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Safeguarding Your Health: Understanding Health Insurance

Navigate the complexities of healthcare coverage with confidence. From routine check-ups to unexpected medical emergencies, ensure you’re protected with comprehensive health insurance tailored to your needs.

Why We Need Health Insurance?

Medical Emergencies:

Travel insurance covers unforeseen medical emergencies abroad, providing peace of mind and financial protection against unexpected healthcare costs that could arise during your trip.

Access to Quality Healthcare:

With health insurance, you gain access to a network of healthcare providers and facilities, allowing you to receive timely medical treatment and preventive care.

Safeguarding Your Family's Well-Being:

Health insurance coverage extends to your family members, protecting their health and providing support during times of illness or injury.

Emergency Preparedness:

Health emergencies can arise unexpectedly. Having insurance means you're prepared for such situations, allowing you to focus on recovery rather than worrying about the financial implications.

Preventive Care Benefits:

Many health insurance plans offer coverage for preventive services such as vaccinations, screenings, and wellness exams, helping you maintain optimal health and catch potential health issues early.

Legal Requirement:

In some countries, having health insurance is mandatory by law. Even where it's not mandatory, having coverage can prevent potential legal and financial repercussions in case of medical emergencies.

Long-Term Financial Planning:

Health insurance plays a crucial role in your long-term financial planning by mitigating the risk of catastrophic medical expenses that could derail your financial goals.

Peace of Mind:

Knowing that you and your loved ones are covered by health insurance brings peace of mind, allowing you to focus on living your life to the fullest without worrying about what-if scenarios related to health emergencies..

Choose the Right Health Insurance Plan!

What is Health Insurance?

Health insurance is a type of insurance policy that provides financial coverage for medical and healthcare expenses incurred by the insured individual or their covered dependents. It is designed to protect individuals and families from the high costs of medical treatments, hospitalization, surgeries, and other healthcare services.  Browse Aapka Policywala – a leading online insurance provider in India – to discover health insurance plans from the best insurance companies!

Indian Health Insurance Plan Types

Individual Health Insurance: Individual health insurance plans provide coverage for a single individual. These policies offer financial protection for medical expenses incurred by the insured person during hospitalization or medical treatment.

Family Health Insurance: Family health insurance plans offer coverage for the entire family under a single policy. They include the policyholder, spouse, children, and sometimes dependent parents or in-laws. Family health insurance provides comprehensive coverage for all family members in one policy.

Group Health Insurance: Group health insurance plans are offered by employers or organizations to cover a group of employees or members. These plans provide collective coverage to the entire group, and the premiums are often more affordable than individual plans.

Senior Citizen Health Insurance: Senior citizen health insurance plans are specifically designed for elderly individuals aged 60 years and above. These plans address the unique healthcare needs of seniors and cover age-related medical conditions.

Critical Illness Insurance: Critical illness insurance provides a lump sum payment upon diagnosis of a specified critical illness such as cancer, heart attack, stroke, or kidney failure. The benefit can be used to cover medical expenses or other financial needs during the treatment and recovery period.

Maternity Health Insurance: Maternity health insurance plans offer coverage for prenatal care, childbirth, and postnatal care. These plans cover medical expenses related to maternity and childbirth, including hospitalization and delivery costs.

Top-up and Super Top-up Plans: Top-up and super top-up plans provide additional coverage over and above the existing health insurance policy. They come into effect after the insured reaches a specified deductible limit.

Hospital Cash Insurance: Hospital cash insurance pays a fixed daily amount to the insured for each day of hospitalization. It helps cover additional expenses during hospital stays, such as transportation and incidental costs.

Disease-specific Plans: Some health insurance plans are tailored to cover specific diseases or medical conditions. For example, diabetes insurance plans provide coverage for diabetes-related treatments and medications.

Universal Health Insurance: Universal health insurance aims to provide coverage for all citizens of the country and is often part of government-sponsored health schemes.

We bring the best deals on health insurance plans in India. Thousands of families also trust Aapka Policywala for car insurance, family travel insurance, and group health insurance in India. Browse our vast collection of policies to meet your insurance goals. 

Features & Benefits of Health Insurance

Features and benefits of health insurance can vary based on the specific plan and insurance provider.

 

FeaturesBenefits
Hospitalization CoverageFinancial protection for in-patient medical expenses
Pre-HospitalizationCoverage for medical expenses before hospitalization
Post-HospitalizationCoverage for medical expenses after hospitalization
Day Care ProceduresCoverage for specific medical treatments
Cashless HospitalizationEasy access to cashless medical services
Domiciliary TreatmentCoverage for medical treatment at home
Maternity CoverageCoverage for pregnancy and childbirth expenses
Preventive CareCoverage for health check-ups and vaccinations
Critical Illness CoverageLump sum payout upon diagnosis of critical illnesses
No-Claim BonusRewards for not making any claims
Room UpgradeOption to upgrade to higher category room

Does COVID-19 Fall Under Health Insurance?

