With Non medical expenses now covered get no surprises in your hospitalization bills and receive 100% of claim.
Switch off your cover when you won't be needing it, like while abroad, for a month & get a discount on the next premium.
No cap on room limit be it a Single AC room, suite or even above.
Unlimited Restoration of Sum Insured for Related and Unrelated illnesses.
Active Plan specifically made for people with pre-existing conditions like asthma, diabetes, hypertension, dyslipidemia, & obesity.
Sum Insured : ₹ 3 Lacs - ₹ 1 Crore
A comprehensive and flexible Health Insurance Plan that offers Better Coverage, Better Control and Better Care
Best suited for
Covers your Non-Medical expenses
Allows you to choose "Any Room" category whether suite or above
Restores your Sum Insured unlimited times incase you are short of coverage for related/unrelated illnesses/injuries
Launch Date: 11-04-2022
Sum Insured : ₹ 2.5 Lacs - ₹ 1 Crore
A comprehensive hospitalization plan for you and your family
Best suited for
Cashless treatment at 7500+ hospitals
Guaranteed cumulative bonus up to 200% of SI
Tax saving benefits under Sec 80D, IT Act
Launch Date: 07-04-2022
Sum Insured : ₹ 50 Lacs - ₹ 3 Cr
A health insurance that lasts for a lifetime
Best suited for
Customize as per the changing life stages with optional packages such as Global+ (Global OPD & more), Women+ (specialized package for women) and Health+ (coverage enhancement)
Loyalty discount on premium from 4th Policy year onwards on the applicable premium
Coverage across the globe for Major illnesses including Cancer treatment
Launch Date: 15-01-2021
Sum Insured : ₹ 0.5 Lac - ₹ 25 Lacs
Design your own health plan and pay for what you choose. Customise your plan according to your needs with ProHealth Select and reassure your future
Best suited for
Reassurance option for premium waiver
Flexible sum insured options
Launch Date: 08-10-2020
Sum Insured : ₹ 1 Lac - ₹ 30 Lacs
The added boost that keeps you covered above and beyond your health plan.
Best suited for
Cashless treatment at 7500+ hospitals
Option to choose any room category
All Day Care treatments covered
Launch Date: 07-10-2022
Sum Insured : Up To ₹ 10 Lacs
Affordable standard health insurance plan
Best suited for
Coverage available for Allopathic & AYUSH treatments
Includes cover for Modern & Advanced Treatments
Affordable all India health coverage
Launch Date: 01-05-2021
Sum Insured : Up To ₹10 Crore
A plan that assures financial support and provides a safety cushion for a better
tomorrow by providing complete protection, on and off the job, including death,
disability, loss of job and financial protection.
Best suited for
Lump sum payout option
Loss of job covered
Financial protection for dependent child
Launch Date: 30-10-2020
Sum Insured : Up To ₹1 Crore**
Standard Personal Accident Policy to safeguard your unexpected expenses arising from death or serious injury caused by an accident, while securing your finances
Best suited for
Accidental Death Cover
Option to choose coverage for Hospitalisation expenses due to accident
Financial protection for dependent child
Launch Date: 01-04-2021
Sum Insured : ₹ 1 Lac - ₹ 25 Crore
A vital protection for your financial health against life-changing critical illnesses that offers you the entire payment of sum insured on first diagnosis of listed illness.
Best suited for
Covers 30 or 15 critical illnesses as per plan.
