A To get a health insurance policy, an individual has to pay a premium amount at regular intervals as selected by him/her during the inception of the policy. From the commencement of the policy, if the insured person has any medical expenses to bear, the insurer will be liable to pay them as per the terms and conditions. Please note that few insurers have a waiting period within which no claims will be entertained. The waiting period differs from one insurer to another.

Health insurance is usually included in the benefits offered by an employer to the employees of an organization. However, the extent of coverage under such a policy may be limited. So, it is advisable to buy a separate health insurance policy for extended coverage.

Broad Classification of Health Insurance Plans in India

Medical insurance plans in India can be broadly classified into two types, namely reimbursement or indemnity based policies and fixed benefit hospitalization plans.

Reimbursement or indemnity-based health insurance:

This type of health insurance plan is commonly known as mediclaim. The insurer will reimburse any medical expenses incurred due to hospitalization, diagnosis, and pre and post-hospitalization treatments. Mediclaim plans have an annual limit which is renewed every year.

This type of plan is available as:

» Individual Health Insurance Plan: Under an individual health insurance plan, only one person is covered for the chosen sum insured. Family members can be enrolled under this plan but a different sum insured has to be chosen for each member.
» Family Floater Insurance Plan: This type of plan is customized for families, wherein a fixed sum insured is available for all insured members for one or more claims during the policy tenure. Spouse, dependent children, and parents can be included under this plan.
» Fixed benefit hospitalization plans: This type of plan offers fixed coverage and benefit payouts if the insured member is diagnosed with a specified illness or is hospitalized. It partially covers hospitalization costs and provides a substitute income.

Some health insurance add-ons or riders that can be attached to your base policy are:

• Critical illness plans: The insurer will pay a fixed benefit payout if the insured person is diagnosed with any of the critical illnesses specified under the policy. The lump sum benefit can cover hospitalization cost and act as an income supplement.
• Hospital Cash and Surgical benefit plans: This plan covers defined hospitalization and surgery costs. Medical bills will have to be submitted to the insurer to receive the benefits.

Health insurance plans in India can be personalized to suit an individual’s requirements. The insured can decide if they want a health insurance plan that covers out-patient expenses, critical illnesses, maternity expenses, accident-related expenses, or a combination of all.