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Introduction

Health insurance is a vital financial safety net that offers protection against rising medical expenses. It provides coverage for various healthcare needs, ensuring individuals can access quality medical services without facing significant financial burdens. Hence, it is important to understand the features of health insurance, shedding light on the essential aspects that every policyholder should be aware of. From comprehensive coverage to preventive care, these features play a crucial role in safeguarding the health and financial well-being of individuals and their families.

Important Update (Dated May 30, 2024) – Good news for Health Insurance policyholders! According to the Master Circular on Health Insurance Business 29052024 rolled out on May 29, 2024 by IRDAI, insurers are to decide on the request for cashless claims within 1 hour of receiving the request. Also, the final claim is to be granted within 3 hours after the policyholder’s discharge from the hospital. Insurers have been directed by IRDAI to establish necessary systems and procedures for this process by July 31, 2024. The Master Circular on Health Insurance Business 29052024 circular is available here - https://irdai.gov.in/document-detail?documentId=4942918

The Features

Here are 10 health insurance features you must know of.

  • Comprehensive Coverage

One of the primary benefits of health insurance is its comprehensive coverage. This feature ensures that policyholders receive financial assistance for a wide range of medical expenses, including hospitalisation, surgical procedures, doctor consultations, diagnostic tests, and medications. With a comprehensive health insurance plan, individuals can focus on their recovery without worrying about the financial implications of medical treatment.

  • Cashless Hospitalisation

Cashless hospitalisation is a significant advantage offered by health insurance policies. Policyholders can get medical treatment at network hospitals without paying the bills upfront. The insurer settles the expenses directly with the hospital, making it convenient and hassle-free for the insured and their families during times of medical emergencies.

  • Pre-hospitalisation  and Post-hospitalisation

Health insurance plans often include coverage for pre-hospitalisation and post-hospitalisation expenses. This feature takes care of medical costs incurred before and after hospitalisation, such as diagnostic tests, doctor consultations, and follow-up treatments, ensuring that the policyholder receives comprehensive care throughout their medical journey.

  • No-claim Bonus

The no-claim bonus is a rewarding feature in health insurance policies. If the policyholder does not file any claims during a policy year, the insurer offers a bonus in the form of an increased sum insured or a discount on the premium at the time of policy renewal. This encourages individuals to maintain a healthy lifestyle and reduces the financial burden on insurers for claim-free years.

  • Maternity Benefits

Several health insurance plans now offer maternity benefits, covering expenses related to pregnancy, childbirth, and postnatal care. Maternity coverage provides peace of mind to expectant mothers, as it alleviates the financial stress associated with the significant medical costs of childbirth and related services.

  • Daycare Procedures

Advanced medical treatments have led to an increase in daycare procedures that do not require extended hospital stays. Health insurance plans often cover these daycare procedures, ensuring that policyholders receive the necessary medical attention without any financial strain.

  • Restore and Recharge Benefits

Some health insurance policies come with restore and recharge benefits. The restore feature automatically reinstates the sum insured if it gets exhausted during a policy year, allowing the insured continued access to coverage. On the other hand, recharge benefits provide an additional sum insured if the primary sum insured is exhausted before the end of the policy term.

  • Health Checkup

Preventive care is essential to maintain good health. Many health insurance plans include provisions for annual health checkups, encouraging policyholders to undergo regular screenings and identify potential health issues at an early stage.

  • Global Coverage

For individuals who travel frequently or reside in multiple countries, global coverage is a crucial feature. Certain health insurance plans offer international coverage, ensuring that policyholders can access medical services anywhere in the world and receive reimbursement for eligible expenses incurred abroad.

  • Family Floater Options

Family floater policies are an excellent option for covering the health insurance needs of an entire family under a single plan. This feature allows policyholders to include their spouse, children, and dependent parents in the same policy, making it cost-effective and convenient to manage healthcare expenses for the whole family.

The Importance of Regular Health Insurance Reviews

In addition to understanding the features of health insurance, it is equally essential to conduct periodic reviews of your policy to ensure it meets your changing needs. As life circumstances and health requirements evolve, adjusting your health insurance coverage becomes necessary to ensure comprehensive protection. Regular health insurance reviews offer several benefits, including:

Assessing Adequacy: As medical costs continue to rise, it's crucial to assess whether your existing coverage is sufficient to handle potential healthcare expenses in the future. Reviewing your policy helps you determine if you need to increase your sum insured to align with current healthcare inflation rates.

• Evaluating Network Hospitals:

Health insurance policies often have tie-ups with specific network hospitals. Ensuring that your preferred healthcare providers are part of the insurer's network allows you to access cashless treatment with ease.

