Health Insurance | Medical Insurance Plans Online

Q: Does the health insurance policy cover COVID-19 treatment?

Yes, indemnity-oriented health insurance plans cover the medical costs you incur if you are hospitalised for COVID-19 treatment. Moreover, there are COVID-specific health plans too that you can get for coverage against COVID-19 treatments.

Q: How to compare health insurance plans?

There are various factors that you should check to compare health insurance plans. These factors include the coverage offered, the premium charged, the range of sum insured, discounts offered, the network of cashless hospitals, etc. Also, understand the type of health insurance policy you want and then compare similar plans against one another. You can compare health insurance plans online through the PhonePe app and get the most suitable policy.

Q: How to calculate health insurance premiums?

Health insurance companies offer online health insurance premium calculators. You can enter your details in the calculator to calculate the premium. The details include your age, number of family members to be covered, the coverage duration, sum insured, and history of pre-existing illness. Then, based on these details, the calculator would calculate the premium.

Q: What are the documents required for health insurance?

To get a health insurance policy, you would need to submit: A valid identity proof, A valid age proof and A valid address proof. At the time of a claim, however, you need to submit the following documents: Filled and signed claim form, Doctor's prescription recommending hospitalisation, All diagnostic test reports, All medical bills in original, All hospital records, A police FIR in the case of accidental injuries, Pre-authorisation claim form for cashless claims. Based on the verification of the documents, the claim would be settled.

Q: What is the age criteria to get health insurance?

You can get a health insurance policy if you are 18 years or above. The maximum entry age is usually limited to 65 years. However, some plans do not have any capping on the maximum age to get the policy. Dependent children can be covered from 91 days onwards under a floater policy. However, if you want an individual sum insured for dependent children, the minimum age is usually 5 years.

Q: When should I make a health insurance claim?

You should make a health insurance claim when you suffer an injury or an illness and require medical attention for the same. Also, check whether the illness or injury is covered under the plan for the claim to be successful. Moreover, make a claim as soon as the medical contingency happens. This would allow you to register your claim with the insurance company and seek guidance on the claim process.

Q: What is the sum insured in Health Insurance Plans?

The sum insured is the coverage level in a health insurance policy. It is the maximum claim that the insurance company accepts to pay in a medical contingency. Every health insurance plan offers a minimum and maximum range of sum insured. You can choose the desired amount of sum insured based on your coverage needs.

Q: What are pre-existing diseases & conditions?

Pre-existing diseases and conditions are those illnesses or medical complications you have when getting the policy. Since such illnesses already exist, they are called pre-existing illnesses. For example, say you have diabetes. When you take a health insurance plan, your diabetes would be considered a pre-existing illness since you already have the ailment when taking the policy.

Q: How to port a health insurance policy?

To port your health insurance policy, inform your existing insurer at least 45 to 60 days before the policy renewal date. You might have to fill up and submit a portability form. Then, you should inform the new insurer of your porting request and port to the new policy after completing the relevant formalities.

Critical illnesses and diseases are some things that most people do not worry about on a daily basis. However, with most of us leading a sedentary lifestyle, common lifestyle illnesses like diabetes, hypertension, stress, and mental health have become common causes of concern. Add to this, the ever-rising cost of treatments and medical emergencies and it becomes a financially challenging affair. So, to help you meet such challenges, a Health Insurance policy comes into the picture.

Health
insurance:
the meaning

A Health Insurance policy covers the medical costs that you suffer in a medical contingency. Health Insurance plans cover specific medical expenses and treatments.

For example, say you are hospitalised for an appendectomy. A basic medical insurance plan covers the cost of hospitalisation and appendectomy treatment. So, the medical bills you incur due to hospitalisation and subsequent appendectomy would be paid by the health insurance policy. Moreover, you might incur post hospitalisation medical expenses after being discharged from the hospital, like physiotherapy or diagnostic tests to monitor your recovery. Such expenses are also covered under the Health Insurance plan.
So, a Health Insurance plan covers the cost of medical treatment, whether it is planned or an emergency.

The benefits of a Health Insurance plan

There are various benefits that Health Insurance plans offer. These benefits include the following:

Financial Relief

A medical insurance policy covers your medical costs, thereby giving you financial relief from expensive bills.

