Features of Health Insurance

Different Types of Health Insurance Plans

There are some features present in certain types of specific health insurance plans, and it is advisable to look at one’s requirements before deciding on which one you should go for.

Some of the different types of health insurance plans include;

1. Individual Health Insurance Plans – These types of plans are typically purchased by people who are looking at insuring themselves only. The coverage includes medical expenses, hospitalisation, and even daycare procedures in some cases.
2. Family Floater – Family Floater health insurance is generally taken to insure the whole family. The coverage usually extends to the spouse and children. All the insured family members can make use of the sum insured, in case of a medical emergency.
3. Senior Citizen Health Insurance – This type of health insurance plan is designed especially for people above a certain age.
4. Critical Illness Insurance – If you would like to take insurance cover for a specific illness, then this insurance plan will be the best for you. Critical illness insurance generally covers ailments related to heart, cancer, stroke, and various other diseases as specified in the plan.
5. Personal Accident Insurance – As the name suggests, the plan provides insurance coverage in case of disability, or even death due to an accident.
6. Top-Up – Top-up is generally taken as additional coverage over and above the ongoing health insurance plan already taken by someone. The premium for top-up is generally lesser than the normal plans. It also provides an additional sum insured over and above the existing plan taken by the insured.

Now, considering your requirement, you can choose the plan type which fits your family’s and your needs.  However, it is important to remember what all features are being offered in the health insurance offered by your insurer. 

Now, let’s look at some of the important features one should explore while deciding to purchase a health insurance plan.

Some Important Features of Health Insurance Plans you should Know

As discussed most health insurance plans provide coverage for different types of medical conditions and emergencies.

Here we will look at some of the important features, you as a customer should look at while buying a health insurance plan.

1. Waiting Period Concerning Pre-existing Illnesses

Once you buy a health insurance plan, certain illnesses do not automatically become a part of this insurance coverage. This is especially true for certain existing illnesses. They become eligible to be covered only after a certain waiting period. This waiting period, however, can be different for different health insurance plans. Thus, do check on the waiting period as it can range from a few months, to even years depending upon the policy. A shorter waiting period will provide you with the right coverage immediately.

2. Sum Insured or Policy Coverage

This is the maximum amount of expense you can incur which will be either reimbursed by the insurer or paid for directly to the hospital. In case, your total medical expenses go beyond your sum insured, you will be forced to pay from your pocket. Ensuring you take the right sum insured thus, becomes important. Choosing the amount which will ensure enough coverage without you having to dip into your savings, thus becomes important.  Do look for this while deciding on your health insurance plans.

3. Sub-Limits

Another area that can be quite expensive when undergoing medical treatment is the room rent. The room rent is mostly tied to the sum insured. 

It is generally 1-2% of the total sum insured. In the case of the ICU, the room rent allowed is a little higher. It is, however, important that you examine your policy closely to ensure this amount is enough for your needs.

4. Network of Hospitals Available for Treatment

The cashless facility available with a health insurance plan is dependent on the network of hospitals that have a tie-up with the insurance company. The larger the network, the easier it will be for you to pay cashless for the treatment. However, if the network hospitals are smaller in number, then you may be required to pay on your own before the expenses can be reimbursed by the insurer. 

A large network of hospitals thus makes it easier to get treatment without any hassles.  The insurance company in this case settles the bill directly. Do look for the list of hospitals available for cashless treatment when you buy health insurance.

5. No Claim Bonus

Just like auto insurance, when health insurance is not claimed in a specific year, the company pays you a no-claim bonus by offering a higher sum insured with no change in premium. Thus, you get higher coverage by paying the same premium as you were paying earlier. You should thus examine the no-claim bonus policy of the insurer while deciding on the health insurance plan.

6. Co-payment Options

In a co-pay option, the policyholder pays for a percentage of the medical expenses incurred, while the rest is paid by the insurer. For example, if the total cost of the medical treatment was Rs 10,000, 10% of this cost, which is Rs. 1000, will be paid by the policyholder first, before the insurance company pays the rest of 90% which is Rs. 9000.  One can opt for a plan with a minimum co-pay percentage to reduce one’s liability.

7. Exclusion in the Policy

Some health insurance plans also contain clauses related to exclusions. This refers to certain illnesses or diseases which are not covered in the health insurance plan. Please read through this clause thoroughly, to avoid getting any last-minute shocks at the time of making a claim.

8. Pre and Post Hospitalisation Expenses

These are the expenses incurred before and after the hospitalisation. One should examine the number of days for which pre-and post-hospitalisation expenses will be covered by the insurer. Generally, 30 days of pre-hospitalisation and 60 days of post-hospitalisation expenses are covered. It is, however, better to read through and ensure you are appropriately covered in the chosen health insurance plan.

These are some of the features which are part of the various health insurance plans. It is always better if you do your research and find out more about them before agreeing to buy health insurance. You can also get in touch with an expert to guide you through this process.

You can also read through the website of various insurers which also has a lot of information about the various features they offer with their health insurance plans. The research and guidance will help you in selecting the right plan.

Aditya Birla Health Insurance (ABHI) is one such insurer that considers the specific needs of people like you to offer the health insurance plan best suited to your requirements. ABHI believes in “Health insurance that cares beyond financial protection” and is present in over 2300 cities across India. 

The products offered are designed keeping in mind the specific requirements of people to ensure long-term customer satisfaction. ABHI is one of the leading and trusted health insurance providers in the country. The various plans offered also reward you for your healthy lifestyle choices when you fulfil your health insurance needs with a plan from Aditya Birla Health Insurance.

Given below are links to some of the most popular health insurance plans from Aditya Birla Health Insurance. Please click on the link below to get more information about them and choose the one that best satisfies your needs.

1. https://www.adityabirlacapital.com/healthinsurance/activ-assure-diamond
2. https://www.adityabirlacapital.com/healthinsurance/super-health-topup
3. https://www.adityabirlacapital.com/healthinsurance/active-health-enhanced-insurance
4. https://www.adityabirlacapital.com/healthinsurance/activ-fit