Health Insurance

Health insurance is a financial safeguard that ensures you and your family have access to quality healthcare without the burden of high medical expenses. A comprehensive health insurance policy covers hospitalization, diagnostic tests, surgeries, and post-treatment care. With the rising costs of healthcare, having a robust insurance plan helps protect your savings and provides peace of mind during medical emergencies.

Why Choose Health Insurance?

Cashless Treatment at All Hospitals: Avail treatment at any hospital without upfront payments. Your insurer directly settles the bill.
Financial Security: Prevents medical bills from draining your savings.
Tax Benefits: Premiums paid are eligible for tax deductions under Section 80D of the Income Tax Act.
Protection Against Lifestyle Diseases: Covers treatments for diabetes, hypertension, and cardiovascular diseases.
Emergency Medical Coverage: Ensures financial support in case of sudden medical crises.

Who Should Get Health Insurance?

Young Professionals: To secure early coverage at lower premiums.
Families: To provide financial protection for all members.
Senior Citizens: To cover high-cost age-related treatments.
Business Owners & Self-Employed Individuals: To ensure medical security without employer benefits.

What Does a Health Insurance Policy Cover?

1. Domiciliary Treatment (Home-Based Treatment)

If a patient cannot be admitted to a hospital due to severe medical conditions or the unavailability of hospital beds, a health insurance policy covers home-based treatment expenses. This includes: Doctor consultations at home Medicines and injections administered at home Medical equipment such as oxygen cylinders or ventilators for home use

2. Organ Transplant Coverage

Organ transplants can be life-saving but are highly expensive. A health insurance policy provides coverage for: Surgery costs for both donor and recipient Pre-transplant diagnostic tests and evaluations Post-transplant recovery and medication
(Note: Coverage may vary based on policy terms, and donor-related expenses may be covered only in certain policies.)

3. Daycare Treatment Coverage

Not all medical procedures require long hospital stays. Some treatments and surgeries are completed within a few hours. A health insurance plan covers such daycare treatments, including: Cataract surgery Chemotherapy and radiation therapy Dialysis Angiography Tonsillectomy and other minor surgeries This coverage ensures that even short-term medical procedures don’t become a financial burden

4. Hospital Room Expenses

A health insurance policy covers the cost of hospital accommodation, including: General Wards – Shared hospital rooms Semi-Private Rooms – A room shared between two patients Private Rooms – Individual patient rooms ICU and CCU Rooms – Intensive Care Unit (ICU) and Critical Care Unit (CCU) charges for patients requiring advanced medical care Some policies have a cap on room rent, while others provide full coverage for any room category.

5. Doctor and Medical Practitioner Fees

Medical practitioners and healthcare specialists play a crucial role in treatment and recovery. A health insurance policy covers: Consultation Charges: Regular visits by primary doctors and specialists Surgeon Fees: Charges for surgeries performed by skilled medical professionals Anesthetist Fees: Expenses related to anesthesia administration during surgery Physiotherapy and Rehabilitation: Costs for post-surgical physical therapy sessions

6. Ambulance Cover

In medical emergencies, quick transportation to the hospital is crucial. Most health insurance plans cover ambulance charges, ensuring you get immediate medical attention without worrying about transport expenses. Road Ambulance: Covers ambulance services for emergency transportation to hospitals. Air Ambulance: Available in select high-value policies for critical patients who need rapid transfer to advanced medical facilities.

7. Pre and Post-Hospitalization Expenses

Medical treatment isn’t just about hospital stays—it often includes expenses before and after hospitalization. Pre-hospitalization Coverage: Expenses incurred before admission, including doctor consultations, medical tests, X-rays, MRIs, and prescribed medicines. Coverage usually extends up to 30 to 60 days before hospitalization, depending on the policy. Post-hospitalization Coverage: After discharge, follow-up treatments, diagnostic tests, medication, and doctor consultations continue to be necessary. This coverage typically extends up to 30 to 90 days post-hospitalization.

8. Hospitalization Costs (In-Patient Care)

Health insurance covers various hospital expenses, ensuring financial protection during medical treatment. It includes room rent and ICU charges, covering the cost of hospital stays in general wards, private rooms, or intensive care units, with some policies having specific limits. Diagnostic tests and medical procedures, such as blood tests, X-rays, MRIs, and CT scans, are also covered. Additionally, it includes doctor’s consultation fees, surgical expenses, and anesthesia costs. The policy also covers prescribed medications, syringes, bandages, and other consumables required during hospitalization. Furthermore, expenses for blood transfusions, oxygen supply, ventilators, and other life-supporting medical equipment are included.