Quality Healthcare Facilities

You can afford quality healthcare facilities if you are insured under a Health Insurance plan.

Floater Policy

You can cover your family members under a floater policy so that even if they suffer any medical contingency, the health plan pays their medical bills.

Tax Deductions

Premiums paid for Health Insurance policies are eligible for tax deductions.

Financial Relief

A medical insurance policy covers your medical costs, thereby giving you financial relief from expensive bills.

Quality Healthcare Facilities

You can afford quality healthcare facilities if you are insured under a Health Insurance plan.

Floater Policy

You can cover your family members under a floater policy so that even if they suffer any medical contingency, the health plan pays their medical bills.

Tax Deductions

Premiums paid for Health Insurance policies are eligible for tax deductions.

Learn More⌄

Health Insurance through PhonePe - the key features

You can fulfil your Health Insurance needs through PhonePe that offers you a standard, comprehensive Health Insurance plan.

Here are some key features of the Health Insurance policies available on PhonePe’s platform:

Hassle-free services

Get a plan within minutes with just a few clicks without any medical test or physical documentation

Access your policy details on PhonePe’s mobile app whenever you want to

Online insurance through PhonePe are entirely safe and secure.

The types of Health Insurance plans that you can take

As mentioned earlier, Health Insurance plans come in different variants. Here’s a peek into the different kinds of Health Insurance plans that you can get on PhonePe:

Health + COVID-19

PhonePe offers the Aarogya Sanjeevani Mediclaim Policy that offers basic coverage for your hospital bills.

Coverage under Health Insurance policies

Indemnity-based health plans cover the actual medical bills that you incur in a medical emergency. Here are the basic medical expenses that are covered under basic indemnity-based Health Insurance plans:

Medical expenses incurred before hospitalisation
Medical expenses incurred after being discharged
Ambulance costs
Daycare treatments that do not require 24-hour hospitalisation
COVID-19 hospitalisation
Modern and advanced treatments
Non-allopathic, alternative treatments that include Ayurveda, Unani, Siddha, and Homeopathy (AYUSH)

Inpatient hospitalisation that includes:

Room rent
ICU room rent
Doctor's consultation fee
Surgeon's fee
Anaesthetist's fee
Nurse's fee
Cost of blood, medicines, diagnostic tests, oxygen, etc.

What don't Health Insurance plans cover?

Despite the broad scope of coverage, there are certain instances that health plans don't cover. Such models are called policy exclusions. Standard exclusions include the following:

Illnesses or injuries suffered due to war or nuclear radiation
Cosmetic treatments are not covered under Health Insurance
Congenital disabilities are not covered under Health Insurance
Experimental and unproven treatments
Maternity-related expenses, unless specifically covered
Sexually transmitted illnesses and venereal diseases
Injuries and illnesses suffered due to participation in criminal or hazardous activities
Treatments for alcohol or drug addiction

The concept of the waiting period in Health Insurance

Almost every Health Insurance policy has a waiting period clause. A waiting period is a period when you don’t get coverage. Once the waiting period is over, coverage is allowed.

The waiting period is applicable in several instances. The most important one is the waiting period for pre-existing illness. If you have any illness when taking an insurance policy, like diabetes or hypertension, medical complications from such illnesses would be covered after the waiting period.

Other waiting periods that you would find would be:

Initial waiting period

An initial waiting period of 30-60 days from the date of getting the policy

Specific illnesses

Waiting period for specific illnesses like hernia, fistula, tonsillectomy, cataract, etc.

Maternity cover

Waiting period for maternity cover

Health Insurance and tax benefits

Health plans give distinct tax advantages. The premium that you pay for the policy is allowed as a deduction from your taxable income. The deduction is available under Section 80D. The limit of deduction is as follows:

For spouse and dependents

If you take a policy for yourself, your spouse, and dependent children, the deduction is Rs. 25,000 if you are below 60 years of age.

For senior citizens

If you are a senior citizen, i.e., aged 60 years and above, the deduction limit increases to Rs. 50,000

For parents

If you take a health plan for your parents, you can claim an additional deduction of Rs. 25,000.

