Types of health insurance we offer

Individual health insurance plans: It is an insurance which covers the individual person medical cost arises against illness.

Family floater health insurance plans: FFH is the plan which covers the medical cost of entire family against Disease under one single plan. A family consist of policy holder, spouse, Dependent children and dependent parents with a specific sum insured which is shared by all family members included in the policy .Any member can make a claim up to the sum insured taken in policy.

Critical illness health insurance plans: Critical illness health insurance plans which cover major critical illnesses of an individual if the insured person is diagnosed with any covered illness, then sum insured is paid to the Insured person. The policyholder can use the sum insured to meet the cost of advanced treatments or pay for any other financial obligations as per his own will.

Top-up health insurance plans: Top-up health insurance plans which gives the extra coverage at minimal rates of premiums. If individuals feel that their health Plan coverage is not enough, they can buy top-up plans to increase the coverage. There is a deductible limit under these plans & any claim which is in excess of the deductible limit is paid.

Super top-up health insurance: A super top-up plan covers the total of all hospitalization bills once the deductible amount is paid. In other words, when the total bill claims the deductible limit, super Top-up plan becomes active for subsequent claims.

Senior citizen health insurance plans: Senior citizen health insurance plans which are made to cover individuals in their older ages. Individuals who are 60 years and above can be covered under senior citizen health insurance plans. The sum insured of these plans are limited and premiums are affordable.

Hospital cash plans: A hospital cash plan is an insurance plan that provides a fixed sum insured to meet miscellaneous expenses for daily hospitalization exceeding 24 hours. One can buy such plans as an add-on along with the existing health policy. Hospicash or hospital cash plans is one of the best options to cover the extra expenses during income loss. There is no need to submit any supporting bills under this plan. Moreover, even if the actual expenses are below the fixed amount, the insurer would not ask for the additional amount.

Disease-specific health plans: As the name itself suggests, a disease-specific plan provides cover for the cost of entire treatment of a specific disease at all stages including diagnosis stage to advanced treatment. The key highlight of a disease-specific plan is that unlike a critical illness plan, it waives future premium of the insured under certain circumstances. Also, disease-specific plans are comparatively cheaper than critical illness covers as they are precisely designed for individuals looking for a low-cost insurance to cover a specific disease they may feel they are most prone to. People with a family history of a particular critical disease must buy a disease-specific plan along with a regular health insurance plan.

FEATURES OF HEALTH INSURANCE IN INDIA:

The most notable features of a modern health insurance plan are-

1.    Health Insurance Coverage: Insurance plans offer comprehensive coverage for all expenses that can be occurred during any health-related emergency. It includes hospitalization charges, post-hospitalization charges, and ambulance expenses all under a single policy. Critical illnesses like cancer, kidney failure, and stroke are also covered for in a health insurance plan.

2.    Renewal discounts : A No Claim Bonus is provided to the person insured in the following year if no claim has been made against the policy in the previous year. This bonus can be in the form of a high discount of the premium or the sum assured can be increased. Some insurers also provide a free check-up if there is a good record of no-claim bonuses.

3.    Co-payment :Co-payment is an option provided by most insurers that helps to decrease the yearly premium. A percentage of the total expenses is paid by the insured while the insurance company pays the balance.

4.    Health Insurance Tax benefits : Among the lesser-known health insurance benefits, is that under section 80D of the Income Tax Act, 1961, health insurance policies entitle you to receive tax benefits. The premium paid for a health insurance policy is tax-deductible, both for your own policy or for your family members.

5.    Flexibility: An insurance plan provides high flexibility to the insured person. Insurance buyers can reduce their premium after a certain period or can change their policy duration entirely. Health insurance providers are also willing to also adjust the terms of your insurance plan in accordance with a change in your lifestyle, like change in your marital status.

With health insurance, one can cast a safety net to protect one from financial troubles during a medical emergency. It is a sound investment to secure your financial stability in the future.

Health insurance policy inclusions:

A basic medical insurance plan provides all the essential coverage features. Find below the coverage for the following – 

• Inpatient hospitalization: It covers for Room rent, ICU room rent, cost of treatments, Doctor’s fees, surgeon’s fees, nurses’ fees

• Pre and post hospitalization: This Benefit Means expenses incurred before being actually hospitalised and after being discharged from the hospital are paid.

• Ambulance costs: Expenses incurred in transporting the insured person to the hospital is covered up to a specified limit.

• Day-care treatments: Treatments which do not require hospitalization for a minimum of 24 hours are covered under this section E.g. Cataract.

• Organ donor expenses: Cost incurred on harvesting an organ from a donor are covered

• Domiciliary treatments: Treatments that are taken at home due to certain reasons like the insured cannot be moved to the hospital or there are no vacant beds in the hospital that would be covered.

• AYUSH treatments: Ayush treatments are alternative, non-allopathic treatments E.g. Ayurveda, Unani, Siddha and Homeopathy. Most health policy cover medical cost incurred on these treatments.

Besides these common coverage features, different Health insurance policies provide different coverage features to which make the plan comprehensive in nature.

Health insurance policy exclusions

Though Health insurance plans provide covers for most of the medical expenses, there are some expenses which are not covered. These are called Health insurance policy exclusions. Some common ones are as following:

• Pre-existing illnesses during the waiting period of policy
• Congenital ailments and diseases
• Cosmetic treatments
• Pregnancy-related treatments, unless specifically covered in the policy
• HIV/AIDS infection
• Diseases or injuries occurring due to war or related perils, aviation, nuclear contamination, self-inflicted injuries, alcohol or drug abuse etc.

