Escaping a medical emergency is not our hands but not letting it drain our pockets definitely is in our hands! According to a World Bank study on India:
- 85% of the working population do not have Rs.5 lac as instant cash
- 14% have Rs. 5 lac instantly, but will subsequently face a financial crunch
- Only 1% can afford to spend Rs. 5 lac instantly and easily
- 99% will face a financial crunch in case of any major illness
Health Cost rising at 20 % p.a
In 80% of cases of hospitalization in India, people have to sell their assets or take loans in order to pay for their treatment.
Life, unfortunately, follows no fixed plan. Sudden illness or bodily injury coupled with rising medical costs can sometimes leave one financially hurt and highly stressed. Health insurance allows one to breathe easy. Health insurance policy kicks in at such junctures to ensure that one gets the requisite treatment & one’s pocket isn’t raided/
What is Health Insurance?
Health insurance is a contract entered between the insured and an insurance company (the insurer), wherein the insurer agrees to pay the insured for health care expenses that might arise due to hospitalization, accident, illness, or disease. All these expenses are subject to limits defined in the contract i.e. the insurance policy.
Health cover provides complete protection to the insured and family. One can cover your spouse, children and dependent parents from all Health worries.
The Health Insurance cover can be of the following types–
- General Health Insurance Cover
- Critical Illness Cover provides for critical illnesses/diseases such as heart attack, kidney failure, diabetes and cancer.
- Top up cover (a deductible product to enhance the existing sum insured under general health insurance cover)
Tax Benefits: Exemption under section 80 (D) of the Income Tax Act, 1961 is presently available for premium paid by cheque.
The Policy Covers:
- The Policy covers illness/disease or accidental injury leading to expenses – hospital charges (room & boarding and operation theatre), fees of a surgeon, anaesthetist, nurses, cost of medicine, oxygen, blood, cost of appliances like pacemaker, artificial limbs and cost of organ donor expenses. Hospitalization expenses are subject to a maximum of the sum insured at the inception of the policy
- Maternity benefit available
- Pre hospitalization Post hospitalization expenses
- Cashless Facilities at hospitals (those who have tied up with the insurer to form a network) throughout the country. The Cashless Facility means that the
- insured does not have to pay from his/her pocket for a large part of the expenses incurred at a network hospital – they are handled directly by what is known as the Third Party Administrator (TPA).
- Any treatment relating to any illness/disease already in existence at the time of proposal. But it is covered after a waiting period of 2 years or 4 years depending on the policy.
- Any disease/injury during the first 30 days of commencement of policy (accidental injury is not an exclusion).
- Treatment of cataract, benign prosthetic hypertrophy, hysterectomy for menorrhagia on fibromyoma, hernia, hydrocele, congenital internal disease, fistula in anus, sinusitis and related disorders only during the first year of cover.
- Vaccination, inoculation, circumcision or change of life or cosmetic or aesthetic treatment, plastic surgery unless necessitated due to accident or as a part of any illness.
- Dental treatment or surgery of any kind unless requiring hospitalisation.
- Cost of spectacles contact lenses and hearing aids.
- Convalescence, general debility. “run-down” condition, sterility, venereal disease, intentional self-injury, use of drugs and intoxicants.
- Aesthetic treatments, plastic surgeries etc. unless required due to medical conditions.
- Any variation of deficiency syndrome or AIDS.
- Treatment arising from or traceable to pregnancy or childbirth.
- Nuclear perils and war group of perils.
- Naturopathy treatment.
Today there are over 200 Health Insurance Plans available to a consumer. Each of these Health Insurance Plans to have its own unique USP, but they all can be differentiated on the basis of 8 broad categories.
- Waiting Period & Duration before Pre-Existing diseases are covered in the Policy
- Lifelong Coverage
- Type of Health Insurance
- Extra Coverage’s of Critical Illnesses
- Presence of Maternity coverage’s for females
- Day Care treatments covered
- Product Premium
- Co-Payment options
We at AppkaPlociy evaluate and offer the plan that best suits your needs at the lowest premiums.