Types of Health Insurance Plans

We know one health insurance is never fit for all, and hence, there are seven different types of health plans to provide you with desired coverage. Let us discuss each of these plans in detail.

As the name suggests, an Individual Health Insurance policy is meant for a single person. This type of insurance policy covers your medical expenses for injury & illnesses-related hospitalization, surgery costs, room rent, daycare procedures and more.

Individuals like you who are above 18 years of age can choose to buy this plan and every Individual Health Insurance plan member will have an Individual Sum Insured.

For example, if you have an Individual health policy with a sum insured of Rs. 3 lakhs, you can claim up to 3 lakh anytime when needed. You can also buy individual plans for your spouse and kids. In this case, each person covered will have a particular sum insured of Rs.3 lakhs.

Features of Individual Health Insurance:

• It covers a single individual
• The sum insured amount is separate for each individual
• It provides coverage for costs related to hospital stays brought on by illnesses or injuries, surgeries, daycare, hotel rental, etc.
• Individuals within the age above 18 years old can purchase this plan.

If you want an affordable health insurance policy for all family members, Family Floater Health Insurance should be your choice.

Under Family Floater Health Insurance, a single sum of insured floats for all the members covered under the policy. A Family Floater Health Insurance Plan is beneficial because the premium is comparatively lower than the Individual Health Insurance policy. This policy can cover you, your spouse, your children and your parents.

For example, if you have a family floater health insurance of Rs. 5 lakh for yourself, your wife and parents, your whole family will share this amount.

Features of Family Floater Health Insurance:

• One health insurance plan covers every member of the family.
• Every individual will split the insured amount.
• It provides financial protection against medical procedures, hospital stays, therapies, daycare, etc.

A Group Health Insurance policy is designed for a group of employees working together. If you own a start-up or a corporate house, you should buy such plans for your employees. It is a kind of benefit offered to the employees. As an employer, you can buy the cover to boost employee retention rate.

Group Health Insurance Plan comes with a low cost premium. Some insurance companies allow to refill the sum insured, that too, unlimited times, if it is exhausted. A Group Health Insurance Plan covers you for hospitalization due to accident, illness, critical illness, psychiatric illness, and maternity.

Buying a Group Health Insurance policy not only offers coverage to your employees but also enhances the goodwill of your company. A very crucial point here is that the employees are covered only till the time they work with your company.

Features of Group Health Insurance:

• It provides health insurance for the employees and, in certain situations, their family members as well
• Generally, the basic coverage is free for the employee
• Value-added services like yearly examinations, online medical consultations, diagnostic exams, etc., might be provided
• Pre-existing illnesses are also covered without a waiting period in health insurance*
• No pre-medical tests are required before this coverage

* If there is a pre-existing condition, the claim cannot be made for that condition or illness until the waiting period has passed. However, at Digit, there is a PED waiting time waiver available if you want to cover more than 50 members.

Also check: Pre Existing Disease Cover in Health insurance

The health insurance policy which is dedicatedly designed for old people above the age of 60 years is called a Senior Citizen Health Insurance Plan. If your parents or grandparents are above 60, then this cover is a good choice.

A Senior Citizen Policy will offer coverage for cost of medicines, hospitalization arising out of accident or illness, pre and post hospitalization and treatment. Along with these, some other benefits like Domiciliary Hospitalization and Psychiatric benefits are also covered.

Some insurers may ask for a complete body check-up before they sell a Senior Citizen Health Insurance Policy. The Government of India has recently removed the age limit for senior citizen health insurance which means any senior citizen can now by senior citizen health insurance at any age.

Features of Senior Citizen's Health Insurance:

• It is ideal for senior individuals above 60 years of age.
• It provides coverage for medical care, psychiatric care, domiciliary expenses, and pre-and post-hospitalization costs brought on by illness or accident.
• Given that older people are more prone to experience health problems, the premium may be greater than it would be for individual or family floater health insurance plans.

A Maternity cover can be bought as a rider along with the basic health insurance plan. All the expenses incurred in the prenatal stage, delivery and post-natal stage are covered under this plan.

Newly married couples or families who are planning a baby in the coming years should buy this policy. It covers child-delivery (including medically necessary terminations), infertility expenses and coverage for the newborn baby up to its first 90 days. The Maternity Cover has a minimum waiting period of 2 years.

Features of Maternity Health Insurance:

• It pays for costs associated with the prenatal, postnatal, and delivery of the child.
• Some policies may cover the newborn for a predetermined amount of time.
• It comes with a specified waiting period (9 months to 2 years).

