Little-Known Features Of Health Insurance Plans

By Adhil Shetty | June 15, 2017


Health Insurance policies have evolved over the years and become more customer-friendly. They don’t just cover the hospitalisation expense involved in mainstream treatment but also come with other varied features which make each plan unique.

With the increasing cost of treatment, it’s important that you are informed about the various kinds of support provided by insurers. Let’s look at a few such features that can ease the burden of medical expense on you:

Alternative Treatments

Alternative treatments used to be an exclusion to medical cover earlier. However, now many insurers have started providing coverage for non-allopathic treatments such as Ayurveda, Unani, Siddha and Homeopathic treatments. While some plans provide coverage up to the sum insured, some have a sub-limit on the coverage.

Free Health Check-ups

This feature is offered through most plans. The policyholders can avail free preventive health check-ups up to a certain amount which is predetermined by the insurer. However, it can be availed only after completing a continuous claim-free period, which typically ranges between one and four years.

Domiciliary Treatments

Sometimes patients are treated at home either because they are not in a condition to be transferred to a hospital or there are no available beds in the facility. Such treatments are called domiciliary treatments and are covered in many Health Insurance plans. Read through the terms and conditions of a policy to understand if such treatments are covered up to a specified limit or entirely.

No Claim Bonus

If you do not make a claim in a policy year, you are offered benefits under no claim bonus. These benefits can come in the form of an increased sum assured or premium discounts. The bonus is cumulative in nature and continues to increase every year when no claim is made.

Convalescence Benefit

Also known as recovery benefit, this one is given out to a policyholder in case the hospitalisation period exceeds the specified number of days which is usually 10 to 12 days. This feature is commonly available and is useful for prolonged hospitalisation.

Daily Cash Benefit

Under this benefit, a fixed cash benefit is given out to the policyholders for each day of hospitalisation. This can be used to meet the additional expenses faced by you during your stay in the hospital, such as the cost of refreshments.

Lifelong Renewability

This one is a relatively new feature added to almost all Health Insurance plans, with the amendment in IRDA regulations mandating lifelong renewability. Now, health plans do not impose any maturity period, as to when the plan can be renewed. Renewals are allowed lifelong if premiums are paid within the stipulated renewal date.

Sum Assured Restoration

This feature allows double sum assured coverage. The sum assured is restored to 100% if it is exhausted in a particular year. This is only allowed under certain terms and conditions.

OPD Treatments

Some insurers provide coverage for outpatient medical expenses such as doctor’s consultation fees, pathological tests, cost of the medicines etc. This is useful for patients availing treatments which do not require hospitalisation.

While choosing a plan, compare the inclusions and exclusions of multiple plans and do not base your decision on the premium cost.

(The writer is CEO,

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About Adhil Shetty

Adhil Shetty is the Founder and serves as the Chief Executive Officer of Adhil has a Master’s degree in International Relations with a specialization in International Finance and Business from Columbia University in the City of New York, and a Bachelor’s degree in Engineering from the College of Engineering Guindy, Anna University. Adhil is an expert in Personal Finance (Car loan/Home loan and personal loan) and he majorly consults on investment and spends rationalization for the Indian loan borrowers. His guidance is number based with real time interest rate calculations and hence useful for consumer’s real time query.

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