Individual Health Insurance
Individual health insurance plan means health insurance which covers only one person. The costly treatments and emergency cases become tension for many individuals. Having an individual health insurance plan helps you get cashless medical treatment in a network hospital. Reimburse your hospital bills in case of non- network hospitals during the non-cashless treatment. The insurance company reimburse the amount but after an appropriate approval process. Individual health insurance plan makes sure that proper medical treatment is available to an insured person without worrying at the time of finical emergency. Individual health insurance is the best key to full fills the heavy hospital bills at the time of hospitalisation. Individual insurance policy helps in financial emergencies.
Individual Health Insurance Plan Covers
- In-patient Hospitalization: All medical expenses are covered by the insurance company at the time of hospitalization. If an insured person is hospitalized for more than 24 hours, the insurance company will pay the whole expenses of hospital bills.
- Pre-hospitalization Expenses: It means the expenses before you are admitted in the hospital are named as pre-hospitalization expenses. For example: – X-ray, MRI, blood test, urine tests, OPD, etc. are covered.
- Post-hospitalization Expenses: It means all expenses of an individual after he or she is hospitalized are named as post-hospitalization Expenses. For example, medicines or any medical tests are done after the discharge to check the improvement of a patient is covered in this policy.
- Restore Benefit: If your Sum Insured gets exhausted towards treatment the insurance company restores your Sum Insured.
- Day care treatment: Day care treatments mean that treatments that do not require 24 hours of hospitalization.
- Ambulance Charges: In individual health insurance policy company pay’s ambulance charges in case of an emergency. The expenses of the emergency ambulance charges are as per in your policy.
- Hospital Cash: Hospital cash means an individual health plan provides a lump sum amount in case of hospitalization and this amount can be used as per the liberty of the insured.
Features and Benefits of Individual Health Insurance
- Individual health insurance provider covers all medical expenses at the time of hospitalization based on the premium paid.
- This policy covers hospitalization charges.
- Lifetime renewal.
- Offers tax benefits under section 80D of the Income Tax act.
- Financial protection for medical costs like surgery costs, room rent, doctors’ consultation charges, emergency ambulance charges and laboratory tests.
- Pre and post hospitalization expenses are covered under this insurance policy.
- Accidental cover from the first day of the policy.
- Provides coverage for day care treatment.
- The insured can migrate his policy from individual to family floater after marriage and enjoy continuity benefits i.e. waiting period of pre-existing disease, specific disease etc will be waived off.
How Individual Health Insurance Premium is Calculated
The individual health insurance premium is calculated based on the sum insured you have chosen and your age. The premium will increase based on the age of slabs according to the premium chart of the insurance company. In case of PSU companies such as National Insurance, The New India Assurance, The Oriental Insurance and United India Insurance the premium can increase without a change in age slab if the person has taken claim in the last year. They charge loading on it and thus your premium will increase.
What is Covered under an Individual Health Insurance Policy?
- Hospitalization and medical expenses
- Pre and post hospitalization
- Emergency services
- Doctors’ consultation fees
- Tax Rebate
- ICU chargers
- Room rent
- Road ambulance
- Free health check-up
- Day care treatment
- Personal accidental
- Domiciliary
- Dental health
- Restoration
- No claim bonus
What is Not Covered under an Individual Health Insurance Policy?
- Claim raised within the 30 days period of the health insurance policy (except accidental case).
- Treatment and expenses incurred due to routine medical check-ups.
- Treatment/surgery is done for gender reassignments or for gender change.
- Treatment is undertaken abroad
- Policy does not cover for certain illnesses like hernia, cataract, sinusitis, etc. during the first year of the policy.
- Certain expenses are not included under this plan like the cost of hearing aid, eye lens, spectacles, etc.
- Treatments for health worries caused by alcoholism and drugs are not included
- Sexually transmitted diseases.
- Treatment related to fertility issues.
Things to check before buying Individual Health Insurance
- Which individual health insurance plan you are choosing
- Basic coverage under an individual health plan
- Claim Settlement Ratio of the company
- Premium they are offering
- Ask for the maximum renewal age
- Flexibility to increase the sum assured of an individual health plan
- Get hassle-free claim settlement
- Avail seamless cashless hospitalization
Documents Required for Purchasing an Individual Health Insurance Policy
- Age Proof: Documents like PAN Card, Voter’s ID, Driving License, Passport, School or College Certificate, etc.
- Photo Identity Proof: Aadhaar Card, PAN Card, Driving License, Passport, Voter’s ID, etc.
- Address Proof: Documents like Ration Card, Telephone Bill, Electricity Bill, Passport, Voter’s ID, Bank A/C Statement, etc.
- Medical Check-up: If the insurance company asked
- Passport size photograph