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Health Insurance: Its importance and why we shouldn’t neglect it

  • Posted on- Oct 01, 2015
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Written by site author.

Hospital bills for very small to considerably large ailments are a pain. It’s difficult to meet such costs on our own without burning a hole in our savings. Also, with medical costs escalating, some even compromise on quality healthcare, because of affordability. It is then that the importance of health insurance comes into the picture. Health Insurance provides us with the ability to afford better healthcare facilities for ourselves and our loved ones. What’s more, you can also enjoy tax benefits.

Understanding the concept of health insurance

Health Insurance in India, popularly known as Mediclaim, is nothing but an insurance which covers expenses related to necessary hospitalisation due to a sickness or an accidental injury. A standard mediclaim covers comprehensive costs of hospitalisation, which include:

  • Investigation costs before the hospitalization like medical tests, doctor fees
  • It includes cost for ambulance
  • All costs while in the hospital which include room charges, surgery charges, diagnostic tests etc.
  • Costs incurred post hospitalization for complete recovery, for example follow up doctor visits, diagnostic tests, medicines connected to the hospitalisation

Benefits of a health insurance plan

Due to skyrocketing inflation and quality healthcare services, hospitalisation is becoming very expensive. Large hospitalisations which cost lakhs of rupees can seriously burn a very big hole in one’s savings or worse, burden one with huge debt. Health Insurance plans help in spreading such a risk to larger no. of people, and hence bring the costs down per person.

How does a health insurance works?

Health insurance is generally an annual insurance policy, renewable every year. The policy covers hospitalisation due to sickness and accidental injury, subject to certain exclusions and waiting periods, which are explicitly mentioned in the policy wordings. You can claim health insurance in 2 ways - cashless or reimbursement.
  • Cashless: Every insurance company has a network of hospitals where they have a direct billing arrangement. In such cases insurance companies directly pay the admissible claim amount to the hospital. When the insured person is admitted in a network hospital, he/she or his/her relative would need to just submit his/her cashless card to the hospital billing desk, who will process cashless admission for the patient, subject to approval by the insurance company. In such cases, the insured person will have to pay only expenses which are not covered under the health insurance policy.
  • Reimbursement: In case you happen to be admitted in a hospital which is not in the network of your insurance company, you will have to make all payments on your own to the hospital, and then submit these original papers along with the claim form to the insurance company for reimbursement.

Tips while buying the right health insurance plans
  • One needs to understand that there is no perfect plan. Understand your needs well, plan for the long term, and go for the closest suitable plan. Don’t wait for that perfect plan with everything covered to arrive and risk delaying your coverage.
  • Remember, you are buying insurance for your old age. With healthcare inflation at its peak, do not go for a small sum insured of Rs. 1 lakh, if you can afford more. A premium of around 25% of your monthly salary is surely affordable.
  • Demand the policy wordings (where all terms and conditions of the policy are mentioned) of the product you are going to buy before you sign the dotted line.
  • Do not solely depend on health insurance from your employer. Employer sponsored coverage is changing every year according to claims experience and budgets of your employer. You may suddenly find yourself or your family with very low or no coverage. It is becoming more and more difficult to get insurance for people above 45 years or people who have an ailment or health condition like diabetes/thyroid/hypertension etc.
  • Check the maximum renewal ceasing age of the policy. This is the age when your policy will discontinue. Today, there are policies available which can be renewed for lifetime. Go for lifetime renewable policies.
  • Ensure you spend time in finalizing a good health insurance advisor, who would provide you unbiased advice across all leading insurance companies as well as assist you for renewals and claims in the long term.

In this present age where affordable and world-class healthcare services are hard to come by, a good health insurance policy can save the day for us. By getting your family’s health insured, you can lead from the front.


user profile image
23-10-2016 01:29 AM

Health insurance is very necessary now a days. Hospital bills are like pain.

user profile image
25-03-2016 06:40 PM

One should have a medi claim of the whole family, emergency can occur at anytime and it’s difficult to meet such costs on our own from savings.

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