Health insurance protects you from financial strain. However, it is necessary to understand the key features before purchasing them. It will help to make a wise decision when selecting what is best for you and your family’s health needs.
Read on to know about some of the important features of health insurance.
Here is a list of some health insurance policy features that you will find in most policies:
A flexible sum insured is something to look for in a policy coverage. It refers to a customisable maximum sum insured option which any given policy offers.
For instance, a basic Rs. 5 lakh individual health insurance is sufficient for young healthy individuals with no dependents. It provides basic treatment and hospitalisation coverage.
These days, modern treatment methods are replacing traditional methods. Having modern treatment in your health insurance means that all expenses of treatments such as Intra-Vitreous injections, Oral Chemotherapy, Robotic Surgeries, are covered.
For instance, the cost of Oral Chemotherapy treatment in India ranges between Rs. 56,000 and Rs. 70,000. Thus, having coverage for this in your health insurance policy would prevent high out-of-pocket expenses.
A pre-existing disease (PED) waiting period prevents fraudulent claims. Many insurers set PED waiting periods ranging from 12 months to 4 years.
For instance, the Majority of insurers offer a PED waiting period of 1 year for critical illness policies. Comprehensive family insurance policies have a minimum waiting period of 3 years.
This is another important benefit of health insurance policy. It allows the policyholders to reduce their pre-existing disease waiting period by paying an additional amount.
For instance, this is ideal for policyholders to get when they have a chronic condition such as diabetes or hypertension.
Outpatient Consultation Coverage is also called Outpatient Department (OPD) Cover. OPD refers to treatments that do not require an overnight hospital stay. Such consultations at network hospitals are payable up to the limits mentioned in policy clauses.
For instance, cataract surgery is a popular outpatient procedure. Patients between 60 and 80 years old get this surgery. Hence, if you are getting a health insurance policy for senior dependents, look for OPD coverage.
Health insurance providers offer coverage for the Bariatric Surgery procedure. It is applicable only up to the limits mentioned in the policy clause.
For instance, insurers provide this coverage in family health insurance policies up to the limits of Rs. 2.5 lakhs and Rs. 5 lakhs.
The delivery expenses feature is mandatory in health insurance policies for family and maternity covers. It refers to expenses covered for delivery for both Normal and C-Section (Caesarean) procedures.
For instance, there are maternity health insurance policy features that provide sum insured coverage for both the mothers and newborn (from day 1). These policies also offer pre- and post-natal care.
The comprehensive family health plans have personal accident cover. This cover is given to the policyholder in case of an accidental death or a permanent disability of an insured person during policy tenure. This cover requires no additional premium and comes included in comprehensive policies.
For instance, people in high-risk occupations, such as working as in-flight crew or construction workers, benefit from this cover.
A hospital encashment benefit is given to an insured person who is hospitalised for each completed day. This feature is also available up to the specified limits of any given policy. The exact amount that a policyholder receives varies from insurer to insurer.
For instance, insurers provide this coverage for a maximum of 7 days of hospitalisation and 120 days during a policy tenure.
Automatic restoration of the sum insured in health insurance policies restores the entire sum insured during the policy period. This feature is generally available in comprehensive health insurance policies.
For instance, if a policyholder exhausts their maximum sum insured of Rs. 5 lakhs due to a treatment or medical procedure, the sum insured is restorable (within a policy year).
A cumulative bonus is another essential feature and increases the sum insured amount without having to pay an extra premium. This bonus is for policyholders when they do not make any claims during a policy year.
For instance, the Majority of insurers provide a cumulative bonus of 50% of the basic sum insured for a claim-free year.
By having a clear idea about the important features of health insurance with your insurer, you can make a choice that suits your health requirements. Apart from just features, you also need to read the policy terms and conditions carefully to understand the policy inclusions and exclusions as well.
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