What is a Comprehensive Health Insurance Plan – Details and Benefits
A comprehensive health insurance policy refers to a medical plan that provides extensive financial coverage against medical emergencies. These health plans are different from basic health insurance policies. Policyholders can receive coverage for outpatient and in-patient treatments, medical tests, consultations, hospitalisations, ambulance charges, physiotherapy and much more.
Insurance providers usually offer individual comprehensive plans. However, some might present it as a family floater plan covering both insured individuals and their families.
What is Covered under a Comprehensive Health Insurance?
Different health insurance plans offer a varying scope of financial coverage. Comprehensive health plans are designed to offer an umbrella of coverage, including numerous services and additional benefits. Here are some of the significant medical expenses that are covered by comprehensive medical insurance plans:
1. In-patient Hospitalization
With a comprehensive healthcare plan, you will be reimbursed for the hospitalisation expenses. These expenses include room rent charges, doctor’s fees, nursing charges, cost of medical procedures, medicines bills and more.
2. Day-care Treatments
There are several surgeries or medical treatments that might not require more than 24 hours of hospitalisation. These treatments are conducted in specially set up hospital units. A comprehensive plan would cover such daycare procedures.
3. Pre and Post Hospitalization Cover
Individuals will receive financial coverage for expenses such as health check-ups and medical tests that are conducted before hospitalisation. Similarly, this health plan will reimburse for post-hospitalisation follow-up procedures, medicine bills and more.
4. Ambulance Charges
Sometimes it might be compulsory to avail of an ambulance service while dealing with a medical emergency. Your comprehensive health plan will cover the costs of the ambulance as well.
5. Cover for Alternative Treatment
Insured individuals can also enjoy financial coverage against the expenses incurred for alternative treatment options under AYUSH.
6. Personal Accident Cover
A comprehensive plan also provides a lump sum amount in case of any fatal accident. The family of the policyholder will receive a 100% payout of the sum insured. This will provide robust financial security in the absence of the insured individual.
7. Daily Hospital Allowance
With a comprehensive healthcare plan, you can also pay for sundry expenses that you may incur during hospitalisation. Such expenses might include the cost of the attendant’s food, travel, lodging, etc.
8. Domiciliary Treatment
Sometimes a patient might have to take at-home treatments if they are either unable to visit the hospital or are advised to continue treatments at home. A comprehensive medical plan will cover such treatments as well.
9. Expense for Consumables
A standard health insurance policy might not cover the costs of medical items such as syringes, gloves, or needles. However, a comprehensive health plan will include coverage for these expenses as well.
Major Benefits of Comprehensive Health Insurance Policies
Buying a comprehensive health plan is probably the best way to deal with the rising cost of medical treatments. You can enjoy the following advantages with a comprehensive medical insurance policy:
1. Vast Coverage with Add-ons
As mentioned in the previous section, a comprehensive health plan comes with highly extensive coverage. You can also opt for several riders and add-on covers. These add-ons will help to expand the coverage provided by your policy. The riders and add-ons include critical illness cover, maternity benefit, personal accident cover and more.
2. Outpatient Treatment
Comprehensive health insurance plans cover the cost of outpatient expenses, which are otherwise not covered under regular insurance plans. For instance, you will receive reimbursements for OPD consultation fees when you opt to visit a doctor without the need for hospitalisation.
3. Coverage for Pre-existing Diseases
Insured individuals are eligible to avail coverage for treatments of pre-existing diseases. However, such coverage is available only after a waiting period. This period varies from one insurer to another. However, it usually ranges between 2 to 4 years.
4. Coverage for the whole Family
Comprehensive health plans come with the provision to cover the entire family of the policyholder. You can cover your parents, spouse and children with a single health insurance plan. Notably, some insurance companies also allow including your in-laws. The sum insured is available either on a family floater or an individual basis.
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Factors to Consider Before Choosing a Comprehensive Medical Policy
Finding a suitable health insurance policy can be quite challenging. Make sure to compare across different comprehensive healthcare plans using the following pointers:
- Analyse the coverage options provided by the health insurance provider
- Check for the maximum renewal age
- Look for add-ons and riders available with the health plan
- Make sure the plan comes with a lower waiting period
- Carefully study and analyse the policy clauses to have a clear idea about the policy terms and conditions
Final Word
Compared to regular health insurance policies, a comprehensive medical plan provides far better coverage and benefits. It enables you to take care of all your medical expenses smoothly, thereby helping you to manage your finances better.
Navi is a leading health insurance provider offering a wide range of health insurance policies such as comprehensive plans, critical illness cover and much more. You can obtain cashless claims in under 20 minutes from over 10,000+ network hospitals across 400 locations Pan India. Download the Navi App and learn more about Navi’s insurance services.
FAQs
Ans: Yes, comprehensive health insurance covers the expenses pertaining to both normal delivery and caesarean delivery. However, both spouses should be a part of the policy.
Ans: Here are some of the limitations that would prevent you from raising a claim:
• Treatments conducted outside India
• Cosmetic or aesthetic surgery
• Sexually transmitted diseases
• Self-inflicted injuries or harm and more
Ans: Yes, comprehensive health plans cover yearly health check-ups.
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Disclaimer: This article has been prepared on the basis of internal data, publicly available information and other sources believed to be reliable. The information contained in this article is for general purposes only and not a complete disclosure of every material fact. It should not be construed as investment advice to any party. The article does not warrant the completeness or accuracy of the information, and disclaims all liabilities, losses and damages arising out of the use of this information. Readers shall be fully liable/responsible for any decision taken on the basis of this article.
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