Types Of Health Insurance Plans

5paisa Research Team

Last Updated: 21 May, 2024 11:17 AM IST

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With a maze of health insurance plans available, choosing the right one can feel like deciphering ancient hieroglyphics. Don't worry, we're here to be your rescue, guiding you through the fascinating world of health insurance in India. So, grab a metaphorical cup of chai, sit back, and let's dive in!

Types Of Health Insurance Plans

Here's a breakdown of the different health insurance plans to suit your needs:

Types Of Health Insurance Suitable For
Individual Health Insurance Individuals
Family Floater Health Insurance A complete family, including Self, Spouse, Children, and Parents
Senior Citizen Health Insurance Senior Citizens above 60 years of age
Top Up Health Insurance Someone who needs additional coverage on existing health insurance
Critical Illness Insurance Treatment of critical diseases like heart attack, stroke, or cancer
Group Health Insurance Employees of an organization
Mediclaim In-patient expenses
Hospital Daily Cash Daily hospital expenses
Personal Accident Insurance Owner-driver to protect them against disability or death caused due to accident
Disease-Specific (M-Care, Corona Kavach, etc.) Covering expenses in case of specific diseases like Corona, dengue, etc
ULIPs Someone seeking the combined benefit of insurance and investment

Taking a Closer Look

1. Individual Health Insurance 

As the name suggests, this plan offers coverage on an individual basis. However, you can add other family members for an extra premium. The premium is determined by your age, medical history, and the sum insured you choose.  This plan offers individual claim settlements, meaning one member's claim won't affect the sum insured of another.

2. Family Floater Health Insurance 

This plan covers your entire family under a single sum insured, including your spouse, kids, parents, and other dependent members. It's generally cheaper than individual plans, but there's a catch: everyone shares the same coverage amount. If one family member uses a significant portion of the sum insured, it leaves less coverage for others.

3. Senior Citizen Health Insurance Plans

These plans cater specifically to people above 60 years old, who are more susceptible to serious illnesses and require expensive treatments. The premium is typically higher due to the extensive coverage, but you can avail tax benefits under Section 80D on the premium paid.

4. Top Up Health Insurance

This acts as an additional layer of security on top of your existing health insurance plan. It increases your medical coverage at a lower cost. Imagine you have a Rs 5 lakh plan, but want Rs 25 lakh coverage. You can buy a Rs 20 lakh top-up plan, giving you a total coverage of Rs 25 lakh.

5. Critical Illness Insurance

This plan safeguards you against life-threatening illnesses like cancer, heart attack, or stroke. These conditions often require multiple hospital visits and expensive treatments. The plan provides a lump sum amount to cover these costs.  You can purchase it as a rider with your existing health insurance or as a standalone plan.

6. Group Health Insurance

This plan is usually provided by your employer and offers limited coverage. You can extend coverage to family members for an extra premium, but it depends on your employer's policy. Since the coverage ends when you leave the company, it's wise to have a separate health insurance plan.

Expanding Your Health Insurance Options

The Indian health insurance market offers a wider selection of plans to cater to diverse needs:
 

● Mediclaim: This is a basic health insurance plan that reimburses you for medical expenses incurred during hospitalization. It covers doctor's fees, medications, tests, surgeries, and ambulance charges. Think of it as a repayment plan – you pay for the medical expenses upfront, and then Mediclaim reimburses you for the covered costs as per your plan.

●  Hospital Daily Cash Benefit Plans: This plan offers a fixed amount of cash for each day you're hospitalized, irrespective of your actual daily expenses. So, if your plan offers Rs. 5000 per day, you'll receive that amount regardless of your daily hospital bill. This can help cover additional expenses not covered by your basic health insurance plan, such as attendant charges or a comfortable hospital bed.

● Personal Accident Insurance: This plan protects you financially in case of accidental death or disability. It provides a lump sum amount to the insured or nominee to manage the financial burden arising from an accident. This plan can also offer additional benefits like compensation for unexpected hospitalization bills and a daily hospital allowance.

● Disease-Specific Health Insurance (M-Care, Corona Kavach, etc.): These plans cover expenses specific to certain diseases like Coronavirus or Dengue. They offer a more targeted approach to managing healthcare costs associated with a particular illness.

● ULIPs (Unit Linked Insurance Plans): ULIPs are a hybrid product that combines life insurance coverage with investment potential. A portion of your premium goes towards life insurance, and the rest is invested in the market. This allows you to build wealth while also having a safety net in place.
 

Conclusion

Healthcare costs are on the rise in India, and health insurance has become an essential tool for managing your financial well-being. By understanding the different types of plans available and choosing the one that best suits your needs, you can safeguard your financial future and ensure peace of mind in the face of unexpected medical situations. Remember, proactive planning is key.

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Frequently Asked Questions

The application process for health insurance is straightforward. You can approach an insurance agent, visit the company's website, or use online insurance aggregators for comparison. Generally, you'll need to fill out an application form, submit relevant documents (proof of identity, address, income, etc.), and undergo a medical check-up (depending on your age and policy chosen).

The best time to buy health insurance is when you're young and healthy. Premiums are generally lower at a younger age, and locking into a plan early ensures continuous coverage without any interruptions. Additionally, pre-existing conditions won't be a concern if you have a plan from a young age.

Yes, in most cases, you can add family members to your existing health insurance plan. This typically comes at an additional premium. However, it's important to check with your insurance provider about their specific policy on adding family members and any limitations that might apply.