Access to online Wellness Programs
Lump sum and staggered payout options
Launch Date: 30-10-2020
Sum Insured : ₹ 500 - 5000 /Day
A daily cash plan to financially aid hospitalization expenses
Best suited for
Coverage up to 180 days per policy year
Access to online Wellness Program
Worldwide cover for illness or injury
Launch Date: 17-03-2021
Sum Insured : Up To ₹ 1 Crore
Every Detail Matters To Your Health
Best suited for
Non Employer-Employee Groups/
Flexible, comprehensive and easy healthcare for illness, injury
Choice of Base and Optional covers
Hospital, home care to OPD expenses cover under one plan
Launch Date: 11-09-2020
Sum Insured : Up To $ 10 Million
Every Detail Matters For Global Protection
Best suited for
Non Employer- Employee
Global care for hospitalisation, day care to out-patient treatment
Choice of base and multiple optional covers
Comprehensive health and wellness solutions
Launch Date: 01-10-2020
Sum Insured : Up To ₹ 50 Crore
Check Detail to Secure Each Member's Lifestyle
Best suited for
Umbrella cover of Group - Personal Accident and/or Critical Illness
Flexibility of Base and Optional covers
Income protection including dependent family cover
Launch Date: 25-09-2020
Sum Insured : Up To $ 50 Lac
Check Details To Secure Overseas Travel
Best suited for
A completely customizable travel protection solution
Choice of Base and Optional covers
Medical expenses & Travel inconvenience cover in a single plan
Launch Date: 28-05-2018
Sum Insured : Up To ₹ 5 Crore
Our All in One Plan to keep you healthy always
Best suited for
Flexibility to design a standard base cover to a premium comprehensive packaged solution
Range of covers including Accident, Mediclaim, Surgery, Domestic Travel and Wellness
Choice of Indemnity, Benefit, Regular cash payout (as per cover)
Launch Date: 29-06-2020
Sum Insured :
ManipalCigna Health 360 – Shield and Advance: As per the underlying base policy
ManipalCigna Health 360 – OPD: ₹ 5000 - ₹ 1 Lac
Best suited for
Coverage for non-medical expenses and durable medical equipment
Unlimited restoration of Sum Insured even for related illnesses/injuries
OPD coverage for those out of pocket expenses/injuries
Launch Date: 07-07-2022
Sum Insured : ₹ 3 Lacs - ₹ 50 Lacs
Parents and elders took care of children in their most sensitive ages and phases of life. It is time to gift them the better Healthcare experience. Presenting ManipalCigna Prime Senior, a comprehensive Health Insurance plan which offers innovative features specially designed for Senior Citizens.
Best suited for
Coverage from 91st day onwards for Pre-existing diseases
Allows to choose 'Any Room' category, whether suite or above
Restores your Sum insured unlimited times in case you are short of coverage for related/unrelated illnesses/injuries
Launch Date: 04-01-2023
With you in Illness and Wellness
We want to help you at every step of Illness and wellness. So, if you’re having trouble selecting the right plan for your needs, let us recommend a cover best suited for you and your family.GET RECOMMENDATIONS HERE
What are the details to be provided at the time of intimation of claim?
The following details are to be provided to the company’s at the tine of intimation of Claim: Policy number, Name of policy, Name of the insured person in whose relation the Claim is being lodged. Nature of illness / injury. Name and address of the attending Medical Practitioner and hospital. Date of Admission and any other information as requested by Us.
ManipalCigna Health Insurance
What is Health Insurance?
Health insurance is a written contract between you and an insurance company. Health insurance plans help recoversurgical and medical expenses incurred either by themselves or others insured as a part of their health insurance plan. Health insurance companies come to financial aid during illness or injury.
Why do you need Health Insurance?
Having a health insurance policy is vital for multiple reasons. People who are insured receive timely medical aid and suffer less financial stress when it comes to paying medical expenses during illness and/or injury. The cost of medical care and hospitalization is on the rise and hence having health cover acts as a financial safety net to ensure minimum depletion of lifetimes savings. Now it is a fact that no one plans to get injured, or fall sick, but having a Mediclaim policy improves access to quicker and faster healthcare During an unforeseen medical event.
Here are a few reasons why everyone needs an health insurance plan.
1. Dynamic lifestyle: With the way life has evolved, there are multiple reasons for which having an health insurance policy in place is crucial. The shift in the way we lead our lives has made us prone to illnesses and lifestyle diseases such as -Traffic laden commute to work, hectic work schedules, unhealthy eating habits, preservative-laden food, increasing pollution, reduced sleep, increased screen time have all added to the risk of developing health problems from a younger age.
