Understand your Health Insurance Variants!

By BankBazaar | July 22, 2014

Health Insurance

With the skyrocketing healthcare costs, any unforeseen circumstances like accident or illness may affect your finances, earning capacity and may even drain your lifetime savings. Having a health insurance policy during those unanticipated times, act as an economic support for you and your family. A health insurance policy not only relieves you from financial distress but also gives you confidence to fight with those odds of life. As a policy holder, you can afford the medication costs from your desired distinguished hospital (provided it is covered under network hospital list of your insurance provider) and need not compromise on the quality of treatment to save some bucks.

Since there are a lot of Health Insurance variants available in the market, it is very important for you to pick the best cover as per your requirements. For Example: While buying an insurance cover for your children, you need not include maternity cover which can increase your cost of insurance in the form of annual premium. The only way to zero in the best insurance cover for you is to do a research and compare all the available health insurance plans. Although all the plans aim to keep the policy holder secure from healthcare expenses, the benefits of the all these policies are different. With each health insurance plan, there are certain value added services with different premiums. These may or may not change with different plans. However, there are also variants with the plans and different coverage choices. You should consider all these options in detail and then should cherry-pick the insurance plan for you based on your needs and budget.

To know more on the basis of comparison for selecting the best policy, please read on to my article on “Factors to consider before buying a Health Insurance Plan”. It provides details on the crucial factors to check before buying a Health Insurance Policy.

Following are some of the Health Insurance Variants basis- the cover:

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Hospitalization Cover:

The Hospitalization cover is an indemnity cover (where one gets paid during or after the treatment) that safeguards you against expensive medical treatment incurred during hospitalization resulting from serious illness or accident. This option covers relevant medical expenses incurred during in-patient treatment, pre-hospitalization (generally up to 60 days prior to hospitalization), post-hospitalization (generally up to 90 days after hospitalization) and day care procedures. It gives you access to cashless facility at the network hospital of your insurance provider and also covers the ambulance charges up to an extent.

Keeping in mind the escalating hospitalization costs, this is the most important cover under a Health insurance plan. You must compare this feature in all the plans (along with its exclusions and waiting period) and wisely pick the one with maximum benefits.

Following are the expenses covered under Hospitalization cover:

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Hospital Cash Cover (Add-on):

The Hospital cash policy is a benefit policy and should be taken along with any other health insurance schemes and should not be substituted with hospitalization cover. Although the hospitalization cover takes care of medical expenses, but there are also few associated expenses which are non-medical in nature. For example, special dietary food expense, cost incurred during traveling to and from the hospital, attendants’ fees etc. The Hospital cash policy safeguards you against these overhead expenses that are generally not covered under Hospitalization plan. It provides a per day expense cover ranging from Rs.500 to Rs.2500 for a maximum period of up to 60 days.

Indemnity Cover vs. Benefit Cover
Under Indemnity Cover, the insured gets paid during or after the treatment. Whereas, under a benefit policy, the insurance company pays the policyholder a lump sum amount, on happening of an insured event.

Personal Accident Cover (Add-on):

Personal Accident is an insurance cover wherein, in the event of the person sustaining bodily injuries resulting solely and directly from an accident, resulting into a permanent physical disability or accidental death. Many insurance providers are offering a personal accident insurance that not only covers the major accident resulting in death or permanent disablement but also minor injury happening in your daily life such as getting burnt while cooking or kids getting injured at school or slipping down from stairs. This is a benefit plan, where the opted cover is paid as a lump sum based on the degree of disability and/or death.

Critical Illness cover (Add-on):

Critical Illness Insurance is also a benefit policy that pays out a lump sum amount up to the Sum Insured upon diagnosis of a critical illness (Cancer, Paralysis, Heart Attack, Kidney failure etc.) covered under the policy. The financial load, in case of acute illness, could be far more than what hospitalization plan (which pays hospital bills) covers. Buying a critical illness plan is the best way to get over these inadequacies. Under this policy, generally, the insurance providers have a wait period of 30 days (to ensure the survival of patient) after the declaration of illness. The lump sum assured is usually paid before the start of treatment keeping in mind the high cost involved for care and treatment, recuperation aids, any income loss due to a decreasing ability to earn, debts pay off and fund for a change in lifestyle.

Top-Up Cover (Add-on):

A top up plan supplements your primary health insurance cover. This policy can be taken as an add-on cover to your existing hospitalization policy. It covers you against medical emergency in case of exhaustion of the stated deductible amount i.e. when the sum insured of your existing policy does not suffice for higher expenses due to illness or accidents, a top-up cover takes care of the additional expenses. For example: you have a health insurance policy with sum assured of Rs. 5 lacs. In this case, Rs. 5 lacs would be the deductible limit. The top-up policy would be triggered when this 5 lac would get exhausted. A top-up policy provides a larger sum insured limit at lower cost and ensures you do not run short of money if your health insurance policy runs out.

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Health Insurance Variants basis- the Insured:

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Health Insurance for Individuals:

Under this policy, the sum insured is valid only for an individual for whom the premium is paid. It can be tailored as per an individual’s requirements and can include all the above mentioned covers.

Family Floater:

As name suggests, family floater is a policy that is extended to cover your entire family. Since it is single policy offering family benefit, it relives you from the task of paying multiple premiums and keeping track of several insurance policies. Moreover, in a case when one of the family member gets sick and has to be hospitalized, the total sum insured of the policy can be utilized by the un-well member of the family for treatment. It usually covers the individual, spouse and children. However, some insurance providers do have provision to cover dependent parents, siblings and parents-in-law.

All information including news articles and blogs published on this website are strictly for general information purpose only. BankBazaar does not provide any warranty about the authenticity and accuracy of such information. BankBazaar will not be held responsible for any loss and/or damage that arises or is incurred by use of such information. Rates and offers as may be applicable at the time of applying for a product may vary from that mentioned above. Please visit www.bankbazaar.com for the latest rates/offers.

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