9. AYUSH Treatment Coverage

Many insurance providers now cover alternative treatments under Ayurveda, Yoga, Unani, Siddha, and Homeopathy (AYUSH). This is particularly beneficial for individuals who prefer holistic and natural treatments. Coverage is applicable only in government-approved and registered AYUSH hospitals and centers. 10. Preventive Health Check-ups Prevention is better than cure, and many health insurance policies offer free or discounted annual health check-ups, including: Full body check-ups Blood sugar tests Cholesterol and heart check-ups Liver and kidney function tests These screenings help in early diagnosis, reducing the risk of serious illnesses.

Additional Add-On Covers (Riders) for Enhanced Protection

1. Critical Illness Cover

Offers a lump sum payout if diagnosed with life-threatening diseases such as cancer, heart attack, kidney failure, or stroke. This amount can be used for medical treatment, rehabilitation, or to support recovery and lifestyle adjustments.

2. Accidental Death and Disability Cover

Provides financial compensation in case of death or permanent disability due to an accident. Helps secure the financial future of the insured’s family.

3. Maternity and Newborn Cover

Covers pregnancy-related expenses, including prenatal care, delivery, and postnatal care. Includes newborn baby coverage for vaccinations and neonatal care.

4. OPD (Outpatient Department) Cover

Covers doctor consultations, medical tests, and prescribed medicines for minor health issues that don’t require hospitalization.

5. No-Claim Bonus (NCB) Benefit

Increases your sum insured every claim-free year without increasing the premium. Encourages policyholders to maintain a healthy lifestyle.

6. Waiver of Premium Benefit

IEnsures continuity of the policy even if the insured is unable to pay premiums due to critical illness or disability.

Pre and Post-Hospitalisation Expenses:

Insurya Consulting General Insurance Company plans also cover pre and post-hospitalisation expenses` related to COVID-19. This includes the cost of diagnostic tests, doctor consultations, and medications required before and after the hospital stay.

Domiciliary Hospitalisation:

In cases where hospital beds are unavailable, Insurya Consulting General Insurance Company health insurance policies provide coverage for domiciliary hospitalisation. This allows the insured to receive necessary medical care at home, ensuring they are not left without treatment options during critical times.

Cashless Treatment Facility:

One of the significant benefits of Insurya Consulting General Insurance Company health insurance is the cashless treatment facility available at network hospitals. This means that the insured can receive treatment without having to make upfront payments, as the insurer directly settles the hospital bills. This feature is particularly beneficial during emergencies when arranging funds immediately can be challenging.

Home Care Treatment:

Recognising the need for flexible treatment options, Insurya Consulting General Insurance Company health insurance plans include coverage for home care treatment for COVID-19. This ensures that the insured who opt for home isolation and treatment can claim expenses related to medical consultations, nursing charges, and medications. This is particularly useful for patients with mild symptoms or those who prefer to recover at home.

Mental Health Support:

Understanding the mental health challenges posed by the pandemic, Insurya Consulting General Insurance Company health insurance plans also offer mental health support. This includes coverage for teleconsultations with mental health professionals, helping the insured manage stress and anxiety during these uncertain times.

Health Insurance Coverage by Insurya Consulting

Insurya Consulting General Insurance Company provides extensive health insurance coverage, ensuring comprehensive protection for the insured against various medical expenses. The broad range of coverage options is designed to cater to diverse healthcare needs, offering peace of mind and financial security.

In Patient Hospitalisation

Insurya Consulting General Insurance Company provides extensive health insurance coverage, ensuring comprehensive protection for the insured against various medical expenses. The broad range of coverage options is designed to cater to diverse healthcare needs, offering peace of mind and financial security.

Pre & Post-Hospitalisation expenses

Pre and post-hospitalisation expenses are also covered under Insurya Consulting General Insurance Company health insurance plans. This includes costs incurred for diagnostic tests, consultations, and medications required before and after hospitalisation. This comprehensive coverage ensures that the insured is protected from financial burdens both before and after their hospital stay.

Ambulance Charges

Insurya Consulting General Insurance Company health insurance plans cover the cost of ambulance services required for transporting the insured to the hospital. This includes emergency ambulance services, ensuring that the insured can access timely medical care without worrying about transportation costs.

Day-Care Procedures

Many medical treatments and procedures no longer require extended hospital stays. Insurya Consulting General Insurance Company health insurance plans cover day-care procedures, which are treatments that require less than 24 hours of hospitalisation. This includes surgeries and other medical procedures that can be completed on the same day. By covering day-care procedures, Insurya Consulting General Insurance Company ensures that the insured can access necessary treatments without the need for prolonged hospital stays.