2. Ever increasing medical costs: Over the recent past, medical expenses have drastically increased. Hence in case of a medical emergency, which always comes as a surprise, people end up spending their lifetime savings. That can take a toll on future financial plans. Hence, a health insurance plan can help ensure that people have timely good quality healthcare facilities, and their finances remain safe.
3. Tax Rebate: One of the health insurance benefits is that the premium payments made for health insurance plans are eligible to receive tax deductions under section 80D of the Indian Income Tax Act. Anyone till 60 years of age can claim a tax deduction of up to ₹ 25,000 for the premium paid towards health insurance. The deduction can be claimed for payments made towards health insurance plans for themselves, their spouse and their children. Another method to increase the tax deduction is by getting an health insurance plan for your parents who are above the age of 60.
4. Cover for both pre and post hospitalization expenditure: A health insurance policy not only helps reduce mainstream medical costs but also can help reduce the financial stress caused by other expenses such as OPD expenses, ambulance charges, pharmacy and diagnostic tests. This makes it highly vital to purchase a health insurance policy for yourself and your family. Do ensure that the policy you opt for covers all such expenses.
What is the difference between medical insurance and health insurance?
Contrary to belief, Health Insurance is different from Medical insurance. Medical Insurance will only provide financial cover for hospitalization, pre-specified diseases and accidents. Also, the medical insurance cover will be for a pre-specified amount. On the other hand, health insurance provides a comprehensive financial cover against pre-hospitalization, hospitalization expenses and post-hospitalization expenses. Depending on the health plan you choose, it also covers ambulance expenses.
Benefits of Health Insurance
The main purpose of health insurance is to receive timely and effective medical care without putting any strain on your savings. Health insurance plans offer financial protection owing to increasing medical costs. Health insurance policies cover most medical expenses; some include hospitalization expenses, day-care procedures, domiciliary expenses and ambulance charges.
Here are a few other benefits of having a health insurance plan:
1. Financial cover against medical expenses
2. Financial cover against critical illnesses
3. Cashless claim benefits
4. Additional financial cover in addition to the cover given by employers
5. Tax exemption benefits
Why should you choose ManipalCigna to get a Health Insurance?
At ManipalCigna Health Insurance, we resonate with the commitment you make towards your health, and the health and well-being of your family. Through a wide range of comprehensive healthcare plans, we provide easy and lifelong access to quality healthcare. We are highly focused on protecting and improving your financial, physical and emotional health with our presence across the country and have great international pedigree too. We are your partners in both, illness and wellness and would be the right choice to get health insurance. We hold a firm belief that “Health Hai Toh Life Hai.”
Types of Health Insurance Plans available at ManipalCigna Health Insurance
- Individual Health Insurance Plan: Individual health insurance plans are designed to cover policyholders against illnesses with cashless hospitalization and numerous other add-on features. Under this kind of policy, the entire sum insured covers only one individual. Hospitalization cover makes up the most basic health insurance plans, but additional riders (added coverage features) and benefits can be customised according to the individual's needs and the insurers’ offerings.
- Family Floater Health Insurance Plan: A family floater is an health insurance plan with the benefits of individual plans, but extends the coverage to the entire family rather than just a single individual. A family floater plan ensures that all family members are covered under a single Mediclaim policy. However, any family member can make a claim. Being covered under a family floater health insurance plan is a smart choice as every family member benefits given that they come under a single large umbrella. The sum insured is generally really high, thus ensuring that everyone is still covered in spite of one of the members making a claim. One single policy also makes the management of finances easier than managing multiple individual health insurance plans.
- Critical Illness Plan: A Critical Illness Policy covers the insured against life-threatening critical illnesses such as cancer, heart attacks, renal failure etc. Since these specific illnesses are high-risk, they are not usually covered under basic hospitalisation plans and require to be purchased as an additional rider. The benefit of this medical insurance policy is that it provides coverage in the form of a lump-sum amount that is handed over to the policyholder at the time of the first diagnosis. Since these illnesses are long-term, the lump-sum amount can be used for the treatment of expenses depending on the policyholder’s needs.