To know the exact exclusions, you should read the policy wordings. Different Health insurance policies have different inclusions and exclusions. So, understanding the policy details before buying the policy becomes essential. It’s very important to disclose medical history of self truthfully before one buy a policy to ensure the claim expectations should met. Discuss this with EDIFS expert to figure out best options for you- we will maintain strict confidentiality.

Health insurance Add-ons:

In the simplest words, an insurance add-on refers to an additional benefit that you pay for, over and above the basic premium, as this benefit is not covered by default in your insurance policy. Health insurance add-ons can go a long way in bolstering your all-around health insurance coverage by including extra protection as part of your plan. Of course, every add-on adds to the premium payable by you. Here are top 6 insurance riders that one must know about-

1. Maternity and new-born baby insurance add-on cover: This add-ons cover generally extends to childbirth and for the following 3 months. The primary coverage will be provided for the delivery and might be restricted for pre and post-delivery. It may not cover the child care expenses and vaccinations. However it entirely varies among policies. It can be availed after the waiting period is over.

2. Hospital daily expenses add-on: Choosing the add-on which covers your daily hospital expenses can offer coverage of up to Rs. 10,000 daily for up to a total of 30 days spent in a hospital in a year. The pay-out generally covers the cost of tests and diagnostics reports or other medical expenses that are typically not covered under health insurance policy. Therefore, the daily hospital expenses add-on can ensure stability during your treatment and after being discharged. Hospicash or hospital cash plans is one of the best options to cover the extra expenses during income loss. There is no need to submit any supporting bills under this plan. Moreover, even if the actual expenses are below the fixed amount, the insurer would not ask for the additional amount.

3. Emergency ambulance services: Regardless of what type of medical emergency, any expenses incurred by you toward making use of a road ambulance to arrive at the hospital of your choice will be covered under the emergency ambulance services health insurance add-on. Emergency ambulance expenses of up to Rs. 30, 000 or sometime more will be covered under this add-on, which essentially means that you can avail the best emergency care at a hospital of your choice.

4.Room Rent Waiver: Few policies come with a cap on room rent. For example, if the room you rented charges one INR 5,000 everyday but your insurance covers only INR 2,500, one will have to pay the rest of the amount from their pocket. To avoid this individual can avail this waiver. One added benefit is, one can choose their own room (subject to certain conditions).

5. Critical illness add-ons: This insurance cover is provided in addition to the amount that is covered by your base insurance policy. This will allow one to deal with their financial health and physical health without having to tackle the shock and stress of both at the same time. This can be purchased as add-on with base policy or stand alone.

6. Global emergency hospitalization add-on insurance cover: The global emergency hospitalization add-on insurance cover ensures that one remain financially protected and secure all over the world in the event of a health emergency. Being an Indian national, accessing medical care abroad can leave a gaping hole in pocket. With this add-on to base insurance plan, one simply must focus on getting the best healthcare without getting stressed about the sky-rocketing expenses. This add-on is specifically recommended for individuals who frequently travel to different countries for business, family, or otherwise. Bear in mind that this add-on covers only one medical emergency in a policy year.

Health insurance cover add-ons can be lifesavers when necessary. Ultimately every individual desire to never avail of health insurance and leading a healthy life. However, a health insurance plan allows having peace of mind in knowing that in the event of some adverse incident regarding our health, we have financial security already that will allow us to deal with the cost of hospitalization and any consequent medical expenses thereof.

Why buying health insurance at an early age is Beneficial?

In today’s Age, rising medical costs and the spurt of lifestyle-related diseases, purchasing a health insurance plan has become a necessity for an individual. Although, there is no specific age for purchasing a health insurance plan, it is always suggestable to start it as early as possible to avail of the maximum benefits. 

Let us explore the advantages of buying health insurance plans when taken during young age.

No waiting period: Buying a health plan at a young age, one would exit the waiting period without any concerns. If an individual buy health insurance at a later stage of age, in that case, a waiting period starts from 30 to 90 days at least.

Comprehensive coverage: If you make the wise decision to purchase the medical policy early, you can enjoy the all benefits of comprehensive and holistic coverage.

Low premium:   The premium which is charged on policy depends on individual current age. So, if a person buys the policy at a young age, He/she can avail of a lower premium.

Tax benefit:  Individual are eligible to claim for the premium payable as a deduction from thier total income under 80D of the Income Tax Act, 1961.

Wider and better options: At a young age, individual have the liberty to compare different health plans offered by the various insurers, thereby allowing an individual to make an informed decision. Also, there is a lower probability of non-acceptance of  proposal.  

Bonus: All the health insurance company offer a ‘no claims bonus’ in the absence of any claims in the preceding year of a policy term. On purchasing a health insurance policy at a young age, one can avail of a cumulative bonus at the time of a policy renewal. As a result, the bonus accumulated increases ones coverage amount which will prove to be an advantage at later stages of life.

Lifelong renewal: Insurers may offers a lifelong renewal when one opt for health policy in the early stage of your life. This secures person financial stability in case of hospitalization at a later age. However, one need to renew the policy on or before its due date to ensure continued coverage.

Financial planning: Buying a health insurance policy early not only gives greater coverage but it also helps to plan your finances in a better way. When one have adequate medical cover to take care of any health emergencies, one can focus on making other long-term investments.

Personal health insurance: Due to the increasing Medicare`          expenses these days, the importance of a health insurance policy cannot be overemphasized. The coverage provided by ones employer may not be sufficient to cover employee costs. Furthermore, one will run the risk of being uninsured at the time of any job change or loss of employment.

No requirement of health check-ups: When you buy a health policy at an early age, you are not supposed to undergo any sort of medical check-up. However, most of the insurers would ask you to undergo a mandatory health check-up when you buy a policy after the age of 45 years.

Bottom line: When you invest your hard-earned money in purchasing a health insurance plan at an early age, you will be able to get the maximum benefits out of the policy.