Little Window to Odisha - Prabhat Nath

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This is Prabhat Nath from Odisha. Currently I live in Hyderabad (India) and work as a Software Developer.
If you are not big enough to lose, you are not big enough to win.
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Friday, November 10, 2006
Health Insurance

What is a Health Insurance

Health insurance insures us and our family against sudden medical expenses. A health insurance policy is a contract between an insurer and an individual or a group, in which the insurer agrees to provide specified health insurance at an agreed-upon price the premium. Depending on the policy, the premium may be payable either in a lump sum or in instalments. Health insurance usually provides either direct payment or reimbursements for expenses associated with illnesses and injuries.

Why do we need Health Insurance

Health insurance has become a necessity in today’s life considering the rise in the cost of medical care and treatment. The increase cost of medical treatment today is beyond the reach of the common man. Even if an individual is healthy and has never had any major problem, it is not possible to predict what may happen in the future. In case of a medical emergency, cost of hospital room, doctor’s fees, medicines and related health services all add up to a huge sum. In such times, health insurance provides the much needed financial relief.

Who can avail this facility

Health insurance can be availed by people aged between 5 to 75 (may vary depending on the policy). The health insurance scheme could either be a personal scheme or family protection scheme or may be a group scheme sponsored by our employer.

Even if we covered under any health insurance plan of your employer still we need to check out whether our dependents are included under the cover or not? If not, then we need to find a solution for our dependents. Even if we are cover by our employer it has its own flip side.

The flip side (If covered by the employer)
- We are covered only for the period we are employed.
- If we change job or retire, we and our family will be left behind in case of medical contingency.
- Our employer may not cover our entire family.

Indian companies offering Mediclaim Health Insurance policies
- Oriental Insurance Corporation
- National Insurance Corporation
- United India Insurance Corporation
- National India Assurance Corporation
- ICICI Lombard
- Bajaj Allianz
- Royal Sundaram

What we need to know

We should understand the policy, and become familiar with common health insurance provisions, including limitations, exclusions, and riders. It is very important to know what your policy covers and what you have to pay yourself. Health Insurance policies generally cover boarding, nursing and diagnostic expenses, which include room rent charged at the hospital or nursing home, fees of the surgeon, doctor, etc. It also covers pre and post hospitalization expenses. Some policies even offer fixed cash amount for each day we stay at any hospital for treatment.

Note (very important): We also need to know the list of Network Hospitals, in our area, that the insurance company covers. Because more the number of hospitals in network it is better for us. We can also go for other hospitals that are not in the list of insurer, but in this case we have to go for reimbursement option. But in case of Network hospitals the treatment will be cash-less.

Note: Expenses on hospitalization, incurred in the first 30 days after taking a policy are also not entitled, except in case of an injury from accident.

Note: Treatment of certain diseases is not covered during the first year of your policy.

Note: If you have a persistent health problem and then decide to take insurance, it might not be covered.

Points to Ponder

Ensure that you renew your policy continuously since it will cover you for medical conditions that may be diagnosed over the years. Make sure that you renew your policy without a break as the renewed policy after a lapse is a fresh proposal and has its own limitations.


posted by Name: Prabhat Nath @ 1:08 PM  
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