Click to know more about Critical Illness Cover Policy – Lifestyle Protection Critical Care
- Accident Insurance Plan: Personal Accident Insurance policy provides complete financial protection to the insured members against uncertainties such as accidental death, accidental bodily injuries, and partial/total disabilities, permanent as well as temporary disabilities resulting from an accident. The benefit of this insurance policy is that it can be claimed as a lump-sum amount that is handed over to the policyholder, at the time of the accident. This policy is like a contingency fund, to protect against loss of income and additional costs that may arise as a result of serious accidents.
Click to know more about Personal Accident Cover Policy – Lifestyle Protection Accident Care
About The Family Health Insurance
Family is the most important thing in the world. Our entire lives revolve around family and ensuring their safety in the time of need is of utmost importance. During unforeseeable medical events, a shortage of money is a totally avoidable scenario if you have a family health insurance plan in place.
A family health insurance plan is a health insurance cover that offers coverage to all the members of your family within a single policy. The members included under family health insurance policies are yourself, your spouse, your parents, and all your kids. A health insurance plan should be part of your financial planning given the rising inflation and the fact that medical costs are rising.
How does a family health insurance plan work?
A family health insurance policy covers all members of a family under one health policy. The sum insured is a fixed amount that gets utilized as and when the policyholder, his/her parents, spouse and/or children avails medical services and ends up making a claim.
Benefits of having a family health insurance policy
1. Your entire family is covered under a single health insurance plan
2. Many family health insurance policies also allow maternity coverage
3. You can choose a family insurance plan with multiple inclusions to get a comprehensive cover
4. The premium payable for a family insurance plan is more affordable as compared to individual health plans for each family member
5. Each member covered under a family floater policy is eligible for a higher coverage
6. You can easily add new members to your family insurance plan
7. You are eligible for tax benefits with a family floater policy
Things to consider before buying family health insurance
1. Choose a family insurance plan with a minimum waiting period for pre-existing diseases
2. Choose a plan that covers pre and post hospitalization expenses
3. Choose the right insurance amount for your family floater policy
4. Check the cashless network of hospitals with your insurance company
5. Go for a family health insurance policy that offers lifetime renewability
6. Go for a family floater plan with a simpler claim process for a faster claim settlement
7. Keep the age and conditions of your family members in mind before buying a family health insurance policy
What is covered under a family health insurance policy?
Among a lot of things that are covered under a family health insurance plan, a few of the important things to note that the plan covers are as follows:
Hospitalization expenses: Just like all health insurance plans, this plan covers the hospital expenses borne by any of the members that are part of the plan.
Pre and Post Hospitalization: All the expenses incurred during pre-hospitalization phase and up to 60 days of hospital admission and post-discharge expenses till a total of 180 days will be covered. Expenses such as costs for diagnostics, further investigation etc. will all be paid for within the family health insurance plan.
Saving on Tax: One of the benefits of health insurance is that it can give you financial benefits such as reducing your yearly taxable amount.
Ambulance Expenses: Any sort of expenses that are incurred for the ambulance before and after hospitalization is covered by the family health insurance.
ManipalCigna’s Health Insurance Products
ManipalCigna ProHealth Insurance: This is a health insurance plan that is suitable for people who are single or recently married. The ManipalCigna ProHealth Protect health insurance plan provides comprehensive cover which can help secure your present as well as your future.
ManipalCigna Super Top Up: ManipalCigna Super Top Up, ensures that the health plan you’ve selected for your loved ones has adequate financial cover, over and above your health plan. After all, emergencies always spring a surprise.
ManipalCigna ProHealth Select: In this plan you have the freedom to design your own health insurance plan and pay for what you choose. You can customise the plan based on your personal needs in order to reassure the financial future of your family. Click here to know more about ManipalCigna ProHealth Select.
ManipalCigna ProHealth Cash: When a loved one is in the hospital, there are multiple small expenses which need to be made in cash. That is where a ManipalCigna ProHealth daily cash plan comes into play. A plan to financially aid hospitalization expenses and ensure you are not worried at that point of time.
