Navigating Health Insurance: Understanding the Different Plan Types

Navigating Health Insurance Understanding the Different Plan Types

As we know, health-related problems are on the rise nowadays, and treatment costs for them are also increasing simultaneously. What exactly does Health Insurance mean? Health Insurance includes the surgical and medical expenses of an insured, which are paid to the insurer afterwards. The insurance provider reimburses the costs and expenses incurred due to illness or injury, etc. It is basically a contract between the insurer and the policyholder, where the health insurance company offers complete coverage to the insured, maximum up to the limit of the sum assured. It also offers medical coverage for medical expenses that are incurred during an emergency or planned hospitalisation, similar to how a fun day at Atlantis Water Park might require extra planning to ensure a smooth experience. Just like a Life Insurance Policy, there are different types of health insurance plans available in the market. Let us go through them:

Types of Health Insurance Plans Suitable For
Health Insurance for Individuals Only Individuals
Health Insurance for Family Covers complete Family, i.e. Self, Spouse, Children, and Parents
Health Insurance in case of Critical Illness For funding expensive treatments
Health Insurance for Senior Citizens For Citizens aged 65 and above
Top-Up Health Insurance It is beneficial when the amount of the sum insured by the existing policy is exhausted.
Hospital Daily Cash Health insurance To incur daily hospital expenses
Health Insurance for Personal Accidents For any loss or damage to the owner or driver of the vehicle.
Health Insurance – Mediclaim In-patient expenses
Group Health Insurance A group of employees
Health Insurance for Specific Diseases, such as (M-Care, Corona Kavach, etc.) For those who are suffering from pandemic-manifested conditions or prone to one
Unit Linked Insurance Policy It provides the dual benefit of insurance and investment.

Different Types of Health Insurance

Mentioned below are the different Health Insurance Plans:

  • Individual Health Insurance

As the name suggests, it is meant for individuals only who can get the expenses compensated for illness and medical expenses. It also includes hospitalisation, surgical, pre-and post-medical expenses until the insured limit is exhausted. The insurance premium is dependent on multiple factors, like the age of the buyer, medical history, etc. An individual can also cover spouse, children, and parents by paying an extra premium under the same plan.

  • Family Health Insurance

It is also known as the Family Floater Plan, which secures the complete family under a single coverage. It includes all family members, i.e. children, spouse, parents. The premium amount is to be paid by only one person in the family, and the entire family can benefit from it. 

If two members of the family are getting treatment, both of them can claim the insurance amount until the limit is exhausted. The insurance premium depends on the age of the eldest member who is covered in the plan. 

  • Critical Illness Insurance

It provides insurance by offering a lump sum amount of money for life-threatening diseases. When the insurance is bought, one has to choose the health-related problems, and if the insurer is further affected by any of the same, the insurance can be claimed.

To claim this kind of insurance, you do not need to be hospitalised; only a diagnosis will allow you to get the benefits of this Critical Illness insurance. The amount that is to be paid against the premium is pre-decided, irrespective of the pre and post-hospitalization expenses. Mentioned below is a list of all the critical diseases that are covered in the category of Critical Illness Insurance:

  • Major organ transplant
  • Cancer
  • Aorta graft surgery
  • Kidney failure
  • Stroke
  • Multiple sclerosis
  • Paralysis
  • First heart attack
  • Coronary artery bypass surgery
  • Primary pulmonary arterial hypertension
  • Senior Citizen Health Insurance

It covers the cost of hospitalisation and medicines, as well as some other benefits like Domiciliary Hospitalization and Psychiatric benefits. It provides coverage to those 65 years and above. Also, the premium is comparatively higher as senior citizens are more prone to diseases.

  • Top Up Health Insurance

One seeking a higher amount of insurance can buy this policy. A “Deductible Clause” has been added to this policy. Hence, where a claim is made, the payment made is over and above the pre-defined limit. 

  • Hospital Daily Cash

This covers unexpected expenses during hospitalisation. Some plans also offer convalescence benefits in case the individual is hospitalised for more than 7 days. Other riders, i.e. add-ons, include Parental accommodation and a wellness coach.

  • Personal Accident Insurance

This policy provides support to the victim of accidents who end up losing their life or getting disabled. It provides financial support to the victim or his/her family. Some of the plans also offer education and orphan benefits to cover the children’s expenses. 

  • Mediclaim

It covers the expenses associated with hospitalisation due to illness or accident. It also covers in-patient expenses, such as surgery, doctor fees, nursing charges, anaesthesia, and oxygen.

  • Group Health Insurance

Many medium and large-scale companies are offering this kind of insurance to their employees. Employers prefer group health insurance because its premium amount is comparatively lower. 

  • Disease-Specific (M-Care, Corona Kavach, etc.)

One of the insurance policies is for Corona Kavach, which provides a fund of INR 50,000 to INR 5,00,000 to the person insured with an age limit between 18 and 65 years. The M-Care Health Insurance Policy provides insurance to the insured person against diseases caused by mosquitoes. 

  • ULIPs

A part of the premium amount is invested, and the rest is directed towards the purchase of health covers. The savings can fall short due to expensive health facilities. ULIPs do not ensure a fixed amount as they are subject to market risks, and returns would be paid to the buyer at the end of the policy tenure.

Conclusion:

Due to the progressive rise in medical costs, it has become mandatory to buy an insurance policy. Due to this, the buyer should put his time and efforts into learning what health insurance is and its different types that are available in the market. One should compare all the different types of insurance plans to analyse their costs and returns, else it may result in paying an extra premium amount and getting less return.

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