Health Insurance Policies and Benefits

Finance & Investment

Dec 22, 2016

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The price of health care is increasing rapidly. With the advancement in technology and services of health care sector, the price is also increasing. The global health care cost rose from 7.5% to 8 % in the year 2014 and is expected to rise more than 9%, in the coming years. Talking about India, the health care inflation rate is increasing at a double digit pace of growth. The inflation rate of Health care is almost near to 20% in India and there is no sign of slowing down in the coming years. Now a days, even a small surgery cost around Rs.4 lakh. And if we take the expected inflation rate, which is 20%, then the same surgery will cost you around 10 lakhs after 5 years.

In such conditions, living a life without health insurance policy can be very risky. A health insurance policy provides you cover for medical and surgical expenses and allows you to tackle the increasing rate of inflation also. You just need to pay a small amount of premium and in return, the insurer provides you cover for health care. The Health insurance policy is also necessary because, number of health issues is increasing day by day due to current lifestyle and environment condition. A health insurance policy provides you many additional benefits and covers and there are many health insurance policies to choose from.

So let’s have a look at what are the various benefits offered with a health insurance policy and what companies are offering you.

Day Care Procedure

Due to the advancement in technology, many treatments can be done within 24 hours and the patient doesn’t even needs to get hospitalized. These types of treatment are called day care procedure and your health insurance policy covers different types of day care procedure under the policy. Every insurance company mentions the list and number of day care procedure they cover.

Health insurance policies and cover for day care

Name of Policy	Number of Day care Procedure covered
Cigna TTK Pro Health Plus Plan	171
Bajaj Allianz Health Guard Plan	130
Religare’s Care Health Insurance Plan	474
Star Family Health Optima Plan	405
Future Health Suraksha Plan	130
HDFC Health Surkasha Medi-Claim plan	140
Max Bupa HeartBeat Plan	All

In Patient Hospitalization

In some cases, you need to be hospitalized for more than 24 hours, so that the doctors can properly monitor you. Such cases of hospitalizations are known as inpatient hospitalization and your health insurance policy covers the cost of inpatient hospitalization also.

Name of Policy	In Patient Hospitalization
Cigna TTK Pro Health Plus Plan	Covered up to shared room (on sum assured of 2.5, 3.5, 4.5 lakh) Covered up to Single Private Room (on sum assured from 4.5 lakh to 100 lakh)
Bajaj Allianz Health Guard Plan	Provides cover for -Accomodation -Boarding Expenses -Nursing Care -Medically necessary procedure -Medical Consumables
Religare’s Care Health Insurance Plan	Pays maximum up to to sum insured for -Room Charges -Nursing Expenses -Intensive care unti charges -Doctor’s fee -Anesthesia -Blood -Oxygen -Operation theatre
Star Family Health Optima Plan	Room, Boarding and Nursing expenses based on your location and sum insured
Future Health Suraksha Plan	Provides Cover for -Room Rent -Board and Nursing Expenses -Suregon -Anesthestist -Medical Practitioner -Consultants -Specialist Fee - Anaesthesia, Blood, Oxygen, Operation Theatre Charges, Surgical Appliances, Medicines & Drugs, Diagnostic Materials and X-ray, Cost of Pacemaker, prosthesis/internal implants and any Medical expenses incurred which is integral part of the operation
HDFC Health Suraksha Medi-Claim Plan	Provides cover for -Room rent, boarding expenses, -Nursing, -Intensive care unit, -A Medical Practitioner, -Anaesthesia, blood, oxygen, operation theatre charges, surgical appliances, -Medicines, drugs and consumables, -Diagnostic procedures, -The Cost of prosthetic and other devices or equipment if implanted internally during a Surgical Procedure
Max Bupa HeartBeat Plan	Provides cover for -Medical Practitioner’s fees -Diagnostic procedures -Medicines, drugs and consumables -Intravenous fluids, blood transfusion, injection administration charges -Operation Theatre charges -The cost of prosthetics and other devices or equipment if implanted internally during a Surgical Operation -Intensive Care Unit Charges

No Claim Bonus

The Health Insurance policy gives benefit to its policyholder if he doesn’t make a claim during the policy term and he can avail the benefit at the time of renewal of the policy. This is known as No claim Bonus in Health Insurance policy. The person is rewarded with either an increase in premium or decrease in the sum insured. It is also known as cumulative bonus.