Arogya Sanjeevani Policy: This is an affordable standard health insurance plan which is up to an amount of INR 5 Lacs. Click to know more about Arogya Sanjeevani Policy
Corona Rakshak Policy: Given the current Covid-19 pandemic, this is a standard benefit-based health policy up to an amount of INR 2.5 Lacs. Know about Corona Rakshak Policy here.
Corona Kavach Policy: This is a health. Insurance plan that is made to have your back given the current pandemic. This Corona Kavach health insurance is created to ensure financial cover for expenses made towards Covid-19 related hospitalization or/and home treatment.
ManipalCigna Group Insurance Policies: Manipal Cinga has numerous Group Health policies which include ProHealth Group Insurance Policy, ManipalCigna Lifestyle Protection Group Policy, ManipalCigna Group Overseas Travel Insurance Policy, ManipalCigna FlexiCare Group Insurance Policy and ManipalCigna Global Health Group Policy.
All you need to know about Manipal Cigna’s Corona Kavach Policy
Given the change in our lifestyle, the threat of the coronavirus pandemic, and the ever-rising medical inflation, health insurance has become a primary requirement for every family. It is evident that the spread of Covid-19 is still going on at rapid pace. The worry is that asymptomatic people are unknowingly spreading the virus for no fault of their own. So, given so much uncertainty, a health insurance provider can help reduce the financial risks. This Covid-19 pandemic has brought a major shift in the way we as individuals and as a community think and act. Individuals have started keeping a close eye at their personal and their family healthcare requirements. That is why most people have started purchasing health insurance plans. Given the pandemic, ManipalCigna has launcheda Corona Kavach Policy for both, men and women, of any age which is also known as Covid standard health insurance policy that is developed by IRDAI and made available by ManipalCigna Health Insurance Company. This Corona health insurance is designed to cover expenses made towards Covid-19 related hospitalization/home care treatment. What’s more is that this policy also provides financial cover towards Pre and Post hospitalisation, Road ambulance, AYUSH treatment with an added option of Hospital daily cash.
Related Article: 15 Things to Know About Coronavirus
How to choose the best health insurance plan?
Financial planners will always look at health insurance as the starting point of all financial plans and goals. After all, illness and injury can strike at any time and a financial safety-net in the form of a health insurance policy can ensure that hard-earned savings are not depleted.
Buying a health insurance plan for yourself and your loved ones with adequate health cover certainly help reduce possible financial stress and burden.
The following features of health insurance plans should help you narrow down on a plan that secures you and your family:
- Study your family health history and learn what kind of health cover is needed
- Check out which indemnity cover suits you and your family
- Study your lifestyle or use a coverage calculator to estimate how much of cover is apt
- Study, in detail, the list of pre-existing ailments which are covered in the health policy
- Check if your health insurance company gives you a co-pay option
Why buy Health Insurance Plans online
Buying a health insurance plan is something that needs careful and attentive deliberation. It is something that can help safeguard the financial future of your family and hence it is important to ensure that you have the time and information at your fingertips. That is why, buying a health insurance plan online is important. Here are a few more reasons to buy health insurance online:
1. Information regarding all major insurance carriers is available easily
2. There is an abundance of choice with the entire market at your disposal
3. It is easy to compare different health insurance policies
4. It is highly convenient to shop for a health insurance plan
5. You have the chance to compare the best health insurance policies available in the industry
6. It is a quick, secure and easy method to transact and buy a health plan
7. It reduces agents and middlemen
8. The claim settlement ratio is high
9. The terms and conditions are clear and transparent
Steps to buy health insurance online
Here is a 5-step guide for how you can buy health insurance online. Buying a Mediclaim policy online is simple and quick. While you buy it online, if you have any queries, you can either get on to a chat or request a call back from the provider. Here are the steps that you should follow to generate a quick quote and then buy:
Step #1: Visit the buy online ManipalCigna page on the brand website. There is a form that you need to fill. You need to first have all the required information furnished and handy.
Step #2: Choose the product that you are looking for from the three options stated at the top of the form.
