Hello friends, you are warmly welcome on this blog of yours. Today we will learn about the benefits of health insurance through this article. We will know what are the benefits after getting health insurance
Comprehensive health insurance plans come with features that can assist an individual in managing expenses related to emergency medical conditions as well as conducting preventive health care check-ups.
The major benefits of health insurance plans are presented along the following lines:
Cashless Health Care
Every medical insurance company is associated with some or the other nursing home and hospital, and these hospitals are called "empaneled hospitals".
If you go to these hospitals for medical treatment then you will not have to bear any expenses. All you have to do is provide your policy number and the rest will be done by the insurer and the hospital authorities.
Benefits of Health Insurance Plans
Such insurance plans are highly sought after as there is no hassle in claiming claims and submission of documents.
But if your medical bill exceeds the pre-specified sub-limit, then you will have to pay the rest of the money directly to the hospital, and one important thing is that the insurance company will not bear the cost of medical treatment in hospitals other than the ones specified by the company.
Pre and Post Hospitalization Expenses
With the help of this feature, your chosen insurance company also covers the pre and post hospitalization expenses.
Read Also: Why to Compare Health Insurance Plans
Your insurer bears the pre and post hospitalization expenses for up to a specified period. Under the bus insurance plan, the insurer will cover the expenses of only those diseases which are named.
Whenever the insured reaches the verge of hospitalization, the insurer also takes care of the transportation expenses to reach the hospital.
NCB (or No Claim Bonus) is a kind of bonus that the insured gets if he has not made any claim on his policy in the previous year.
This bonus can be offered to them as an increase in the sum assured or as a discount on the premium cost. You can get this benefit on policy renewal.
Medical Check-Up Facility
A medical insurance plan provides regular medical check-up facility to the insured. Some insurance companies offer this check-up at no cost and others as an add-on benefit.
Room Rent Ceiling in Your Health Insurance Policy
Various sub-limits can be associated with a health insurance plan; And one of these is room rent. The general insurance company provides you the maximum coverage on the sum assured.
However, they may intentionally reduce their liability by introducing a sub-limit clause into hospital room rent coverage.
When the insured is admitted to the hospital, room rent is charged on a daily basis.
For example, if your plan covers room rent up to Rs 3000 and your rent is Rs 5000, then you will have to pay the remaining Rs 2000 from your own pocket. Subsequently, the room rent depends on the room type, such as a single room or a shared room.
Everything else happens the same way.
If the total cost of any medical treatment is Rs 5, 00,000, then you can see the table given below as an example.
In this situation, you will have to pay only Rs 1,16,000 out of the total Rs 5,00,000. Therefore, buy a policy only after considering whether you want a sub-limit on your policy.
The medical insurance plan offers a co-pay option which defines the voluntary deductible, which has to be borne by the insured.
So in case of getting a medical done, some amount is paid by the insurer and the rest by the insured. According to this facility, you can reduce the cost of your health insurance.
Co-pay is cost-sharing under a health policy, which states that the organization or individual will bear a certain portion (in percentage) of the total allowable cost.
However, the co-pay option does not have any effect on the Sum Assured. It allows you to reduce your premium to some extent (subject to the terms of the insurer and the insurance policy).
Tax Benefit in Insurance Plan
Under Section 80D of the Income Tax Act, 1961, the insured gets tax exemption on the insured under his health insurance. You get this discount on the payment of your insurance premium amount.
The discount that is available on premium depends on the age of the insured and the maximum exemption limit.
If you are below 60 years of age, then you can get a deduction of up to Rs 25,000. If above 60 years then the maximum exemption can be up to Rs 50,000.
If you are paying premium for medical insurance for your parents or yourself, you can get a deduction of up to Rs 55,000 under section 80D. The condition is that your parents are senior citizens.
The TPA concept has been formulated by IRDA which helps both the insurer and the insured. While it benefits the insurer by reducing their administrative costs, counterfeit claims and claim ratio, the insured, too, can enjoy better and faster insurance services.
TPA are important in the health insurance sector. They have the ability to settle claims in whole or in part.
They have tie-ups with health insurers or self-insurers to manage services like premium collection, enrollment, claim settlement and other administrative services.
Preexisting Disease Cover
After 2 to 4 years of inception of the policy, many insurers also start providing cover for preexisting diseases like diabetes, high blood pressure, etc.
This coverage is given for only a few specified diseases which the insured can know about at the time of buying the insurance.
Preventive Health Care
Certainly no one likes to be admitted to the hospital and home care is also very valuable. That's why, we now have a preventive health checkup for you so that you don't have to be insured.
Preventive care like regular health check-ups, waived off X-ray charges, waived off doctor visit charges, etc. are covered under the insurance plan. Such plans keep you safe from disease.
It is designed to get advance information about the disease.
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