Question 1

How will health insurance pay for my emergency medical expenses?

Accepted Answer

A health insurance policy requires you to pay annual premiums as per your chosen health plan. Once you or any other policyholders under a health insurance plan require medical treatment at a hospital or medical institution, you need to contact your insurance provider. They will in turn contact the medical centre and will either pay your hospital bills (if you have opted for cashless insurance) or will reimburse you after you share your bills with the insurance provider.

Question 2

Who is eligible to buy health insurance?

Accepted Answer

Anybody who is above the age of 18 and is a resident of India is eligible to buy health insurance. However, the age eligibility for coverage will differ between insurance providers. The general eligibility for health insurance is 18 years to 65 years. Under family floater plans, policyholders can add the names of newborn babies to the policy ninety days after birth. Senior citizen health insurance plans usually start at 60 years and depending upon the insurance provider, can cover anywhere from 65 years to no age limit.

Question 3

Can I buy more than one health insurance plan?

Accepted Answer

There is no hard and fast rule that you can only limit your health plan to a single insurance provider. Often, some insurance providers might not cover the cost of specific medical treatments. For instance, LASIK eye surgery or critical illness. You are free to buy more than one health plan from multiple health insurance providers depending on your medical needs.

Question 4

What are the types of health insurance plans I can buy?

Accepted Answer

Depending on the person or people being insured, there are several types of health insurance plans offered by insurance providers. These include - Individual Health Insurance Plan Family Floater Health Insurance Plan Senior Citizen Health Insurance Plan Critical Illness Insurance Plan Maternity Health Insurance Plan

Question 5

Can I pay my health insurance premium in instalments?

Accepted Answer

Most health insurance providers require policyholders to pay the insurance premium on an annual basis but some do offer flexible payment plans which allows the policy holder to break down the premium and pay in instalments on a monthly, quarterly, half yearly basis.

Question 6

Why should I buy health insurance at an early age?

Accepted Answer

It is always recommended that people buy health insurance early on - this doesn't just give them tax benefits, they can also avoid getting crushed under personal loans and medical loans. As policyholders get older, their lifestyle habits, existing health conditions, etc. are factors used to determine their premium. This means health insurance for an older person can be much more expensive than health insurance for a younger person. Additionally, it is always recommended to buy health insurance at an early age because policyholders can enjoy the benefit of no claim bonus and end up with double the sum insured in just a few years.

Question 7

Will I be eligible for tax benefits if I buy health insurance?

Accepted Answer

Yes. The purchase of a health insurance policy comes with tax benefits. Taxpayers are eligible to claim tax benefits up to a specific amount of rupees under Section 80D of the Income Tax Act, 1961.

Question 8

Will I gain more benefits by buying health insurance at an early age?

Accepted Answer

Yes, buying a health insurance policy early on is highly recommended as it is said to be very beneficial to the policyholder. You can usually enjoy the following benefits - Lower premium amount Higher cover if no claim or cumulative bonus applies Lower rejection rates Wellness benefits Tax benefits

Question 9

What should I consider before buying my health insurance policy?

Accepted Answer

When you are buying a health insurance policy, don’t just go for one with the lowest premium or the easiest purchase process. Go for a comprehensive health insurance plan that will work best for you and your loved ones. The team at Royal Sundaram always recommends choosing a health insurance policy that is SMART. Service expenses covered under the policy Medical care network Access to insurance providers Ratio of settlements Top up or value added services

Question 10

Do I get a discount on the renewal of my health insurance policy?

Accepted Answer

Not really. But if the policyholder has not made a claim in that year, they are entitled to a no claim or cumulative bonus. Under this bonus, the policyholder is usually offered a discount on the premium or is offered an increase in the sum insured at no extra cost. The decrease in premium or the increase in sum insured can usually be applied each year till a predefined threshold is reached.

Question 11

What is meant by donor expenses?

Accepted Answer

Sometimes, the insured person needs to undergo a medical procedure that involves organ transplant. In such a scenario, the policyholder is required to ensure that all the hospitalization expenses incurred by the donor in organ donation except the cost of the organ during an organ transplant are included under donor expenses.

Question 12

What to look for in a COVID-19 health plan?

Accepted Answer

While you might be taking all precautionary measures to avoid the Coronavirus, it is always recommended that you prepare for a health emergency as the cost of treating Coronavirus is considerably higher. Also remember, most coronavirus specific health plans are individual plans and not family floater or group health plans. If you are looking for a Covid-19 health insurance plan, make sure it covers the following expenses - Hospitalisation expenses Ambulance expenses PPE Kit costs Medicine costs Doctor's consultation costs ICU costs

Question 13

What is a pre-existing disease?

