A health insurance policy offers protection against various health conditions. Health insurance is a contract between you and your insurer. Your insurer offers coverage when requested against specified health conditions at a particular premium. Depending on the Health Insurance plan you choose,, it either offers coverage or reimburses the medical expenses from hospitalization to post medical care related to illness and injuries. Details of the coverage vary from plan to plan.

Your health insurance policy ideally provides coverage in case of:

• A sudden illness
• An accident
• The surgery required to cure any disease during the policy period

Again, the details of which vary, depending on the plan you choose.

Insurers exclude policy coverage on pre-existing illnesses for a certain period. In case you are suffering from any pre-existing illnesses while buying a health policy, do check the waiting period of your policy. Once the waiting period is over, you can get the coverage to treat your pre-existing illnesses. However, you need to understand if the pre-existing disease is temporarily excluded or not covered at all under your health insurance policy.

During an emergency, you are already stressed, which is natural. So insurers make sure you don’t have an additional burden on you or your family. In case your policy provides cashless settlement, you only need to check the terms of emergency hospitalization. So, while buying a policy makes sure you understand what documents are needed and most importantly, who you should contact at the time of hospitalization. Aviva has a team and a customer service desk set up for customers to help you out at the time of policy claim.

Health insurance is a big step for your future, both related to your health and financial security. Health insurance plans are a long-term commitment to your health and your family’s happiness.

Thus it is important to buy a policy that very well suits your needs. While buying offline or online health insurance plans for family or yourself, you should check these factors:

• Maximum renewal age of the plan: The insurance company provides you coverage only up to a certain age. After that, you would have to switch plan or go for a new plan which gets very difficult once you cross your 60s, especially if you have any pre-existing health conditions.
• First and second-year exclusions: Every insurer excludes certain illnesses or health conditions from the policy coverage. Understand these exclusions and a waiting period for pre-existing illnesses if any.
• Day care treatment or procedures covered.
• Sub-limits for policy coverage, if any.
• Any per-illness limit.
• Thirty days of coverage exclusion.
• Your renewal premium: You may start with a lower health insurance premium, but when it comes to renewal, you may have to pay a higher premium as per your growing age or health condition. This is an important factor one must take into consideration.
• Cashless facility in hospitals nearby you.
• Additional cover and riders benefits such as critical illness, accident or OPD coverage.
• Top-up covers: These policies let you start with a lower premium, and you can increase your premium as you may need on the next renewal of your policy. It becomes cheaper that way than paying higher premium right from the start.

Health/Medical insurance plans also have tax-saving benefits under Section 80D if the Income Tax Act. Premiums paid on such plans can not only buy you health cover but also aid in saving taxes.*
(*Please refer to the Income Tax Department’s online tax filing site, https://www.incometaxindia.gov.in/Pages/tax-services/file-income-tax-return.aspx, for any further clarifications)

You may need to get admitted in a non-network hospital during an emergency. As you may know, claiming the policy coverage as per the protocol is imperative. However, you can reimburse the medical expenses. So you will need to shoulder your medical bills at the time of emergency and later get those reimbursed from the health insurance companies. Make sure you understand reimbursement process and the documents required, along with the deadline to for claiming the reimbursement in such situations.

This is one of the most important and common questions among the policyholders. And having an answer from the get-go will make the policy claim process much simpler and smoother for you, especially at the time of emergency. When you face such a situation where you need to claim your policy coverage, you need to get your identity proof ready when your insurer asks for it. Next, you will need to show your health card and submit the medical bills you need the claim for. You may also need to fill the pre-authorization form in case your policy provides cashless claims. Make sure you understand the claim procedure thoroughly while you are in the process of buying your individual health insurance.

Medical emergencies may arise anywhere, and the first thing you would have to worry about is the financial needs to meet your emergency medical expenses. Thus this one of the important queries, you need to consider while buying health insurance. Usually, health insurance plans in India cover medical expenses and costs against treatments anywhere in India; however, you should make sure of this clause in your policy. Find out whether your plan has any geographical limitations for your claim settlement.