Step #3: Choose the kind of cover that you are looking for from the two options. The form changes based on your choice/requirement.
Step #4: Once you do that, fill up all the details about yourself and your family. There is no need to worry, the information is safe.
Step #5: Once you do this, you need to click on the quick quote to generate a quotation based on the details you filled in.
Who should buy a health insurance plan?
The clichéd and right answer to this question is that anyone and everyone should buy a health insurance plan. After all, it is a product that you are bound to benefit from when you buy it. However, if you are concerned whether you should buy one or not, here are a list of people that should look to buy an health insurance plan.
- Individual person / Bachelor / Spinster
- Family with spouse & parents
- People with financial responsibilities
- People with kids and old parents
- People with diabetes and hypertension
- People with critical illness history
- People that have hereditary illnesses in the family
- People looking to increase their health insurance coverage
- People looking to reducing their taxable income
How to calculate your health insurance premium?
Busting myths and misconceptions regarding health insurance
There are a lot of myths and misconceptions that people have about health insurance. Here are five myths related to the health insurance that you should be aware of to ensure that you are well informed while buying / claiming your health insurance.
Myth #1: Young and healthy individuals do not need a health insurance plan
Reality: Even if you are young and healthy you are at the risk of getting sick anytime. No one plans to fall ill or sick. Specially taking the context of the current situation of the COVID-19 outbreak, lots of youngsters fell sick and had to be hospitalized. If they did not have an health insurance plan, they would have ended up paying from their own pockets.
Read More: The Covid-19 Coronavirus and Your Current Health Insurance
Myth 2: My company has me covered under a corporate health plan, hence I do not need another personal health insurance plan
Reality: It certainly is a good thing that your company offers a corporate health cover. It does certainly bring peace of mind but more often than not, the cover might not be sufficient to cover medical expenses. Hence depending on that entirely is not the best choice. Also, if you quit your job or lose your job, then the health insurance benefit will also end. Hence, getting a plan for yourself and your family other than corporate cover makes a lot of sense.
Myth 3: Benefits of the health insurance plan you buy begin from the first day
Reality: This is a total misconception that many people have. All health insurance plans come with something called a waiting period. The usual waiting period is one month. During this period, you are not allowed to make any claim, however, some policies do cover accidental hospitalization from the first day itself.
Myth 4: My health insurance provider will cover unrevealed pre-existing illnesses
Reality: It is never a good idea to conceal information from your health insurance provider. If the insurance provider does find out about a pre-existing health illness or a hereditary illness that was hidden from them, then the claim can stand rejected. The health insurance company is always under the assumption that any pre-existing illness will be revealed to them during the time of purchase.
Myth 5: You have to be admitted in a hospital for a minimum of 24-hours to claim insurance
Reality: It is important to know that apart from in-patient hospitalization, you can claim your health insurance cover in case of day-care facilities also which are completed in less than 24-hours. Some of these procedures include dialysis, chemotherapy, cataract surgery, tonsil surgery, amongst others. On average most health insurance providers cover up to anything between 20 and 50 such day-care facilities.
How to make a health insurance claim
Here is how you can make an health insurance claim to ensure that you are either reimbursed for your expenses or the health insurance provider can make a cashless payment on your behalf.
- Step1: Your pre-authorization form and medical records will be submitted by the hospital TPA to insurer TPA as specified in your policy card
- Step 2: After assessing your claim request, an initial approval will be given.
- Step 3: In case during hospitalization, there is a need to increase the approved cashless amount, the relevant documents need to be submitted by the hospital TPA desk to the insurer for enhancement.
- Step 4: At the time of discharge, the hospital TPA will submit your final bill and discharge summary to insurer TPA.
- Step 5: After final enhancement of your claim request, the insurer TPA gives final approval for the final billed amount.
- Step 6: Once the final approval comes, there are some non-payable items and expenses depending on your policy terms, which are not covered by your insurance as per regulations. Please settle them with the hospital to complete the discharge formalities
Read More: Steps to Make Cashless Claims towards Health Insurance
How to save tax on health insurance premium?