• Checking Exclusions:

Policyholders must review the policy's exclusions to understand what medical conditions or treatments are not covered. This helps avoid surprises during a medical emergency and allows you to plan for any out-of-pocket expenses not covered by the policy.

• Updating Personal Information:

Life events such as marriage, childbirth, or changes in dependent status should prompt you to update your health insurance policy with accurate personal information. Keeping your details up-to-date ensures a smooth claims process and accurate premium calculations.

• Add-On Coverage Options:

Insurers offer add-on coverage options that policyholders can consider based on their specific needs. Reviewing available add-ons allows you to customise your health insurance policy to suit your requirements better.

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The Pandemic’s Inputs

The world witnessed the devastating impact of pandemics like COVID-19, highlighting the crucial role of health insurance during such global health crises. Health insurance played a significant role in providing financial support to individuals affected by the pandemic, ensuring that they received timely medical attention without bearing the full burden of healthcare expenses. Here are some of the special features added to health insurance plans in lieu of the Covid-19 pandemic. 

  • Covid-19 Hospitalisation Expenses:

Health insurance covers hospitalisation costs, which can be substantial during pandemics when hospitals face increased patient loads. Policyholders could access cashless Covid-19 hospitalisation, reducing financial stress during challenging times.

 

  • Testing and Diagnosis:

Health insurance can cover the costs of COVID-19 testing and diagnosis, encouraging individuals to get tested without worrying about the expenses involved.

 

  • Telemedicine Services:

During pandemics, telemedicine emerged as a safe and convenient way to consult doctors remotely. Some health insurance plans extend coverage for telemedicine consultations, ensuring continuous access to medical advice.

 

  • Mental Health Support:

The stress and uncertainty during pandemics can take a toll on mental health. Some health insurance policies offer coverage for mental health consultations and treatments, providing support to policyholders in times of emotional distress.

Conclusion

The recent pandemic has emphasised the critical role of health insurance in providing support during global health crises. It is essential to be prepared with adequate coverage to face any unforeseen medical emergencies confidently. For those seeking to secure health insurance with comprehensive features at an affordable price, Bajaj Markets offers a range of plans starting at just ₹53/month. 

 

With customisable options and a wide network of healthcare providers, Bajaj Markets ensures that policyholders receive the best possible medical care without incurring significant financial burdens. So, don't wait any longer—protect yourself and your loved ones with health insurance on Bajaj Markets and enjoy the benefits of a secure and healthy future. Remember, a well-structured health insurance plan is not just an investment; it's a crucial step towards securing your well-being and that of your family's in times of need.

Frequently Asked Questions About Health Insurance

What is comprehensive coverage in health insurance?

Comprehensive coverage in health insurance refers to a policy that offers financial assistance for a wide range of medical expenses, including hospitalisation, surgical procedures, doctor consultations, diagnostic tests, and medications. It ensures policyholders can access quality medical services without facing significant financial burdens.

How does cashless hospitalisation work in health insurance?

Cashless hospitalisation allows policyholders to get medical treatment at network hospitals without paying the bills upfront. The insurer directly settles the medical expenses with the hospital, making it convenient and hassle-free for the insured during times of medical emergencies.

What does pre-hospitalisation and post-hospitalisation coverage entail?

Pre-hospitalisation and post-hospitalisation coverage in health insurance includes medical costs incurred before and after hospitalisation. This typically covers expenses such as diagnostic tests, doctor consultations, and follow-up treatments, ensuring comprehensive care throughout the policyholder's medical journey.

What is a no-claim bonus in health insurance?

A no-claim bonus is a reward offered by health insurance policies when the policyholder does not file any claims during a policy year. It can come in the form of an increased sum insured or a discount on the premium at the time of policy renewal, encouraging a healthy lifestyle and rewarding claim-free years.

How do maternity benefits work in health insurance plans?

Maternity benefits in health insurance cover expenses related to pregnancy, childbirth, and postnatal care. This feature provides financial support to expectant mothers, helping to alleviate the significant medical costs associated with childbirth and related services.

What are restore and recharge benefits?

Restore and recharge benefits are features found in some health insurance policies. The restore benefit automatically reinstates the sum insured if it gets exhausted during a policy year, allowing the insured to continue claiming coverage. The recharge benefit provides an additional sum insured if the primary sum insured is depleted before the policy term ends.

How does a family floater policy work in health insurance?

A family floater policy allows the coverage of an entire family under a single plan. Policyholders can include their spouse, children, and dependent parents in the same policy, making it cost-effective and convenient to manage healthcare expenses for the entire family under one umbrella policy.

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