Cashless Treatment

One of the standout features of Insurya Consulting General Insurance Company health insurance is the cashless treatment facility available at network hospitals. This allows the insured to receive treatment without having to make any upfront payments. The insurer directly settles the bills with the hospital, making the process seamless and stress-free. This feature is particularly beneficial during emergencies when immediate financial arrangements can be challenging.

Preventive Health Check-Ups

Insurya Consulting General Insurance Company health cover plans often include coverage for preventive health check-ups. These check-ups help in the early detection and management of potential health issues, promoting overall well-being. Regular health check-ups can prevent major health problems and ensure timely medical intervention.

How to Reduce Health Insurance Premium?

Reducing health insurance premiums is a key concern for many individuals and families. While comprehensive coverage is essential, there are ways to manage and lower the cost of premiums. Here are some effective strategies:

Opt for a Higher Deductible:

One of the simplest ways to reduce your health insurance premium is by opting for a higher deductible. A deductible is the amount you pay out-of-pocket before your insurance coverage kicks in. By choosing a higher deductible, you can significantly lower your premium because the insurer's risk is reduced. However, it’s important to ensure that the deductible amount is manageable for you in case of a medical emergency. This approach works well for individuals who are generally healthy and do not anticipate frequent medical expenses.

Maintain a Healthy Lifestyle:

Your lifestyle choices have a direct impact on your health insurance premium. Engaging in unhealthy habits such as smoking, excessive alcohol consumption, and a sedentary lifestyle can lead to higher premiums because they increase the risk of health issues. To reduce your premium, maintain a healthy lifestyle by eating a balanced diet, exercising regularly, avoiding smoking, and limiting alcohol intake. Insurers often offer lower premiums to individuals who demonstrate healthy behaviours, as they are considered lower risk. Additionally, regular health check-ups and managing chronic conditions effectively can further contribute to lower premium costs.

Choose Family Floater Plans:

If you need health insurance coverage for your entire family, consider opting for a family floater plan instead of individual plans for each member. Family floater plans cover all family members under a single sum insured and typically come at a lower premium compared to separate policies for each member. This can be a cost-effective way to ensure comprehensive coverage for the entire family. The premium is based on the age of the eldest family member, which can help reduce overall costs if the family members are relatively young and healthy. Moreover, family floater plans are convenient, as you only need to manage a single policy instead of multiple ones.

Why Should You Buy a Health Insurance Plan at an Early Age?

Purchasing health insurance at an early age is a strategic decision that comes with numerous benefits, ensuring long-term financial protection and peace of mind. Here are several compelling reasons why it’s advantageous to secure a health insurance plan early:

Lower Premiums:

One of the most significant benefits of buying health insurance early is the lower premium costs. Insurance premiums are calculated based on the risk profile of the insured, which typically increases with age. Younger individuals are generally healthier and less likely to have pre-existing conditions, leading to lower premiums. By securing a policy at a younger age, you lock in these lower rates, potentially saving a substantial amount over the life of the policy.

Comprehensive Coverage:

Health insurance plans purchased at an early age often provide more comprehensive coverage. Younger insured are less likely to have pre-existing conditions that require waiting periods or exclusions. This means you can benefit from a broader range of coverages, including preventive care, maternity benefits, and critical illness coverage, without significant limitations.

Financial Protection:

Unexpected medical emergencies can occur at any age. Having health insurance ensures that you are financially protected against high medical costs, including hospitalisation, surgeries, and treatments. Early coverage means you are prepared for unforeseen health issues without facing the financial burden that can deplete your savings.

Peace of Mind:

Knowing that you have a health cover plan in place provides peace of mind. It allows you to focus on maintaining a healthy lifestyle and achieving your personal and professional goals without the constant worry of potential medical expenses. Early investment in health insurance means you are proactive about your health and financial security.

Cumulative Benefits:

Many health insurance policies offer cumulative benefits for claim-free years, such as no-claim bonuses that increase your sum insured without additional cost. Starting early means you can accumulate these bonuses over a longer period, enhancing your coverage as you age.

Health Insurance Myths

Health insurance is a critical aspect of financial planning and health management, yet several myths often prevent people from investing in it. Understanding the facts behind these myths can help you make informed decisions and ensure you have the necessary coverage.

Health Insurance is Expensive

One common misconception is that health insurance is too costly and beyond the reach of many. However, the truth is that there are numerous affordable health insurance plans available in the market. These plans offer various levels of coverage, allowing you to choose one that fits both your budget and healthcare needs. For instance, basic plans cover essential medical expenses at lower premiums, while comprehensive plans offer wider coverage for a higher premium.

