7 Types of Health Insurance Plans

By | July 16, 2015

Health Insurance

The hero wheels his ailing mother to the surgical ward and the doctor refuses to treat her without a huge deposit towards surgery cost.  A tearjerker scene that you’d have seen in a gadzillion movies.

But have you wondered what you would do in a similar situation? Would you be helpless or feel confident that you have covered yourself and your family with a health insurance cover?

As lifestyles go berserk, the chances of ending up with one ailment or the other shoot up.  While cure for most of them is possible, medical costs are spiralling, while insurance needs of individuals have become diverse. Correspondingly, health insurance too comes in different shapes and packages, catering to specific needs.

We give you 7 types of health insurance that you may need (remember that tearjerker scene?):

Individual health plan: This is the basic version of a health plan and as the name suggests, it is for an individual.  Premiums here differ based on the amount assured. For example, in a family of 4, all members can be individually covered for Rs 2 lakh, so that in case of hospitalization all can claim expenses up to a maximum limit of Rs 2lakh individually.

Family floater plan: Here the cover is for a family as a whole, instead of individuals.  Returning to the scenario above, the family could go in for a cover for the same amount. However, here all of them are eligible for a cover of up to Rs 8 lakh. If a member of the family is hospitalised and incurs an expenditure of Rs 4 lakhs, the cover for the remaining part of the year will be Rs 4 lakhs.

Top up plans: Higher health covers usually come at higher premiums, which is beyond a common man’s reach. Enter top up plans. These plans increase your cover without increasing your premium outgo significantly. Top up plans work like covers that provide hospitalization expenses, but come with a basic deductible.

For example, if you have a top-up plan of Rs.8 lakhs with a deductible limit of say Rs.2 lakhs, it means that the first 2 lakhs of the hospitalization bill will have to be borne by you, and the balance by the insurer. Top ups can be for both individual and floater plans, and is a good way to get an additional cover when you are having other insurance plans like an employer’s insurance.

Critical illness plans:  Some diseases like cancer can not only drain you of your resources, but can also result in other consequences like inability to work or partial disability. In these cases, a basic medi-claim plan can hardly provide you with the cover that you would need. Critical illness plans are specifically catered to meet these.

It is a fixed benefit plan, wherein you receive a bulk sum assured on being diagnosed with any of the illness listed in the policy. Details, clauses and illness covered vary from plan to plan.

Unit linked health plans: Combo plans are quite a fad today. If “data+ talk time” and “sugar+rice+oil” at reduced prices do the trick in the telecom and retail sectors, Unit linked health plans are the way to go in the insurance world. They are a combination of mediclaim + unit linked insurance plan. Here, you pay the premium and part of it goes into investment on which you receive returns, and the rest is used towards health insurance.

These plans are built to suit those who think that investment in health insurance is unwarranted, as it earns no returns.  The investment part of the fund can be channelized in line with your risk profile. But before you invest, learn about the various exclusions, charges etc that come along with such plans.

Health saver plans: Health saver plans are similar to unit linked health plans. Under this plan, a part of the premium goes towards providing you health cover and other part is invested in a savings or in an investment account. The major benefit of this plan is that the savings part of the fund can be withdrawn to meet medical expenses that are not covered under normal medi-claim policies like consultation fee, post hospitalization expenses etc.

Surgical benefit plans:  The high costs of surgeries can easily drain your sum insured, making it inefficient to cover your other medical expenses. In such cases, Surgical Benefit Plans prove handy. It is available as a standalone policy or as a rider with existing plans or medi-claims.  Amount payable on surgeries are associated with the Initial Daily Benefit (IDB) chosen by you.

For example, LIC’s Jeevan Arogya gives Major Surgical Benefit of 100 times the IDB, along with other benefits such as day care procedure benefit etc. Rates for major and minor surgeries differ with plans.

With so many options at hand, don’t you wish the heroes in those tearjerkers had a family floater or critical illness plan and save us from melodrama!


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