A health insurance policy is a contract between an insurer and an individual or a group, in which the insurer agrees to provide specified health insurance at an agreed-upon price called the premium.
Health insurance has become a necessity in today's world considering the rise in the cost of medical care and treatment. The escalating cost of medical treatment today is beyond the reach of the common man. Even if an individual is healthy and has never had any major problem, it is not possible to predict what may happen in the future. In such times, health insurance provides the much needed financial relief.
Health insurance can be availed by people aged between five and seventy five (The upper and lower age limits may vary slightly depending on the policy). The health insurance scheme could either be a personal scheme or a group scheme sponsored by your employer.
In anticipation of unexpected events that create the need for medical goods and services, the health insurance does not cover certain ailments. It does not cover ailments for some time (often in the first year) after the policy is taken. It covers hospitalisation charges for heart attacks, strokes, prolonged illness, injuries, maternity emergencies, loss of limb, eye, or other parts of the body due to accident, medicines etc. Coverage and exclusions may vary from one policy cover to another.
Treatment of certain diseases is not covered during the first year of your policy. The list of diseases may vary from one health policy to another.
You should understand the policy, and become familiar with common health insurance provisions, including limitations, exclusions, and riders. It is very important to know what your policy covers and what you have to pay yourself.
Health Insurance policies generally cover boarding, nursing and diagnostic expenses, which include room rent charged at the hospital or nursing home, fees of the surgeon, anesthetist, doctor, etc. Some policies even offer fixed cash amount for each day you stay at any hospital for treatment.
If you have a persistent health problem and then decide to take insurance, it might not be covered. Expenses on hospitalization, incurred in the first 30 days after taking a policy are also not entitled, except in case of an injury from accident. Some policies may cover it at an enhanced premium after a minimum lock-in period.
Some of the existing health insurance schemes currently available are individual, family, group insurance schemes, senior citizens insurance schemes, long-term health care and insurance cover for specific diseases.
In India, LIC and GIC are well-established names. Private players include Max India, Tata Group, Reliance, HDFC, Aditya Birla Group, Kotak Mahindra Finance and ICICI.