Different Types Of Health Insurance Policies In India

Not all health insurance policies sold by the insurance companies in India are the same. More than ever before, the health insurance sector in India is undergoing a sea change as insurance companies are constantly innovating and re-inventing their products in a bid to grab a larger market share. Customization of health insurance plans is the buzzword as insurers modify their products to suit their customers’ needs. 

Whether you are opting for cashless settlement or reimbursement of the claims made, you will always find a health insurance plan suited to your needs. While many people buy health insurance policies to cover medical expenses stemming from planned treatment in the future, policies that meet medical emergencies are also available. Some of the popular health insurance policies include:

Individual Health Insurance Policy:

Are you planning a health cover for yourself? Afraid not as many insurance companies sell health insurance plans that ensure a health cover to individuals against illnesses while covering the risk of hospitalization and medical treatment. These policies offer benefits like cashless hospitalization, reimbursement of medical expenses, pre and post-hospitalization charges in addition to add-on cover benefits. However, as the name suggests, this cover is available for an individual only, and hence, the sum assured must be chosen accordingly. 

Family floater health insurance:

Nothing matters more than family. This is precisely what family health plans or family floater insurance plans are all about. The idea to ensure that your family avails the necessary treatment at their choice of a hospital without worrying about the resulting hospital charges. This kind of cover brings the entire family under one umbrella. These plans offer a fixed amount of sum assured, which means that the insurance company will pay for treatment of the family members (one or more than one) subject to the condition that the hospital bill does not exceed the amount of sum assured predetermined while buying the policy.

Senior citizen health cover:

Seeking cover for aged parents used to be difficult once. This is because old people are more likely to fall ill or seek treatment for major health disorders. Since the risk associated with their health is high, most companies refrained from providing them with any kind of health cover. However, the insurance scenario has drastically changed in the last few years with new players entering the market. 

Maternity cover health insurance:

Family planning has its own place in financial planning too. That is why many insurance companies sell health insurance policies that cover the expenses on pre and post-natal care, child delivery, and vaccination of the newborns in the family. However, the expenses on the treatment of the newborn child are supported by the insurance company only until the policy is active. There are other policies too that cover additional expenses including covering the amount expended on Ambulance while driving the mother to the hospital of your choice.

Top-up plans:

As the name suggests, these plans have the advantage of top-up or the benefits of an added coverage amount, i.e., over and above the amount of cover you had opted for while buying the plan. These plans are bought as supplementary plans, i.e., a plan in addition to the basic health cover that you had bought in the first place. The top-up plans operate on the concept of “deductible limit”. This means that the plan will not come into force until the hospital expenses exceed a particular limit also called the deductible limit. If the claim made by the policyholder exceeds the deductible limit, then the insurance company is liable to pay the excess amount. 

Super top-up plans:

These plans are way better than the top-up plans and must be bought by those whose loved ones are prone to serious disorders due to a family history of illnesses. Since the treatment of these illnesses incurs a very high expenditure, it makes sense to pay for these plans so as to offset the rising medical expenses in the long run. As opposed to top-up plans where each claim over and above the deductible limit is said to trigger the plan, in super top-up plans the aggregate claims incurred during any particular year are considered. 
This can be explained with the help of an example. Take, for instance, Shyam Sundar has bought a super top-up plan with a threshold limit of  ₹100,000. Suppose Shyam has made two health insurance claims of  ₹80,000 and  ₹70,000 respectively. Since the total claim made on the two plans amounts to ₹1,50,000 which is in excess of the threshold limit of the super top-up policy, then the insurance company is liable to compensate to the tune of  ₹50,000 (aggregate of the two claims – threshold amount limit). 

Fixed benefit plans:

These are also called defined benefit plans. Instead of compensating for the claim made by the policyholders, these plans promise a fixed benefit predetermined while buying the plan. The plan benefits are irrespective of the claims made on them and may exceed or be less than the claim amounts. 

There are different kinds of fixed benefit plans. These include:

Critical Illness Plans:

These are also a kind of health insurance plans that operate differently and provide a specific amount of coverage only during hospitalization or treatment of specific critical disorders only. Every critical illness plan is different in the sense that each plan covers a list of specific critical illnesses only and is activated only if the policyholder receives treatment for that particular grievous disorder only. Instead of paying the claims made on the hospitalization costs, the insurance company is liable to pay in a lump sum the predetermined coverage amount to the policyholder. A majority of the insurance companies selling critical insurance plans cover the following disorders under the policy:

1. Major organ transplantation
2. Cancer
3. Pulmonary arterial hypertension
4. Cardiovascular disorders
5. Aorta graft surgery
6. Coronary artery bypass surgery
7. Multiple sclerosis
8. Kidney failure
9. Paralysis

Hospital Daily Cash Plans:

These plans are also called hospital cash benefit plans and promise a fixed amount for each day of hospitalization in the event of any, irrespective of the nature of the treatment of the insured. The amount of money given out by the insurance company is unbiased of the amount spent on hospitalization and treatment. 

Personal Accident Cover:

These are not individual health insurance plans but offered as riders to the health cover bought. Opting for this rider by paying an additional amount of premium benefits the policyholder as the insurance company is liable to pay for hospitalization and treatment in case of an accident. The payout by the insurer is in the form of a fixed benefit and is independent of the amount spent on treatment.