The usual form of health insurance policies in India covers the expenses incurred on Hospitalization, illness and injuries through a range of health cover products, depending on the need and choice of the insured and such costs are specified in advance.

Health insurance protects from any sudden, unexpected costs of hospitalization,critical illnesses  accidents,injuries etc which would otherwise make a major dent into savings or even lead to indebtedness.

All are exposed to various health hazards and a medical emergency can strike any one without any prior warning. Healthcare is increasingly expensive, with technological advances, new procedures and more effective medicines that have also driven up the costs of healthcare. While these high treatment expenses may be beyond the reach of many, taking the security of health insurance is much more affordable.

Health insurance policies are available from a sum insured of Rs 5000 in micro-insurance policies to even a sum insured of Rs 50 lakhs or more in certain critical illness plans. 

Health Insurance Plans are available for Individuals,Groups,Family,Senior Citizens,Special Covid -19 Plans,Maternity,Critical Illness,Parents,etc- in between Rs 1.00 lakhs to Rs 5.00 lakhs even more depends on the age,and type of Health Insurance one is looking for and it is advisable to take adequate cover at an early age to get bonuses,reharge benefits, etc because once a claims arises it would be difficult to increase the sum assured.and these Insurances are for practically one year but one can also health policies for one or more years upto five years 

A Critical Illness benefit policy provides a fixed lump sum amount to the insured in case of diagnosis of a specified illness or on undergoing a specified procedure and once this lumpsum is paid the plan ceases to be in force 

There are also other types of products, which offer lumpsum payment on undergoing a specified surgery (Surgical Cash Benefit), and others catering to the needs of specified target audience like senior citizens.

It is a facility wherein the Insurance Companies pay the hospital bills directly to the hospital which are in their network list of hospitals by the Third Party Administrator on behalf of the Insurance Company

Cashless facility, however, is not available if you take treatment in a hospital that is not in the network.

Expenses beyond the coverage of the policy will have to be paid by the Insured directly.Some cases reimbursement facility is also available with some companies.

Age is a major factor that determines the premium, the older one is the premium cost will be higher because you are more prone to illnesses. Previous medical history is another major factor that determines the premium. If no prior medical history exists, premium will automatically be lower.  Claim free years can also be a factor in determining the cost of the premium as it might benefit you with certain percentage of discount. This will automatically help you reduce your premium.

Generally pre-existing diseases (read the policy to understand what a pre-existing disease is defined as) are excluded under a Health Insurance policy. Further, the policy would generally exclude certain diseases from the first year of coverage and also impose a waiting period. There would also be certain standard exclusions such as cost of spectacles, contact lenses and hearing aids not being covered, dental treatment/surgery ( unless requiring hospitalization) not being covered, convalescence, general debility, congenital external defects, venereal disease, intentional self-injury, use of intoxicating drugs/alcohol, AIDS, expenses for diagnosis, x-ray or laboratory tests not consistent with the disease requiring hospitalization, treatment relating to pregnancy or child birth including cesarean section, Naturopathy treatment. 

Yes. When you get a new policy, generally, there will be a 30 days waiting period starting from the policy inception date, during which period any hospitalization charges will not be payable by the insurance companies. However, this is not applicable to any emergency hospitalization occurring due to an accident. This waiting period will not be applicable for subsequent policies under renewal.

It is a medical condition/disease that existed before you obtained health insurance policy, and it is significant, because the insurance companies do not cover such pre-existing conditions, within 48 months of prior to the 1st policy.  It means, pre-existing conditions can be considered for payment after completion of 48 months of continuous insurance cover.

The policy will be renewable provided you pay the premium within 30 days (called as Grace Period) of expiry date. However, coverage would not be available for the period for which no premium is received by the insurance company. The policy will lapse if the premium is not paid within the grace period. 

Yes. The Insurance Regulatory and Development Authority (IRDA) has issued a circular making it effective from 1st October, 2011, which directs the insurance companies to allow portability from one insurance company to another and from one plan to another, without making the insured to lose the renewal credits for pre-existing conditions, enjoyed in the previous policy. However, this credit will be limited to the Sum Insured (including Bonus) under previous policy. For details, you may check with the insurance company.

After a claim is filed and settled, the policy coverage is reduced by the amount that has been paid out on settlement. For Example: In January you start a policy with a coverage of Rs 5 Lakh for the year. In April, you make a claim of Rs 2 lakh. The coverage available to you for the May to December will be the balance of Rs.3 lakh.

‘Any one illness’ would mean the continuous period of illness, including relapse within a certain number of days as specified in the policy. Usually this is 45 days.

Any number of claims is allowed during the policy period unless there is a specific cap prescribed in any policy. However the sum insured is the maximum limit under the policy.

Some health insurance policies pay for specified expenses towards general health check up once in a few years. Normally this is available once in four years.

Family Floater is one single policy that takes care of the hospitalization expenses of your entire family. The policy has one single sum insured, which can be utilized by any/all insured persons in any proportion or amount subject to maximum of overall limit of the policy sum insured. Quite often Family floater plans are better than buying separate individual policies.  Family Floater plans takes care of all the medical expenses during sudden illness, surgeries and accidents.