Medical emergencies can erupt at any time. In our everyday lives tussled with stress and hustle, seldom do we pay attention to what our bodies are trying to tell us. But, it is not just about ailments. It is also about how in a split second our lives can change and God forbid, we may end up strapped to a hospital bed. The expenses are excruciatingly high. At that point of time, we need assistance. That’s where life insurance comes into picture.

What is health insurance premium?

Health insurance premium is a fixed amount the policyholder pays in fixed installments, in exchange for a cover. There are certain factors that affect the premium amount

Factors that affect insurance premium

• Type of insurance plan: Family floater plan or an individual plan
• Nature of work of the applicant: The riskier the profession, the higher the premium amount
• Medical condition of the applicant: The more medical conditions the applicant suffers from, the higher the premium amount
• Age of the applicant: Higher the age, more the complications, and hence, more the amount of insurance premium
• Policy term: The longer the duration, higher the premium amount
• Number of family members covered: This again depends on whether or not the applicant goes for a family health plan

What are the various types of insurance plans?

Broadly, there are two types of insurance plans; indemnity and fixed. Let’s understand both better with the help of an infographic.

Health insurance:

1. Indemnity plan:

• Individual insurance: Covers the treatment and hospital expenses of an individual
• Senior citizen insurance: Covers the treatment and hospital expenses of a senior citizen, i.e. an individual over the age of 60 years
• Family floater insurance: A single health insurance that covers all the family members
• Maternity insurance: Provides cover for all the pre and post pregnancy expenses
• Group medical insurance: One health insurance that covers all the group members

2. Fixed benefit plan:

• Critical illness insurance: A lump sum is provided for critical illness treatment
• Preventive insurance: This one covers all the regular health checkup expenses
• Personal accident insurance: This plan covers all the expenses in the event of death or partial or total disability
• Hospital daily cash benefit plan: It covers all the daily expenses in the event of hospitalisation

What are the documents required for the claim process?

• Claim form, duly filled
• Medical certificate from the doctor
• Summary of discharge
• Prescriptions
• Pharmacy bills
• FIR and investigation reports (if applicable)

What are the cases not covered by health insurance?

• AIDS treatment
• Dental treatment or surgery
• Maternity and newborn coverage
• Non-allopathic treatment
• Existing critical illness

Note that this is not an exhaustive list. The terms and conditions of insurance companies also affect this list.