Health Insurance Policies and No Claim Bonus

Name of Policy	No Claim Bonus
Cigna TTK Pro Health Plus Plan	5% increase in sum insured (on sum insured of 2.5, 3.5 and 4.5 lakhs) 10% increase in the sum insured (on sum insured from 4.5 lakh to 50 lakh) Maximum up to 50% of sum insured in both cases
Bajaj Allianz Health Guard Plan	10% increase in sum insured for every claim free year, maximum up to 50% of sum insured
Religare’s Care Health Insurance Plan	10% increase in sum insured for next year, maximum upto 50% of sum insured
Star Family Health Optima Plan	25% of expiring sum insured in 2^nd year and 10 of sum insured in 3^rd year(only if sum insured is Rs.3,00,000 and above) and maximum uotp 35% of expiring sum insured
Future Heallth Suraksha Plan	10% increase in sum insured for every claim free year, maximum upto 50% of sum insured
HDFC Health Suraksha Medi-Claim Plan	5% increase in sum insured, maximum upto 50% of sum insured
Max Bupa HeartBeat Plan	Not applicable

Ambulance Charges

Health insurance policies aren’t only limited to expenses in hospital but they provide cover for ambulance charge also. The allowance on ambulance charges varies from policy to policy.

Name of Policy	Ambulance Cover
Cigna TTK Pro Health Plus Plan	Upto Rs.3,000 per hospitalization
Bajaj Allianz Health Guard Plan	Upto Rs.1,000 per hospitalization
Religare’s Care Health Insurance Plan	Upto Rs.2,000 (on sum assured of 5,7 and 10 lakh) Upto Rs.2,500 (on sum assured of 15,20,25,30,40 lakh)
Star Family Health Optima Plan	Upto Rs.750 per hospitalization and maximum up to Rs.1,500 per policyholder
Future Health Suraksha Plan	Rs.1,500 per hospitalization
HDFC Health Suraksha Medi-Claim Plan	upto the limit mentioned in the schedule for using an ambulance
Max Bupa HeartBeat Plan	Covered at actual costs in Network hospitals up to Sum Insured Upto Rs. 2,000 per event for Non network

Free Health Checkup

Most of the health insurance companies provide free health checkup to their policyholder after a certain period of time during the policy term. It allows the policyholder to get aware about any change in health condition, so that you can take action before the situation gets worst.

Name of Policy	Free Health Check up
Cigna TTK Pro Health Plus Plan	Available once after every 3^rd year(on sum isnured of2.5, 3.5, 4.5 lakh) Available at each renewal(on sum insured from 4.5 lakh to 50 lakh)
Bajaj Allianz Health Guard Plan	Available after continuous 4 years of policy term without making a claim
Religare’s Care Health Insurance Plan	Available after each policy year
Star Family Health Optima Plan	1% of basic sum insured, maximum upto Rs.5,000 after every 3 years of conitnous policy term
Future Heallth Suraksha Plan	Available once after every 4 years of continuous policy term without any claim
HDFC Health Suraksha Medi-Claim Plan	Available once after every 4 claim free policy years
Max Bupa HeartBeat Plan	Available once after 2 years of policy term (Silver Plan) Available after every year during the policy term(Gold Plan)

Domiciliary Hospitalization

Your Health Insurance Policy covers your treatment at home also but only on the advice of a doctor if there is no bed available in hospital due to rush or the patient is not in the condition to go the hospital. This type of treatment is covered under domiciliary hospitalization of health insurance policy.

Name of Policy	Domiciliary Treatment
Cigna TTK Pro Health Plus Plan	Cover up to full sum insured
Bajaj Allianz Health Guard Plan	Not Applicable
Religare’s Care Health Insurance Plan	10% of sum insured if treatment at home exceeds 3 days
Star Family Health Optima Plan	Cover for treatment exceeding than 3 days
Future Health Suraksha Plan	Covers up to sum insured for treatment exceeding than 3 days
HDFC Health Suraksha Medi-Claim Plan	Cover for treatment exceeding than 3 days
Max Bupa HeartBeat Plan	Rs.75,000 for sum insured of Rs.15 lakh Rs.1,00,000 for sum insured of Rs.20 lakh Rs.250,000 for sum insured of Rs.50 lakh Rs.4,00,000 for sum insured of Rs.1 crore

Outpatient Benefit

The Outpatient benefit of health insurance policy covers treatment which doesn’t require hospitalization and is not even mentioned in the day care treatment. Such treatment requires just a visit to the clinic without being admitted, for example, dental treatment.

Name of Policy	Outpatient benefit
Cigna TTK Pro Health Plus Plan	Not applicable
Bajaj Allianz Health Guard Plan	Covered
Religare’s Care Health Insurance Plan	Covered
Star Family Health Optima Plan	Not applicable
Future Health Suraksha Plan	Not applicable
HDFC Health Suraksha Medi-Claim Plan	Not Applicable
Max Bupa HeartBeat Plan	Not applicable

There are various benefits available with a health insurance policy and if you want to avail it, the only thing you need to do is to have a better understanding of these benefits. The above information will help you to compare different policies and their various benefits, so that you can choose the best one for you.

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Health Insurance Policies and Benefits

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