July 14, 2024

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Benefits of Individual Health Insurance Policy

What is an Individual Health Insurance Policy? Benefits & Plans - ABC of  Money

There are two types of health insurance in India: individual and family health insurance.

While a family floater plan is better suited to someone in their 30s or 40s who has a family, an unmarried person in their 20s who is single should consider an individual health insurance policy. 

But what are individual health insurance plans? How do they function? What are the health insurance benefits? Read on to know more.

What is an individual health insurance policy?

 As the name implies, An individual purchases an individual health insurance plan for themselves. The insurer can pay the policyholder’s medical expenses up to a fixed amount, depending on the policy. The insurers take into account the policyholder’s age, current health status, medical history, and geography when determining the price for such individual policies.*

How does individual health insurance policy work?

You get into a contract with the insurer when you buy individual health insurance. According to the agreement, the insurer can pay for your medical expenses up to the amount insured and in accordance with the conditions of the policy. You must consistently pay the premium in exchange.*

What does a standard individual health insurance policy cover, and what does it not?

The type of insurance and insurer you choose can impact the features and exclusions of an individual health plan. The following is the standard list of includes and exclusions:

Inclusions

  • Day Care Procedures
  • Hospitalisation
  • Ambulance Costs
  • Domiciliary Treatment 
  • Pre and Post-Hospitalization*

Exclusions-

  • Pre-Existing Conditions (depends upon the insurance company)
  • Alternative Therapies
  • Cosmetic Surgery
  • Dental, Hearing, and Vision-related Expenses
  • Pregnancy and Related Conditions*

What are the various single health insurance plan types offered in India?

The following categories of health insurance plans are further classified into single or individual health plans:

  1. Critical illness insurance: Consider buying critical illness insurance, which covers a variety of severe disorders, if your family has a history of serious health issues.*
  2. Senior citizen health insurance: This insurance provides coverage for several health issues that older people are more likely to experience. Anyone between the ages of 55 and 80 can acquire these plans.*
  3. Personal accident insurance: In the event of an accident, the plans typically pay for the policyholder’s hospitalisation and medical costs.*

How does your insurance company pay your medical bills?

You must submit a claim to your insurer. There are two methods to accomplish payment: 

  1.  Cashless claims: The insurance pays the hospital immediately for your medical expenses. It is only accessible at the insurer’s network hospitals.*
  2. Reimbursement claims: You must first pay your own medical expenses before requesting reimbursement from your insurance company. You can access this at out-of-network hospitals.*

What does cumulative bonus mean?

In health insurance, the sum insured of the policy is increased by a specific percentage for each year without a claim. However, the renewal premium isn’t decreased. Regardless of the total number of claim-free years a policyholder has, insurers are not permitted to offer cumulative bonuses of more than 50%.*

Are tax benefits available for individual health insurance?

You can deduct up to Rs. 25,000 in taxes from the premiums you paid for the health insurance coverage under Section 80D of the Income Tax Act. For health insurance obtained by a senior adult over the age of 60, the maximum is Rs. 50,000. This is available for both individual and health insurance plans for family.**

Conclusion:

If you have a medical problem, the high cost of healthcare in India may have a substantial financial impact. A single or individual health insurance policy gives your finances an extra degree of security and guarantees that you can get high-quality medical care when you need it.*

*Standard T&C apply
** Currently, there are 2 tax regimes in India – new and old. To get the tax benefit you desire, choose the correct one after consulting an expert. You can opt for a regime change during the next financial year.

Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.