospital means Hospitals or health care providers enlisted by an insurer, TPA or jointly by an Insurer and TPA to provide medical services to an insured by a cashless facility.
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