Life is uncertain and you never know what illness you might encounter on your way. You can end up paying a lot of money for the treatment related to illness in case you are not insured. Health Insurance helps you to pay for any unexpected injuries and illness to the healthcare system for yourself and for your family when the expenses are high. As medical care advances, the prices we pay also increase and we cannot afford to pay for the expense always. When you have health insurance in place, you do not have to pay for the penalties that people without insurance always pay.
Health Insurance in India has a wide scope of improvement and it is one of the fastest growing industry meaning that the market penetration is very low and only twenty percent of Indian population has insurance coverage. With time, the insurance providers are including more specialties to the Insurance plans. The specialties include diagnostic service, Surgeries, Cardiology, Arthritis, Pediatrics, Ophthalmology, endocrine systems, gynecology, Obstetrician etc. There are other services included in the health insurance policies such as pre and post treatment expenses, Maternity care, Accidents and related deaths, childcare, elderly care services are part of the coverage plans nowadays.
The premium charges for these specialties depend on the age of the insurer and the type of policies you want to opt. The more the age of the policyholder, the greater is the chance to have health problems. Therefore, the insurance company charges more premium for them.
Inclusions in a Health Insurance
With time, the insurance companies are including more features to their Health insurance plan they offer to their customers. There are some common disease and features common in every insurance.
The diseases such as cancer, heart attack, Parkinson’s, Alzheimer’s, brain tumors are included. Some of the common features include pre and post medical expense, preexisting diseases after a definite amount of time, Prescription drugs, staying expenses, day care procedures etc. There is some optional coverage such as ambulance expense, maternity care etc. You need to choose the right insurance plan for your comparing the coverage inclusions by each of the insurance providers.
Exclusions in a Health Insurance
Every policyholder must go through every exclusion mentioned in the Health Insurance plan to avoid last minute rush or problems in an emergency. Though the inclusions and exclusions might vary from policies to policies, there are a few exclusions common across every type of insurance. You must be aware of the exclusions at the time of enrollment.
Preexisting diseases – If an Insurer has a pre-existing disease, the insurance plan will not cover the expenses. The policyholder has to wait for one to two years depending on the type and severity of the disease. These diseases might include arthritis, kidney stone etc.
Waiting condition – Once you are enrolled in a policy, you have to wait for one to two months to take the benefit related to the policies. There are exceptions to the rule as well. In case you met with an accident or sudden death, the insurance will cover your expenses.
Pregnancy – If you are planning to have a child after a waiting period of enrolling in the insurance, then you can enjoy the maternity benefit of it. If you are already pregnant or have a baby, who needs vaccination, the costs will not be covered by the insurance plan.
Surgeries – Surgeries such as replacements, cosmetic surgeries, or dental surgeries are not part of the insurance policies.
Other treatments – If anyone chooses to go for Ayurveda, homeopathic treatment, then, your insurance plan will not cover as per the terms and conditions of the policy.
Hospital cost – There is an upper limit applied to the expense you report while you are admitted to the hospital. Upper limits may be applicable on the doctor charges, room fees, ambulance fees etc.
The above exclusions might change in the future depending on the insurance provider and market conditions. However, there are some permanent exclusions such as HIV, Intentional injuries, congenital diseases, which are never going to be a part of your health Insurance.
Every year your financial planning must include a health Insurance. Choosing the right insurance plan for you and your family is as important as getting insured. If you are insured but cannot use your insurance in an emergency situation then getting the insurance for you is a complete wastage of your time and money. You can choose the right plan only when you are aware of your requirements.