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Frequently Asked Questions (FAQ) on Health Insurance
Q 1. What is health insurance?
Health insurance is an insurance product that provides cover for medical and surgical expenses of an insured person, in case of a medical emergency. However, you are required to pay a premium to avail health insurance policy.
Q 2. Why should I buy health insurance?
You should purchase health insurance so that you don’t lose your lifelong savings while paying for medical bills in a critical situation.
Q 3. How will health insurance pay for my emergency medical expenses?
Your health insurance will either pay your hospital bills directly if opted for the cashless facility or it will reimburse any payment made by you towards medical expenses incurred due to an illness or injury.
Q 4. What is the eligible age to buy health insurance?
While the eligibility age for health insurance policies differs, the general eligibility age for adults ranges between 18 years up to 65 years. The eligibility age for children lies between 90 days up to 18 years.
Q 5. Will I be allowed to cover my family under my health insurance?
Yes! You can gain coverage for self, spouse, children, dependent parents, and multiple other relationships such as parents-in-law, siblings, and others if your plan allows.
Q 6. Will I be allowed to buy more than one health insurance plan?
Yes, you are free to buy another plan based on your specific medical needs.
Q 7. What are the types of health insurance plans I can buy?
You can buy Individual Health Insurance Plan, Family Floater Health Insurance Plan, Senior Citizen Health Insurance Plan, Critical Illness Insurance Plan, Maternity Health Insurance Plan, Group Health Insurance Plan, Personal Accident Insurance Plan.
Q 8. Can I pay my health insurance premium in installments?
In general, the health insurance premium is paid on a yearly basis. But, you can pay your premium in installments (monthly, quarterly or half-yearly basis) as well.
Q 9. What are the common coverage benefits under my health insurance?
Health insurance benefits differ from policy to policy. However, basic health insurance benefits include cover for an inpatient hospitalization, pre & post hospitalization, daycare procedures, emergency ambulance expenses, organ donor expenses, domiciliary hospitalization, OPD expenses, and more.
Q 10. What are the benefits of buying a critical illness insurance policy?
Critical illness policies provide coverage for life-threatening illnesses such as Cancer, Stroke, Heart Attack, Kidney Failure, and others. If buying a critical illness plan, you can expect wide cover for critical illnesses (number of illnesses covered depends on plan), lump-sum amount payment on diagnosis, tax benefits, and more.
Q 11. Will I be eligible for tax benefits if I buy health insurance?
Yes! Buying health insurance will earn you the eligibility to claim tax benefits under Section 80D of the Income Tax Act, 1961.
Q 12. What if I already have a health insurance policy, but I just want to increase my sum insured?
If you already have an insurance policy but want to extend your cover, you can do so at the time of policy renewal.
Q 13. I have been recently diagnosed with a medical condition. Will I be allowed health insurance?
If you have already been diagnosed with a medical condition, it will be considered a pre-existing disease. In this case, you may have to wait for a specific period (waiting period) until allowed coverage. Based on your insurer, you may be required to pay a higher premium or face policy denial.
Q 14. What documents do I need if I want to buy health insurance?
If you want to buy health insurance, you need to submit the documents like aadhaar card, voter ID, driving license, and pre-medical check-up report (in some cases). The documents are required for age proof, identity proof, address proof, and medical check-up
Q 15. If I want to cancel my health insurance policy after purchasing?
If willing to cancel your health insurance policy after its purchase, you can do so within 15 days of receiving the policy documents. You will receive a refund only if you did not make any claims in the policy during that year.
Q 16. Will I gain more benefits by buying health insurance at an early age?
Yes, buying health insurance in the early years of life comes with many benefits. Upon doing so, you may gain a lower premium amount, no waiting period, better options, accumulate bonus, lower rejection rates, and others.
Q 17. What are the things I should consider before buying my health insurance policy?
Before making a health insurance policy purchase, it is advisable for you to consider your medical needs, the type of plan you want to invest in, features of the plan, sum insured options, network hospital list, exclusions, premium, and customer reviews.
Q 18. Is there a limit on the number of claims that I can avail in one year?
No, there is no limit to the number of claims in a year. However, it should be ensured from your end that your policy sum insured amount does not get exceeded.
Q 19. Will my health insurance cover begin from day one?
You will have to wait for a period of 30 days (waiting period) before your policy starts covering you. If you have a health insurance policy for accident cover, there will be no waiting period. Furthermore, in the case of a pre-existing disease or specific diseases, you will have to serve the waiting period (depending on the plan) before enjoying the coverage.