For parents who are seniors

If your parents are senior citizens, the deduction limit increases to Rs. 50,000.

So, you can claim a deduction of up to Rs.75,000* through medical insurance premiums if you take insurance policy for yourself and your parents, and both of them are senior citizens.

*Tax benefits are subject to change in tax laws

Factors affecting Health Insurance premiums

Various factors affect your Health Insurance premium. Here are the factors that affect your Health Insurance premium:

Age

The older you are, the higher would be the premium and vice-versa.

The sum insured

The higher the sum insured that you choose, the higher would be the premium and vice-versa.

The number of members covered

If you opt for floater coverage, the premium will increase for every family member that you cover under the policy.

The scope of coverage

Different health plans have a different scope of coverage. If the coverage is wide, the premium would be high. Alternatively, if the coverage is limited, the premiums would be low.

The city in which you live

Insurers also follow geography-based pricing wherein premiums are categorised for metro and non-metro cities. If you are living in a metropolitan or Tier 1 city, the premium would be high. If you live in a non-metro city or a town, the premium would be lower.

The add-ons selected

You can add coverage benefits to the policy by paying an additional premium. So, if you choose add-ons, the premium would increase.

The claim experience of the insurer

Lastly, every insurance company fixes the premium of its insurance policy differently. The claim experience of the company determines the premium that it would charge. If the company has incurred a high amount of claims in a financial year, premiums would be higher in the next financial year and vice-versa.

Age

The older you are, the higher would be the premium and vice-versa.

The sum insured

The higher the sum insured that you choose, the higher would be the premium and vice-versa.

The number of members covered

If you opt for floater coverage, the premium will increase for every family member that you cover under the policy.

The scope of coverage

Different health plans have a different scope of coverage. If the coverage is wide, the premium would be high. Alternatively, if the coverage is limited, the premiums would be low.

The city in which you live

The add-ons selected

You can add coverage benefits to the policy by paying an additional premium. So, if you choose add-ons, the premium would increase.

The claim experience of the insurer

Learn More⌄

Things to check when getting Health Insurance

When you are taking a Health Insurance policy, make an informed choice. Hasty decisions might result in you choosing the wrong policy. So, when getting a Health Insurance, here are some things that you should check:

Always opt for an optimal sum insured

Always opt for an optimal sum insured. Medical costs have touched the roof, so you need a high sum insured to cover your medical bills sufficiently.

Parents to opt for an independent plan

For parents, opt for an independent plan. Adding parents to the floater coverage would considerably increase the premium, and there might be coverage restrictions.

Look for the coverage benefits of the plan

Look for the coverage benefits of the plan. Choose a plan that offers a comprehensive scope of coverage. Moreover, ensure that the coverage benefits suit your needs.

Always compare

Always compare. Comparison helps you check the coverage benefits and choose a plan that offers the most inclusive scope of coverage at the most affordable premium.

Get the policy online

Try and get the policy online. It is quicker, convenient, and cost-effective too.

Claiming from your Health Insurance plan

When you incur a claim in your Health Insurance plan, there is a process that you should follow. Here’s a look:

Inform the insurance company

Inform the insurance company immediately if you incur a claim.

Submit a pre-authorisation claim form

If you get hospitalised in a network hospital, your claims would be handled on a cashless basis. You should fill and submit a pre-authorisation claim form for getting approval for cashless claims.

Non-networked hospital

In a non-networked hospital, you need to pay the bills yourself till you are recovered. After that, submit the bills to the insurer. The company would reimburse you for the medical expenses you bore.

Submit all your medical bills

Make sure to submit all your medical bills, reports, and hospital documents to the insurance company to settle your Health Insurance claim.

Getting or renewing Health Insurance - the PhonePe way

PhonePe offers you a convenient platform to get or renew your Health Insurance plan. Here are the steps on how you can get a Health Insurance plan from PhonePe:

STEP 1/5

1. Select 'Health' Insurance
Select the Insurance tab and choose a Health Insurance type
2. Enter Details
Select the persons you wish to insure, cover amount & postal code
3. Select Plan & Add aditional details
Select the plan & add additional details such as nominee details
4. Health Declaration
Health Declaration
5. Make Payment
Review & Buy