3 tips to keep in mind before buying health insurance
We all already know the importance of getting health insurance for yourself and your family. However, it is essential for everyone to keep in mind the following three tips before they opt to purchase a health insurance plan.
- Have sufficient health insurance cover: It is important to note that in spite of being covered via your company through a corporate group health insurance, you should still have a personal policy for yourself and your family. This is because your corporate cover will end once you switch jobs, retire or lose your job. Also, there is an uncertainty that the company might withdraw this benefit. Having additional cover during times of inflation and increasing medical costs is a wise thing to do.
- Choose the right amount as sum insured: It is important to note rising costs (inflation), increased medical expenses and general cost of medical care while deciding the sum insured. By rule of thumb, if you are residing in a smaller city, then you should look for a health insurance cover of at least INR five lakhs, whereas, if you live in a metropolitan then your cover should not be anything less than INR 10 lakhs.
Read More: How to Get the Best Budget Health Insurance Plan?
- Get health insurance at an early age: It is important to get health insurance as early in life as possible. You should look at buying a health cover definitely before you turn 40. The reason for this is the changing dynamic lifestyle and in addition to that, you are less likely to make claims at that age meaning you are liable to receive a no-claims bonus and other benefits that add up to the original coverage every claim-free year.
Most Common Exclusions of health insurance plans
- Pre-existing health conditions
Any sort of pre-existing health conditions, illness or medical conditions that the insured may or may not be suffering at the time of buying the health insurance plan are not covered. The insurance plan he/she opts for covers unforeseen medical situations. However, do note that pre-existing health conditions are covered, but with a clause of a waiting period. The waiting period for such pre-existing health conditions are defined in the policy kit.
- Cosmetic Surgery
Any form of cosmetic procedures and dental procedures that are done to enhance the physical look and appearance is excluded from health insurance. However, it is essential to note that when it is recommended by a doctor, medical practitioner, specialist or a general physician due to an accident and /or injury, then it is covered under your health insurance plan. In addition to these, joint replacement surgeries are also excluded from common health insurance plans.
- Injuries caused but intentional self-harm and suicide attempts
It is important to note that intentional suffering and injury caused to oneself or a harmful attempt to end one’s life is not covered under any health insurance plan. Do keep in mind that such physical injuries are under, all circumstances (waiting period included), never covered by any health insurance policy.
- Alternative Treatment and Special Therapies
It is a known fact that there is something called alternative medicine. Some people choose to try out alternative methods as they do not find the required relief through regular treatment. Such therapies, special treatments, alternative treatments, acupressure, magnetic therapy, naturopathy, Ayurveda, sound healing etc. are not covered under a lot of medical insurance policies.
What is waiting period in health insurance?
The waiting period is the amount of time a person who has bought an insurance policy has to wait before a part of or all of their coverage comes into effect and is ready to use. It is important to note that the person insured might not receive any benefits for claims that are filed during this waiting period. Waiting periods are also known as qualifying periods and/or elimination periods.
What is maternity benefit in health insurance?
Some maternity health insurance plans cover all expenses that are associated with childbirth. These expenses are covered up to a certain period bit pre and post- pregnancy. There are two ways of insuring childbirth - it can be a standalone policy or be included as an add-on in your existing health insurance plan with maternity cover by paying an extra premium.
What are riders in health insurance?
A rider is an additional benefit which can be added to your health insurance plan. The reason this is done is to ensure that you have a more extensive cover for a few things that are not included in a basic health insurance plan. However, while adding riders, it is important to note that the IRDAI has capped premium on riders to a maximum of 30% of the basic health insurance plan.
Why is critical illness coverage necessary?
Health emergencies strike without invitation or intimation. It is very important to have a critical illness cover as it provides additional coverage for heart attacks, strokes or even cancer. The reason is, treatment for these medical emergencies and illnesses cost far greater than average. These critical illness policies have a cash pay-out which help in covering those expenses if you might fall short.
How to use health insurance portability?
