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FAQs on Health Insurance

Buying the perfect health insurance plan for you and your family can be quite a complicated task. More over technical jargons used by insurance companies make it even more difficult for us to understand the terms and its benefits and importance. We have tried to put together a series of basic questions as well as some very critical doubts that will be in everybody's mind and have tried to answer these questions as well. Hope you will find answers to most of your queries right here on Policynation.com.
  1. What is health insurance?
    The term 'Health Insurance' refers to a scheme whereby all medical expenses incurred by an individual is subject to reimbursement. A health insurance policy is a contract between an insurer and an individual / group in which the insurer agrees to provide a specified amount of reimbursement at a particular "premium" paid periodically subject to terms and conditions specified in the insurance policy.
  2. How much does health insurance cost?
    There is no specified amount that one pays to avail health insurance. Depending on the extent of your needs there are various plans and policies that you can pick. Each policy will require you to pay a different premium based on the scope of your requirements. Some of the factors that play a role in determining the premium to be paid are:
    • Age
    • Previous medical history
    • Claim free years
    To compare policies now, click here.
  3. What are the different types of health insurance?
    Health Insurance can broadly be divided into two kinds of offerings in India:
    • Indemnity Policy
    • Benefit Policy
    To know more about each, click here.
  4. What is the right time to buy health policy?
    Typically, is no 'right' time to buy health insurance. As medical emergencies seldom come with prior warning, it is good to have a health insurance cover that can shield you from sudden expenditures and unwarranted worry. As the cost of healthcare is also on the rise, a comprehensive and affordable health insurance for you and your family is a must. Most people realize the importance of the same only when inflicted by adversity. If this happens when you are over 50, there are a lot more complications in even obtaining insurance. So no matter what your age is and how good your health is, "Now" is the time to insure yourself and your dear ones.
  5. What are the various riders and benefits available in a health insurance policy?
    There are many add-on covers that each insurance company offers that one can choose from while purchasing a health insurance policy. The benefits of each vary but overall, most help you to save unnecessary expenditures at the time of need and help increase the amount owed to you during claim. To know in detail about add-on covers, click here.
  6. Is medical checkup necessary before buying a policy?
    A medical checkup may be necessary when you sign up for a new health insurance policy, depending on the company that you choose to buy your policy from. Usually, it is mandated that an individual above 45 years of age be tested while applying for a new health insurance policy. However, medical checkups are not usually needed for renewal of policies.
  7. Is the cost of a medical checkup part of every policy?
    Health insurance policies entitle policyholders to a free medical check-up once every four claim free years. Every insurance company is not liable to include the cost of an annual health checkup ina policy. Each company may offer different add-on schemes that include the costs or may offer it as part of certain packages. Do read through every policy document carefully to pick one that is perfect for your needs.
  8. Why should I buy critical illness cover?
    Critical illness cover, also known as critical illness insurance, is a long-term insurance policy to cover specific serious illnesses listed within a policy. Should the worst happen, it gives a tax-free 'lump sum' - a one-off payment, to help pay for your monetary needs arising out of sudden blockage in income. It is imperative to buy this cover if:
    • you don't have savings to tide you over if become seriously ill or disabled
    • you don't have an employee benefits package to cover a longer time off work due to sickness
  9. What are the minimum and maximum policy durations?
    As each company offers unique health plans tailored specifically to meet certain requirements, it is best to analyze each policy to make an informed decision. Usually, each policy starts at a minimum of 1 year and could extend until 2 years or more based on plans offered.
  10. Can my friend buy a health insurance policy if he/she is not an Indian National but living in India?
    Yes, foreigners residing in India can surely be covered under a health insurance policy. However, the coverage will be applicable within India only.
  11. Do health insurance policies cover diagnostic charges like X- ray, ultrasound or MRI?
    Usually, a health insurance plan covers all diagnostic test like X- ray, MRI, blood tests etc. as long they are associated with the patients stay in the hospital for at least one night. Any diagnostic tests which have been prescribed in the OPD are generally not covered.
  12. What is cashless hospitalization?
    Insurance companies have tie-ups with several hospitals all over the country as part of their network. Under a health insurance policy offering cashless facility, a policyholder can take treatment in any of the network hospitals without having to pay the hospital bills as the payment is made to the hospital directly.
  13. What happens to the policy after the claim is filed?
    After a claim is filed and settled, the policy coverage is reduced by the amount that has been paid out on settlement. For Example: In January you start a policy with coverage of Rs 5 Lakh for the year. In April, you make a claim of Rs 2 lakh. The coverage available to you for the May to December will be the balance of Rs.3 lakh.
  14. Do insurance policies cover outpatient expenses also?
    No, Normally Health policies cover only expenses incurred as Inpatient. However, some insurance companies do offer it as a part of their product offerings. There are however, terms and conditions for each and these need to be perused through before deciding on an insurance plan.
  15. What is age range for buying a health insurance?
    Health insurance can be bought from 91 days for dependent children until when an individual turns 70. For a separate insurance to be bought, the minimum age is 18.
  16. Is Ayurvedic treatment covered in health insurance?
    Ayurvedic, Naturopathy and Homeopathy treatments are generally not covered under a standard health insurance policy. Coverage is applicable only for allopathic treatments in recognized hospitals and nursing homes.
  17. What are pre-existing diseases or conditions?
    Critical illness and Pre-existing diseases are health conditions that you might have encountered in the past but will affect the amount of premium that you will pay now. While filing for insurance, you will be required to provide details of all diseases suffered in your lifetime. The company will then decide based on a medical panel, whether these diseases are newly contracted of pre-existing. It is important however, to disclose all information pertaining to the same as any non-disclosure can result in issues in future.
  18. What are the tax benefits available on health insurance?
    The Income Tax Act 1961 regarded health insurance as an important investment and hence you can enjoy tax deductions under Section 80D of the Act. According to this section, deductions are offered towards policies on self, spouse and children and also towards non-senior citizen dependent parents and towards senior citizen dependents. The total deductions you can claim under Section 80D is as follows:

    DescriptionSelf, Spouse & Dependent ChildrenParents (whether dependent or not)Total Deduction
    u/s 80D
    No one has attained the age of 60 yrsRs. 25,000Rs. 25,000Rs. 50,000
    Assessee and his family is less than 60 years & Parents are above 60 years of ageRs. 25,000Rs. 30,000Rs. 55,000
    Assessee and his parents have attained the age of 60 years and aboveRs. 30,000Rs. 30,000Rs. 60,000
  19. What is grace period?
    The grace period is a time offered by insurance companies after the due date for your policy renewal expires. Grace period works differently for life and medical insurance policies. You must be aware of this timeframe and try to pay up within the time, so that you are not denied cover or face large financial liabilities in the case of an accident during that time.
  20. If my policy is not renewed in time before expiry date, will I be denied for renewal?
    The policy will be renewable provided you pay the premium within 15 days (called as Grace Period) of expiry date. However, coverage would not be available for the period for which no premium is received by the insurance company. The policy will lapse if the premium is not paid within the grace period.
  21. Can I cancel my health insurance? If yes, will I get my premium back?
    Generally, there is no prohibition against insured or plan members canceling their health insurance coverage unless there is a legal obligation to continue a policy. If you cancel the policy, you may not get your entire premium back. You generally get back your "unused premiums." Cancellation is not retroactive, and you've got to pay for theinsurance you got before you canceled.
  22. What is the maximum number of claims allowed over a year?
    Any number of claims is allowed during the policy period unless there is a specific cap prescribed in any policy. However the sum insured is the maximum limit under the policy.

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