Young People Don't Need Health Insurance

Many young and healthy individuals believe they do not need health insurance. This myth can lead to significant financial strain if an unexpected health emergency occurs. Health issues can arise at any age, and accidents or sudden illnesses can lead to high medical costs. Having health insurance provides financial protection and ensures that you receive timely and quality medical care without worrying about expenses. Moreover, purchasing health insurance at a young age can be more cost-effective, as premiums are typically lower for younger, healthier individuals.

Group Health Insurance is Sufficient

Employees often rely solely on their employer-provided group health insurance, assuming it offers adequate coverage. While group health insurance is beneficial, it often comes with limitations such as lower sum insured and fewer benefits compared to individual health plans. Additionally, group insurance coverage ends when you leave the job, leaving you uninsured during job transitions. An individual health insurance policy provides more comprehensive coverage tailored to your specific needs and ensures continuous protection regardless of employment status.

How to Calculate Health Insurance Premiums?

Calculating health insurance premiums is a simple process, thanks to the availability of online premium calculators. These tools help you estimate the cost of your health insurance policy based on several key factors. Here’s how to calculate your health insurance premiums:

Use Online Premium Calculators

Insurya Consulting General Insurance Company offers an online premium calculator on the website. These tools are designed to provide quick and accurate premium estimates.

Enter Personal Details

Start by entering your basic personal information, such as age, gender, marital status, and smoking habits. These details are crucial in determining your risk profile, as younger individuals and non-smokers typically pay lower premiums.

Select Coverage Amount

Choose the sum insured or coverage amount you desire. This is the maximum amount your insurer will pay for your medical expenses. Generally, higher coverage amounts lead to higher premiums.

Provide Medical History

Some calculators may require details about your medical history, including any pre-existing conditions or chronic illnesses. This information helps assess risk and can influence the premium amount.

Choose Additional Benefits

If you want to include add-on benefits such as critical illness cover, maternity benefits, or personal accident cover, select these options. While additional benefits increase the premium, they provide enhanced coverage.

Get a Quote

After entering all the required information, the premium calculator will generate an estimate of your health insurance premium. Review the quote to ensure it fits your budget and meets your coverage needs.

Factors to Consider Before Buying a Health Insurance Policy

Choosing the right health insurance policy is crucial for ensuring that you have adequate coverage and financial protection in the event of a medical emergency. Here are some important factors to consider before making a decision:

Coverage

One of the most critical aspects to look at when buying a health insurance policy is the extent of coverage it provides. Ensure the policy covers major medical expenses such as hospitalisation, surgeries, treatments, and pre and post-hospitalisation costs. Comprehensive coverage should also include critical illnesses, maternity benefits, outpatient treatments, and day-care procedures. Evaluate your and your family’s health needs and choose a plan that covers potential medical expenses without leaving any significant gaps. Opting for a policy with broader coverage might mean a slightly higher premium, but it ensures peace of mind knowing that you are well-protected.

Network Hospitals

The insurer’s network of hospitals plays a significant role in the convenience and accessibility of medical services. Check if the health insurance provider has a wide network of hospitals, including reputable and accessible facilities in your area. A large network of hospitals ensures that you can avail of cashless treatment, where the insurer directly settles the hospital bills. This feature is particularly beneficial during emergencies when immediate financial arrangements can be challenging. Additionally, having a wide network means you have the flexibility to choose from various hospitals and specialists, ensuring you receive quality medical care.

Claim Process

A hassle-free claim process is essential for a smooth experience during medical emergencies. Research and choose insurers known for their efficient and transparent claim settlement processes. Look for insurers with a high claim settlement ratio, which indicates their reliability in processing claims. Understand the claim procedures, documentation requirements, and the average time taken for claim settlement. Reading reviews and testimonials from existing insured can provide insights into the insurer’s claim-handling efficiency. An insurer with a straightforward and quick claim process reduces the stress and financial burden during hospitalisation, ensuring timely medical care.

How to Choose the Right Health Insurance Company?

Selecting the right health insurance company is crucial to ensure that you receive reliable coverage and efficient service. Here are some key factors to consider when choosing the best health insurance provider:

Reputation

A company's reputation in the market is a strong indicator of its reliability and trustworthiness. Consider insurers with a long-standing presence and positive track record in the industry. Companies with a good reputation are more likely to provide consistent and quality service. Researching the company's background, history, and accolades can give you a sense of its credibility. Well-established companies often have better infrastructure and more extensive resources to support their insured effectively.