Disclaimer: Currently, at Digit, we are not offering any Maternity coverage with our Health Insurance.

Critical illness insurance is provided to safeguard your finances in the case of life-threatening diseases.

Dedicatedly designed for middle-class families, this health plan covers diseases like:

• Cancer
• Stroke
• Kidney Failure
• Paralysis
• Coronary Artery Bypass Surgery
• First heart attack
• Pulmonary Arterial Hypertension
• Multiple Sclerosis
• Aorta Graft Surgery

Getting treatment for these diseases is an expensive affair. Under the Critical Illness Plan as soon as you are diagnosed with the disease, it will pay you a predefined amount irrespective of the actual cost of treatment incurred.

Nothing can be a smart move than buying a Critical Illness Policy as it prevents any impact on your savings. The policy has lifetime renewability. If you take the Critical Illness Policy, then you should survive for 30 days after diagnosis of the illness.

It will be wise to buy this policy if you have had a family history of some diseases. Other than the lump sum amount, a Critical Illness Policy reimburses you the cost of care and hospitalization expenses. You can also avail the benefit of the complementary health check-ups.

Features of Critical Illness Health Insurance:

• This plan typically covers life-threatening diseases such as heart
• There is a lifetime renewal feature on the insurance
• At least 30 days should pass after the serious illness diagnosis
• Coverage is provided if you are experiencing this covered surgical operation or critical illness for the first time in your life

You can buy a top-up policy if you seek coverage for higher amounts. But such plans come with a “Deductible Clause”. So, in case of a claim the payment will be made over and above a defined limit mentioned in the policy.

Like if you have taken a cover for 15 lakhs and it has a deductible of Rs.3 lakhs, then you will have to bear claim up to Rs.3 lakhs out of your pocket. The amount over and above this, will be paid by the insurer.

So, if you seek a wider cover over and above your basic health insurance policy, then you can buy this plan.

Features of Top-Up Health Insurance:

• It provides an option for a higher sum covered amount beyond the basic plan
• It supplements your existing plan, ensuring you are covered when the hospital bills are high
• This policy only becomes active after you have paid a set deductible amount under this plan
• For a larger sum insured, you can also choose the Super Top-up Health Insurance Plan

You must have read and heard too much about buying health insurance as early as possible in life.

Buying a health plan at an early age has its benefits as you get rid of the waiting period at an early stage of your life when the chances of attracting diseases are less, you earn a good amount of Cumulative Bonus, and you can increase the sum insured over the years.

But you should also know the other important aspects of having a health insurance policy as:

• It gives you peace of mind and financial security from high treatment costs.
• You get better health facilities because the insurance company will cover the cost.
• If health insurance comes as a Group Insurance from your employer, then you can improve your savings.
• Some health insurance companies offer complementary annual health check-ups.
• It acts as your savings for a time of distress. You will pay a premium, but the financial help you receive is much greater.
• Buying a health insurance policy will offer you a tax benefit under Section 80D of the Income Tax.
• The plans can be customized according to your specific requirements.

When many health insurance companies are in the market, choosing one health insurance plan according to your needs can be challenging. But here is a quick checklist to consider before you finalize your insurance product.

1. Sum Insured

Be sure of the Sum Insured chosen. Think about whether it will be sufficient for you or your family members. Set the right Sum Insured limit for your dependent parents if they are included in the policy.

2. Medical History of the Family Members

Check for the medical history of the included individuals, the sum insured they would require, and any specific add-on that they might require. A medical history might also raise the policy premium.

3. Waiting Period

Most insurance plans have a waiting period for pre-existing diseases and certain other medical conditions. Choose the plan with the minimum waiting period.

4. Check for the maximum age-renewal

Since age of the insured members plays a vital part in the health coverage, check for the maximum age for which the renewal option, i.e. coverage, is available.

5. Claim Settlement

Buy health insurance policies from companies with a high claim settlement ratio and a fast claim settlement process. This reflects their trust and hassle-free claim process.

6. Network Hospitals

A wider range of network hospitals make sure you get the best possible treatment without loading you with financial burden. Choose the insurance company that has the widest network of the hospital on their list.

In India, having health insurance coverage has become nearly mandatory due to the country's skyrocketing medical costs. Whether you are a young professional or a family man, there is a health insurance plan just designed for you. By understanding the different types of health insurance, you can find the perfect fit for your needs.