When you go into a hospital, your first thinking is usually about how much less money you will have when you leave. The medical industry is one of the leaders in a world of cutting-edge technologies, but technology comes at a price. A standard check-up may easily cost thousands of dollars, and a prolonged hospital stay would almost certainly cost several lakhs. At the very least, having a solid and extensive health insurance coverage might save your skin—and your money—when you’re receiving medical care in a hospital.

Health insurance: what is it?

Your health insurance provider will cover your medical costs if you choose a plan, but in exchange, you must pay an annual payment that may also be paid in monthly installments. This is known as the premium. Health insurance protects your pocketbook by paying for treatment costs, hospitalization fees, ambulance costs, laboratory costs, and other connected expenditures, depending on which policy you choose and who offers it. In some cases, plans even pay for missed wages.

What makes owning a health insurance coverage necessary?

To put the rising demand for health insurance coverage in India into perspective, the WHO reported that an alarming 68% of Indian medical costs are paid out-of-pocket (OOP). Furthermore, in India, only 18% of people live in cities and 14% in rural areas and have access to health insurance. Early health insurance purchase is important since rates are much cheaper. It is important to remember that many plans, with the exception of those resulting from accidents, do not cover pre-existing conditions or diseases that develop within 30 days of the policy’s acquisition.

This list of factors will help you understand the significance of health insurance, whether you already have coverage or are considering obtaining one.

• Cashless treatment:All you need to do to get treatment at any of these hospitals is show your health insurance card—or even just your policy number—and the rest will take care of itself once you fill out the necessary paperwork. However, you will have to pay for the treatment and submit a claim for reimbursement if you choose a non-network facility. Therefore, one of the greatest advantages of having a health insurance coverage is cashless treatment, since few people can organize huge quantities of money for medical expenses on short notice.
• Increasing Medical Costs and Health Disorders: India, the cancer rate has almost doubled over the last 26 years. In addition, there has been an increase in other serious illnesses including diabetes and TB. You won’t need to search far to understand why health insurance is essential when you combine this with the steadily rising costs of medication and medical care.
• Free Annual Medical Check-up & Extra Benefits:  entitled for a No Claim Bonus (NCB), which is a boost in the total covered amount. Moreover, pre- and post-hospitalization costs, ambulance fees, and other perks are provided by insurance companies.
• Tax advantages: ance policy under section 80D of the Income Tax Act. A total deduction of ₹50,000 can be claimed by individu Known as network hospitals, all major health insurance companies have a large number of well-known hospitals inside their network. 
•  11,57,294 cancer patients were reported in 2019 according to data from India’s Cancer Registry. In
• A lot of insurance firms provide their clients a free annual medical check-up as a complimentary advantage (though some only do this if you haven’t made a claim on your policy in a few years). Additionally, if you haven’t made any claims to your insurance throughout the policy period—aside from outpatient claims—you may be
• You are eligible to get tax benefits for the premiums you pay toward your health insurals under 60 if their parents are under 60 (₹25,000 for the individual, the spouse, and any dependent children, and ₹25,000 for the parents), and ₹75,000 if the parents are over 60 (₹25,000 for the individual, the spouse, and any dependent children, and ₹50,000 for the parents). A deduction of ₹1,00,000 may be made if the person and their parents are both above 60.
• Peace of mind: More than anything else, knowing that you have a well-thought-out insurance coverage protecting your back is a huge comfort, particularly in light of the startling rise in serious illnesses over the last several decades. In addition to saving you and your family in medical situations, it will also give you one less thing to worry about in your already hectic daily routine.

Now that we recognize the value of health insurance, let’s look at some factors to take into account while making your decision.

Things to think about while searching for a health insurance policy

• As previously said, it is preferable to have health insurance while one is young. The likelihood of health problems also tends to rise with age, as do premiums.
• Seek for an insurance that provides coverage for last illnesses. These are the ones that most often deplete our funds, thus it seems sensible to put them on the list.
• A insurance with a high co-payment provision should not be selected. The amount of the bill you have to pay out of pocket in the event of a claim is known as a co-payment. According to the conditions of the policy, the insurance company pays the remaining amount.
• Select the appropriate riders or add-on features for your health insurance policy to increase the net total coverage of the policy.

Health Insurance Types

Under an indemnity plan, you would be responsible for paying a portion of the hospital bills while the insurance company would cover the remaining costs. The insurance company has no say over the hospital or whether the visit was required; you get to choose the doctor you see. However, this liberty is limited in scope. If you are not debilitated, you must still get insurance company clearance before being admitted to the emergency department in case of an emergency. If you choose the indemnity plan, you will be required to pay the whole amount upfront before submitting a claim for reimbursement.

Exclusive Provider Organization (EPO): Participants in an EPO plan are obliged to utilize a predetermined physician network, along with a Primary Care Physician (PCP) who will recommend patients to network specialists for medical care. But in an emergency, this criterion does not apply. Additionally, there will be a modest co-payment that you must pay.

Point of Service (POS): POS offers a PCP to choose among the network providers, much as in the EPO pan. In certain circumstances, your coverage will be increased. But, if you choose a hospital that is not in the network, your coverage may be reduced and you could have to pay a deductible (co-payment). Furthermore, you may need to make an upfront payment before requesting a refund.

Supplements to health insurance

• Top-ups: You may get enough coverage at reasonable costs by combining a basic insurance plan with a top-up plan. A top-up plan is an extra insurance that begins to pay for medical expenses above what your base insurance plan would pay. Super top-up plans pay for the costs of a full year’s worth of medical bills for a variety of conditions, while top-ups only cover the cost of one hospital stay.
• Riders: You may extend your insurance coverage and customize it to meet your needs by adding a rider to your basic health insurance plan for an extra cost. There are several riders available, including those for personal accidents, maternity leave, and critical sickness.
• Defined benefit plans: Most basic health insurance plans do not cover costs associated with things other than hospitalization, such as meals, transportation costs for your caretaker, prescription drugs, and costs associated with treating conditions that did not result in your hospitalization. No matter what your costs are, defined benefit plans will save the day and guarantee you a pre-determined payout.

What is not covered by your health insurance coverage

• Substance-related illnesses: Your claim will be denied if it is clear that your sickness is the consequence of abusing alcohol, cigarettes, or other illegal drugs.
• Home treatment: The claim will be null and invalid if the patient is not admitted to the hospital. Treatment received at home may be covered by certain insurance companies, but the maximum amount will be lower.
• Certain Medications and pharmaceuticals: Insurance companies may not pay all prescription pharmaceuticals needed to treat serious conditions like cancer. Certain oral chemotherapy medications are not covered, and immunotherapy medications are often not covered either. Certain insurance exclude coverage for intra-arterial and intra-lesional injections.
• Charges made by the resident physician: The resident physician’s charges will not be paid if they are listed separately in the bill. On the other hand, if it is included in the lodging rate, the coverage provider could cover it.
• Novel or advanced therapies: Treatments that are experimental or unproven, such as robotic surgery, are not covered by policy. Moreover, stem cell treatments are often not covered.
• Non-medical expenses: The insurance does not cover costs for toiletries or other convenience products. Please refer to IRDAI circular number. IRDA/HLT/CIR/036/02/2013 for a list of all things that are not covered.
• Pre-existing conditions: Generally, pre-existing conditions are either completely excluded from coverage or may not qualify for a claim until an insurance company-determined lock-in period.

In conclusion, it is impossible to exaggerate the value of health insurance. Obtaining health insurance for your parents, children, spouse, and yourself at the earliest opportunity is essential. Our health insurance plan is available to you here.