So, what do you do when you want to port your health insurance policy between health insurance providers? All you need to do is approach the new health insurance provider about 60 days before your existing health insurance policy expires. Then you will need to fill a proposal form for portability. You will have to furnish details and copies of your previous year policy and then apply to port it from your existing provider to the new one.
Health Insurance Glossary Terms that you should be aware of related to your health insurance
Comparing Health Insurance Terms
1. Beneficiary vs Nominee: A beneficiary is a person or entity that gets the insurance proceeds when the insured dies. And a nominee is the person that receives the insurance proceeds when the insured dies. Here, the nominee receives the proceeds but may not be able to use it.
2. Sum assured vs Sum insured: Sum assured is a pre-defined amount that is to be paid in case of an eventuality. Life insurance works on the sum assured. While sum insured is the upper limit of the pay-out an insurer is liable to pay in case of any eventuality to the insured. Health insurance works on the sum insured.
3. Agent vs Aggregator: An insurance agent is nothing but a sales representative of an insurance company. An aggregator is a platform where a buyer can see and compare several plans to suit his/her needs.
4. Co-pay vs Co-insurance: Both co-pay and co-insurance are out-of-pocket expenses that are needed to be borne by the insured. The difference, however, is that while co-pay is a fixed sum that needs to be paid, co-insurance is a fixed percentage of the entire claim amount.
List of Most Frequently Asked Questions on Health Insurance
1. What is a family health insurance plan?
A family health insurance policy is a health insurance cover which provides medical insurance for all members of your family within one policy itself. The members that you can include are yourself, your spouse, all your kids and your parents. The reason this is so useful is that it gives you the ability to manage all the health insurance requirements within one single health insurance policy.
2. Can a single individual have multiple health insurance covers?
Yes, it is possible for an individual to have multiple health insurance covers. In most cases, people are covered by their personal health insurance as well as an employer health insurance cover. The smart thing to do is to use the individual policy and opt for riders like critical illness insurance cover, personal accident cover, etc. This ensures that you have sufficient cover in case of a medical emergency and do not have to dip into your savings.
3. How do I choose the right health insurance cover?
There are a few things that you need to keep in mind while choosing the right health insurance partner. Look for the following points that you should factor-in in your health insurance plan:
- The amount of cover should be sufficient to cover the medical expenses of all family members.
- The correct type of health insurance plan. Choose wisely between Individual plans, family floater plans, senior health insurance, etc.
- Ensure that your provider has a vast list of network hospitals to make sure you get high quality and timely medical attention during an emergency.
- Ensure that the reputation of your health insurance provider is good. You can ask for the claim to settlement ration to help understand if they follow through with their claims.
4. Can I increase the sum insured of my health insurance policy after purchasing it?
If you feel that your health insurance sum insured is not enough, you can in fact, have it increased. However, you have to make sure you do it before the policy begins. If the policy period has started, then you have to wait for it to end. Only after that, you can get the health insurance sum insured increased during the renewal process. However, no one stops you from having two health insurance plans at one time. Hence, if you think that your cover is not enough, you can purchase a second health insurance plan to cover the difference.
5. Am I allowed to cancel my health insurance policy once the period begins?
It is imperative to remember that you can cancel a health insurance policy only within the first 15 days. These 15 days are referred to as the free-look period. In these 15 days, you are expected to study your health plan, read the policy wordings and then agree to its clauses. If you disagree with any of the details and clauses, then you can have it cancelled within the first 15 days. If that does happen, then the insurance provider will subtract all the expenses incurred during the health check-up, the stamp duty, etc. and then give you the rest as a refund.
6. Is a maternity cover available in a standard health insurance plan?
In most cases, maternity cover will not be available under a health insurance policy. Some insurance providers include this as an advantage that can be availed after a waiting period while for some, it needs to be purchased as a rider. There are also a few specific maternity health insurance plans that you can look at to stay covered.
7. Am I liable to receive a loyalty discount during the renewal of my health insurance policy?
In most cases, yes, you can get a discount on your health insurance premium. However, this can be done only when you opt to renew your policy with the same health insurance provider.