What are Individual Health Insurance Plans – Benefits and Cover
The COVID-19 pandemic demonstrated how unprepared most people are in the face of a major health crisis. Its debilitating effect has made many aware of the importance of being financially secure. Hence, individual health insurance policies have become more popular as they provide customisable coverage per your own medical needs.
What is an Individual Health Insurance Plan?
This medical insurance policy offers financial coverage for the hospitalisation and surgical expenses of a single individual. Unlike family health insurance policies, these need to be purchased separately for each family member.
A unique feature of individual policies is that their coverage can be customised as per the insured person’s needs. You can choose from a range of coverage features and get high-value benefits in case of a medical emergency.
Benefits of Purchasing Individual Health Insurance Plans
1. High Sum Insured
An individual health plan comes with a fixed sum insured, covering the health expenses of the policyholder. With a sum insured of up to Rs. 1 crore (depending on the plan), these provide enough coverage for a single person.
2. Tailor-made for the Policyholder
Unlike family floater or group health insurance plans, individual policies provide the flexibility to cover your unique health needs.
3. Covers Everyone in the Family
With individual health insurance for each member, your family does not have to worry about lacking coverage if one of them falls sick. Even when a member spends their sum, other members’ insured sums remain unaffected.
4. Affordable Insurance Cover
Family health insurance policies consider the age of the oldest member when deciding on the premium amount. An Individual health insurance policy can be a cheaper option for families that include senior citizens or members with pre-existing medical conditions.
5. A Wide Range of Coverage
Depending on the health plan, individual policies can offer coverage for Ayurvedic/homoeopathic treatment, pre and post hospitalisation expenses, ambulance charges, etc. Some individual health insurance policies may also provide free health check-ups.
Why Should You Purchase Individual Health Plans?
1. Rising Medical Costs
With healthcare expenses rising in India, almost everyone needs financial coverage to meet unexpected medical expenses. Individual health insurance policies can provide adequate financial coverage to fulfil such unforeseen financial requirements.
2. Lifestyle Diseases
Some Individuals might be prone to diseases like obesity, high blood pressure etc. In this regard, health insurance plans can be beneficial as they provide coverage for the treatment of such conditions.
3. Saving Your Investments
No one wants to spend their hard-earned savings on hospital bills. With an individual medical insurance plan, you can avoid financial stress and invest your money to fulfil specific goals.
What Expenses do Individual Health Insurance Policies Usually Cover?
Most individual health policies cover the following medical expenses:
- In-patient Hospitalisation Expenses: These expenses are incurred when one gets admitted to a hospital. Such expenses include room rent, ICU charges, cost of medicines etc.
- Pre and Post Hospitalisation Expenses: These policies typically cover medical expenses for a certain number of days before admission and after discharge.
- Domiciliary Expenses: An individual health insurance policy provides coverage for the costs incurred for home treatment when recommended by a doctor.
- Road Ambulance Cover: This refers to the costs of road ambulance services in case of medical emergencies.
- Alternative Treatment: Many individual health policies cover treatment that one gets through alternative schools of medicine like Unani, Homeopathy, Ayurveda, Yoga and Unani.
- Daycare Procedures: These health plans cover daycare treatment that requires less than 24 hours of hospitalisation.
- Other Covers: Depending on the policy, individual health insurance can cover organ donor expenses, cataract surgery, bariatric surgery, maternity expenses, etc.
- Health Check-ups:Some health plans offer preventive health check-ups.
How to Buy the Best Individual Health Insurance Plan?
Given are some of the factors you should check to determine the best individual health plan for your needs:
- Scope of Coverage: If you suffer from an illness, consider various expenses like the cost of diagnostic tests, consultation fees, medical procedures etc., to decide how much coverage you may need.
- Inclusions and Exclusions: A policy buyer should check inclusions and exclusions to avoid discrepancies at the time of making claims.
- Waiting Period for Pre-existing Diseases: Pre-existing conditions like thyroid, diabetes, cardiac conditions etc., come with a waiting period. The shorter this is, the sooner you can get financial coverage.
- The Number of Network Hospitals: Check the number of network hospitals present in your vicinity where you can get cashless treatment.
Navi offers a huge network of more than 10,000 hospitals across India for you to get cashless claims. You can Just download the Navi App from Google Play Store to get an individual health plan. The best thing about the app is that it’s efficient and the procedure is 100 percent paperless and less time-consuming.
Also Read
Final Word
An affordable individual health insurance policy is necessary as it allows you to choose the coverage you need and remove the ones you do not. For example, you can decide whether to add or remove critical illness cover based on your and your family’s medical history and change the sum insured.
FAQs
Ans: Yes, all individual health plans come with a few waiting periods. Firstly, you cannot raise any claims within the first 30 days except in case of accidents. Secondly, specific illnesses and pre-existing conditions come with waiting periods of 1-3 years and 2-4 years, respectively.
Ans: The following factors decide the premium amount of an individual health insurance plan:
• The policyholder’s age
• Pre-existing medical conditions
• Coverage amount
• The policyholder’s annual income
• Policy tenure
• The locality where he/she lives
Ans: Yes, you can avail of cashless treatment from any of the network hospitals of your insurer. With this, the insurer will settle all bills with the hospital directly, so you do not have to pay anything.
Ans: According to some experts, your health insurance policy should have coverage of at least 50% of your yearly income. It is recommended to have a minimum coverage of Rs. 10 lakhs as expensive treatments like bypass surgery have similar costs.
Ans: Yes, senior citizens above the age of 60 years can get tax benefits of up to Rs. 50,000. You can also claim tax deductions of up to Rs. 75,000 if you are below 60 years and pay for a separate individual plan for your parents who are senior citizens.
Before you go…
How about an affordable health insurance policy 👨⚕️ starting at a monthly premium of just ₹235? Install the Navi app now and get your policy in under 2 minutes.
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.
Health Insurance Knowledge Base
