Questions

• What are the benefits of health insurance?
• What are the different kinds of Critical Illness covered under Health Insurance Plans?
• Is maternity benefit available under an individual Health Insurance Plan?
• What are the factors that determine the premium payable for a health insurance plan?
• What is meant by hospitalization?
• Is there a tax deduction on the premium paid?
• Are there limits to the number of claims on a Health Insurance Plan?
• If I avail of the cashless facility, will the insurance company pay the entire bill at the hospital?

What are the benefits of health insurance?

Some of the key benefits of typical health insurance policies include:

1. Saving huge amount of unplanned expenses, in case of unexpected medical emergencies
2. Tax benefits under section 80D of the Income Tax Act
3. The amount of premium is usually small and manageable
4. Added coverage of family members
5. Covers of hospitalization and medical bills
6. Domicilliary expenses
7. Disability and custodial bills

What are the different kinds of Critical Illness covered under Health Insurance Plans?

Typically, a critical illness plan would provide cover for the illnesses mentioned below.

1. Cancer
2. Coronary artery bypass surgery
3. First heart attack
4. Kidney failure
5. Major organ transplant
6. Multiple sclerosis
7. Paralysis
8. Primary pulmonary arterial hypertension
9. Stroke

Is maternity benefit available under an individual Health Insurance Plan?

No maternity benefit is available under individual health insurance plans. However, it may be available on a group plan; this varies from company to company.

What are the factors that determine the premium payable for a health insurance plan?

Following factors determine the premium payable for a health insurance plan:

1. Age of the insured
2. Previous medical history
3. Sum Assured
4. Term of the policy

What is meant by hospitalization?

An instance where the insured individual is hospitalized for a minimum period of 24 hours can be termed as hospitalization.

Specific treatments like dialysis, chemotherapy, radiotherapy, laser eye surgery, dental surgery, etc when the patient is discharged on the same day are also considered as hospitalization.

Is there a tax deduction on the premium paid?

Health insurance plans are covered under section 80 D, Income Tax Act, 1961. The limit for individuals is Rs. 15,000 and for senior citizens is Rs. 20,000.

Are there limits to the number of claims on a Health Insurance Plan?

There is no limit to the number of claims per annum but there is a limit to the amount that you can claim in a year. Usually, the maximum amount that you can claim in a year is limited to the sum insured.

If I avail of the cashless facility, will the insurance company pay the entire bill at the hospital?

The insurance company will pay parts of the bill which are covered under the policy. It is possible that there are certain expenses, which have been specified by the insurer which are considered inadmissible – it is recommended you read your policy wordings carefully or check with your insurance advisor.