You can use your regular health insurance to cover COVID-19. With infections spreading like wildfire in India, one of the worst-affected nations, customers of medical insurance are in a bind. People who now have insurance for their health during the pandemic should be covered by COVID-19 by all insurers, according to expectations. The IRDAI standards state that since the ailment is a new illness and not a pre-existing one, coverage cannot be denied. Consumables including personal safety gear (PPE), oxygen, masks, and oximeters, that are crucial components of the treatment, might not be covered by it. Two common health insurance plans, Corona Kavach and Corona Rakshak Policy, were created and widely purchased in accordance with IRDAI requirements.

Policy of Corona Kavach

To safeguard you and your loved ones from COVID-19, Corona Kavach has become an indemnity-oriented policy that pays for all COVID hospitalisation costs.

The policy intends to pay for hospitalisation, pre- and post-hospitalization costs, home care treatment costs, and AYUSH treatments if the insured tests positive for COVID-19.

In addition to hospitalisation costs, the coverage also includes coverage for oxygen, blood, surgery fees, surgical tools, medication and drugs, diagnostic costs, PPE package, mask, and other comparable things.

Corona Rakshak

An affordable health insurance programme called Corona Rakshak pays policyholders with COVID-19 a flat sum as compensation. The plan covers a 100% sum insured if the diagnosis identifies the virus and necessitates a 72-hour hospital stay.

How Do You Make a Claim on an Indian Health Insurance Policy?

Inform the Insurance Company: As soon as you or your insured family member requires medical treatment, inform your health insurance company about the hospitalization or treatment. Most insurance companies have a 24/7 helpline or customer service number for claim intimation.

Pre-Authorization (For Cashless Claims): If you are availing of cashless treatment at a network hospital, request a pre-authorization from the insurance company. You or the hospital staff can initiate this process by submitting relevant medical documents and details of the planned treatment to the insurer.

Document Collection: Gather all necessary documents to support your claim. These typically include the original bills, discharge summary, diagnostic reports, prescriptions, and any other relevant medical records.

Complete Claim Form: Obtain and fill out the claim form provided by the insurance company. This form is available on their website, at their branch offices, or you can request it via email.

Submit Claim Form and Documents: Submit the filled claim form along with the required documents to the insurance company. You can do this through email, courier, or by visiting their nearest branch office.

Claim Processing: The insurance company will review your claim and the submitted documents. The processing time can vary, but it is typically done within a few days to a couple of weeks.

Approval or Rejection: The insurance company will communicate their decision regarding the claim. If approved, they will specify the amount covered and any applicable deductions or co-payments.

Cashless or Reimbursement: If you have opted for a cashless facility and the claim is approved, the insurance company will directly settle the bills with the hospital. If not, you will need to pay the bills yourself and then apply for reimbursement as per the approved claim amount.

Follow-up: If there are any discrepancies or additional information required, cooperate with the insurance company to expedite the claim settlement process.

Claim Settlement: Once the claim is approved, and all necessary verifications are complete, the insurance company will settle the claim amount either through direct payment to the hospital (for cashless claims) or through reimbursement to you (for reimbursement claims), as per the terms of your policy.

Document Required For Filing The Claim

Claim Form: A duly filled and signed claim form provided by the insurance company.

Original Bills and Receipts: Original bills and receipts for medical expenses incurred. This includes hospitalization bills, pharmacy bills, diagnostic tests, doctor’s consultation fees, etc.

Medical Reports: Any medical reports, such as laboratory test results, X-rays, MRI/CT scans, or other diagnostic reports related to the treatment.

Discharge Summary: A copy of the discharge summary from the hospital, which includes details of the treatment received during hospitalization.

Prescriptions: Prescriptions from the treating doctor, specifying the medications and treatments prescribed.

Policy Document: A copy of the health insurance policy document showing your coverage details, policy number, and the terms and conditions.

ID Proof: A valid ID proof of the insured person filing the claim.

Payment Receipts: Receipts or payment proofs of the medical expenses paid by the insured at the time of treatment.

Medical History: In some cases, the insurance company may require the insured’s medical history, especially if the claim is related to a pre-existing condition.

FIR or Medico-Legal Certificate (if applicable): If the claim is related to an accident or injury, an FIR copy or a medico-legal certificate may be required.

Cashless Approval Letter (for Reimbursement Claims): In the case of reimbursement claims, if the insured had sought prior cashless approval but ended up paying the bills, a copy of the initial cashless approval letter may be needed.