Claim Settlement Ratio

The claim settlement ratio (CSR) is the percentage of claims an insurance company has settled compared to the total claims received in a given period. A high CSR indicates that the insurer is reliable and prompt in settling claims. When evaluating health insurance companies, opt for those with a high CSR, as it reflects their commitment to honouring claims. This ratio can typically be found on the insurer's website or through regulatory bodies' reports. A CSR above 90% is generally considered good.

Customer Reviews

Customer reviews and testimonials offer insights into the real experiences of insured. Checking online reviews on independent platforms can help you gauge customer satisfaction and identify common issues or praises. Look for the consistent positive feedback regarding the insurer's customer service, ease of claim processing, and overall experience. Be cautious of insurers with numerous negative reviews, especially if they highlight issues like delayed claim settlements, poor customer support, or hidden terms.

Range of Plans

A good health insurance company should offer a variety of plans to cater to different needs and budgets. Check if the insurer provides comprehensive plans, family floater plans, critical illness coverage, and add-on options. The availability of multiple plans allows you to choose one that best suits your specific requirements.

Customer Support

Efficient customer support is essential for a smooth experience, especially during emergencies. Choose insurers known for their responsive and helpful customer service. Check if they offer multiple channels of support, such as phone, email, chat, and social media, ensuring you can reach them easily when needed.

Health Insurance: Important Terms

Understanding key terms in health insurance is essential for selecting the right policy and making informed decisions.

Sum Insured:

The sum insured is the maximum amount that the insurer will pay for your medical expenses during a policy year. It is the coverage limit of your health insurance policy. Choosing an adequate sum insured ensures that you have sufficient coverage to meet potential medical costs without significant out-of-pocket expenses.

Waiting Period:

The waiting period is the time span you must wait before certain coverages become active. This period can range from a few months to a few years, depending on the policy and the specific condition being covered. Common waiting periods include those for pre-existing conditions, maternity benefits, and specific treatments. Understanding the waiting period helps you plan for potential healthcare needs and avoid surprises when you file a claim.

Premium:

The premium is the amount you pay periodically (monthly, quarterly, half-yearly, or annually) to keep your health insurance policy active. It varies based on factors such as age, health condition, coverage amount, and lifestyle habits.

Co-payment:

Co-payment, or co-pay , is the percentage of the medical bill that you must pay out-of-pocket while the insurer covers the rest. It helps reduce the premium cost but means you share the cost of treatment.

Deductible:

A deductible is a fixed amount you need to pay each year before the insurer starts covering the expenses. Higher deductibles generally lead to lower premiums but require you to pay more out-of-pocket initially.

Health Insurance FAQs

Which health insurance is the best?

The best health plan offers comprehensive coverage, cashless treatment at network hospitals, a high claim settlement ratio, and excellent customer support.

What are the four common health insurance plans?

The four common health insurance plans are individual, family floater, critical illness, and senior citizen health insurance, each catering to specific needs and demographics.

Do you need Rs. 1 crore health insurance?

A Rs. 1 crore health insurance plan provides extensive coverage for high medical expenses, offering comprehensive financial protection against significant healthcare costs.

Which is better: health insurance or medical insurance?

Health insurance offers broader coverage, including pre and post-hospitalisation expenses, while mediclaim policy primarily covers hospitalisation costs, making health insurance more comprehensive.

Which is the best health insurance provider in India?

The best health insurance provider in India is Insurya Consulting General Insurance Company. We offer comprehensive plans, a wide network of hospitals, a high claim settlement ratio, and responsive customer service.

Why is medical insurance necessary for your health?

Medical insurance provides financial protection against unexpected medical expenses, ensuring access to quality healthcare without depleting your savings.

How many dependent members can I add to my family health insurance plan?

You can add your spouse, children, parents, and other dependents as per the policy terms, ensuring comprehensive family coverage.

Why should you compare health insurance plans online?

Online comparison helps you find the best plan that suits your needs and budget, offering a clear understanding of coverage and benefits.

Why should you never delay the health insurance premium?

Delaying premiums can result in policy lapse, losing coverage benefits and financial protection, and may lead to difficulties in renewing the policy.

How to get a physical copy of your Insurya Consulting General Insurance Company Health Insurance Policy?

Request a physical copy from the insurer or take a printout of the digital policy document received via email.

Is there a time limit to claim health cover plans?

Claims should be made within the stipulated time as per the policy terms to avoid rejection and ensure timely processing.

What are network hospitals in health insurance?

Network hospitals are those with tie-ups with the insurer, offering cashless treatment facilities, simplifying the claim process for the insured.

How to Buy Insurya Consulting General Insurance Company Health Insurance Online?

Visit the website or app, select the desired plan, fill in personal details, compare options, and make the payment to receive the policy document via email.