Q 20. What if I miss the premium renewal date?
In case of missed health insurance renewal due date, your insurance company will give you a grace period of 15-30 days. If you again miss making the premium payment during the grace period, you may be denied coverage, denied policy renewal, lose out on no claim bonus, or asked to serve with waiting periods from the start.
Q 21. Is maternity covered in standard health insurance policies?
Usually, health insurance companies do not cover maternity and related expenses. But a few including Apollo Munich (now HDFC Ergo Health), Max Bupa have some particular plans which offer maternity cover after specified waiting periods. The waiting periods generally vary from 2-4 years.
Q 22. Do I get a discount on the renewal of the policy with the same health insurance company?
Some health insurance companies offer a renewal discount of 5% of the renewal premium if there are no claims made during the policy year. It can be accumulated upto 50%. Under some health insurance plans like National Varistha, the insured can either avail cumulative bonus or renewal discount.
Q 23. What is a cumulative bonus?
Cumulative bonus is an increase in the sum insured by a specific percentage for every year a claim is not made, up to a certain limit. It is offered by insurers on indemnity based health insurance plans and only when the policy is renewed without a break.
Q 24. What is meant by donor expenses?
All the hospitalization expenses incurred by the donor in organ donation except the cost of the organ during an organ transplant are included under donor expenses.
Q 25. What is a pre-existing disease?
The pre-existing disease is an ailment, injury, or disease that the insured individual is already affected by when purchasing a health insurance policy. Conditions like depression, anxiety, sleep apnea, diabetes, etc. are considered as pre-existing diseases in health insurance.
For any other query related to health insurance, feel free to get in touch with us at 755 1196 989.
Q 26. Will my health insurance policy expire if not renewed on time?
Yes. Every policy comes with a validity like 1 year, 2 years, or 3 years, after which it needs to be renewed. The insurance companies provide you a grace period of 15 days from the date of expiry during which you can pay the premium and continue availing of policy benefits. If the premium is not paid even during the grace period, then the policy will lapse and you will lose the accumulated benefits such as waiting period benefits or No Claim Bonus and will have to buy a new policy to seek protection from healthcare expenses.
Q 27. Can I transfer my health insurance policy from one health insurance company to another?
Yes, you can transfer my health insurance policy from one health insurance company to another due to various reasons. Some include better quotes with another insurance company, better services, coverage for more healthcare expenses with a different insurer, etc. The Insurance Regulatory and Development Authority of India (IRDAI) had issued a circular in which the insurance companies were directed to allow the insured to transfer one health insurance plan to another or one insurance company to another without making the insured lose any accumulated benefits like renewal credits for pre-existing diseases.
Q 28. What happens to the policy coverage once the claim is filed?
Suppose a health insurance policy is issued for a sum insured of Rs. 3 Lakh from January to December and the insured files a claim of Rs. 50,000 in the month of March. Then, once the claim is approved and settled, the amount of benefit availed will be deducted from the total sum insured amount. This means that the coverage will now be left of Rs. 2.5 Lakh for a period from March to December.
Q 29. What is the maximum number of claims allowed in a year?
There is no limit to the number of claims that can be made during a policy term. But the claim amount should not exceed the sum insured amount for which the insured had purchased the policy.
Q 30. Does my health insurance policy cover me for COVID-19 treatments?
Yes. As per the Insurance Regulatory and Development Authority of India (IRDAI), every indemnity based health insurance policy will cover you for expenses related to treatment required due to positive diagnosis of COBID-19, if taken as an in-patient.
Q 31. What are some common exclusions under health insurance plans?
Common exclusions under health insurance plans include cosmetic surgeries, dental treatments, treatments required due to participation in adventure sports like mountain climbing, paragliding, etc., treatments required due to self-harm like a suicide attempt, etc., therapies such as naturopathy, magnetic therapy, acupressure, and other alternative treatments.
Q 32. What is a network hospital in health insurance?
Every health insurance company has a tie-up with several hospitals where the insured can avail cashless treatment for the treatments covered in his/her health insurance policy. These hospitals are known as network hospitals.
Considering the increasing number of diseases and more than ever healthcare costs, it is imperative to make wise decisions when buying health insurance plans. As important as choosing the right health insurance policy, equally important is choosing the right insurance company. This will help you enjoy a smooth claim settlement process.
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