Accepted Answer

A pre-existing medical condition, like its name suggests, is an ailment or an injury or a medical condition that is already affecting the person who is applying for a health insurance policy. Some of these conditions include - Depression Sleep apnea Diabetes Hypertension High cholesterol High blood pressure Asthma

Question 14

I have been recently diagnosed with a medical condition. Will I be allowed to buy health insurance?

Accepted Answer

Health insurance is offered to people with pre-existing medical conditions; however, there will be certain underlying conditions to the provision of the health insurance policy. There will be a wait time before the policyholder can claim the cost of treatment for those pre-existing medical conditions. There might also be a possibility that the policyholder might have to pay a higher than usual premium amount as the risk of health emergencies is considerably higher.

Question 15

Can the waiting period for pre-existing conditions be reduced?

Accepted Answer

Yes The waiting period for individual health plans can be reduced at the price of additional premium. Group health insurance policies generally don’t have a specific waiting period as a large number of people are insured together. If a policyholder is diagnosed with an ailment like diabetes or high blood pressure etc during the waiting period, it will not be considered as a pre-existing condition and the policyholder can claim expenses for medical treatment. Some senior citizen health plans usually get rid of the waiting period by offering a co-pay clause where the policyholder and the insurance provider will share expenses based on a predetermined ratio.

Question 16

What if an ailment is diagnosed during the waiting period? Does that fall under the category of pre-existing medical conditions?

Accepted Answer

If a policyholder is diagnosed with an ailment like diabetes or high blood pressure etc during the waiting period, it will not be considered as a pre-existing condition and the policyholder can claim expenses for medical treatment.

Question 17

Will I be allowed to cover my family under my health insurance?

Accepted Answer

Insurance providers offer coverage to several people under family floater plans including the following - Self Spouse Children (aged above 3 months and below 18 years) Dependent parents Parents in law Siblings

Question 18

Is my health cover valid anywhere in India?

Accepted Answer

Usually, insurance providers have a wide network of affiliated hospitals where the policyholder can claim health insurance. However, it is recommended that people signing up for a health insurance policy look up if there are any clauses citing geographical limitations in their insurance policy.

Question 19

I already have a health insurance policy, I just want to increase my sum insured. Is that possible?

Accepted Answer

Your health insurance policy is renewed each year and you can consider increasing the sum insured or look at adding other value added benefits to your existing health insurance plan at the time of policy renewal.

Question 20

Will my health insurance cover begin from day one?

Accepted Answer

No. When you purchase a health insurance policy, there is usually a cooling period of 15-30 days or as specified in the contract before the policy becomes active. This cooling period is set aside for the policyholder if they would like to cancel the policy. However, some insurance providers can cover the cost of medical treatment from the very next day of purchasing medical insurance. Especially if you have a health insurance policy with an accident cover. Additionally, if you have pre existing medical conditions, there will be a waiting period - this waiting period can be anywhere from 1 to 4 years.

Question 21

Is maternity covered in standard health insurance policies?

Accepted Answer

Most health insurance providers do not cover the cost of maternity in their offerings unless specified in the policy - but there will be a waiting period between two to four years to claim maternity costs from your health insurance provider. If maternity costs are included in the health insurance policy, the premium is likely to be higher.

Question 22

Does the health insurance renewal premium increase every year?

Accepted Answer

Health insurance premiums increase from time to time but it could be for various reasons. Let's understand these reasons in brief- Change in age Typically, Health Insurance premium is charged based on age slabs. If the age changes from one slab to another the premium will rise. COVID-19 pandemic The number of insurance claims usually increase after a natural disaster but that is usually limited to a specific region. The pandemic however has hit our country in an unexpected and unimaginable way. With so many people claiming insurance, it is the natural progression for insurance premiums to increase. Inflation Inflation plays a very important role in determining health insurance premium rates. Naturally, treatments which weren’t as expensive in the past are bound to get more expensive in the future. This is another reason why health insurance businesses charge higher premium amounts after intervals.

Question 23

Do I get my money back if I have not utilised the cover provided by the health insurance and the cover period is over?

Accepted Answer

Sometimes, health insurance policyholders might not get any medical treatment in the time that they are insured. This does not mean that they will get their money back. But it does entitle them to a no claim bonus, if the same is provided by the health insurance provider.

Question 24

What is a cumulative bonus?

Accepted Answer

When a policyholder does not claim their health insurance policy for the period they are insured, they are usually offered a cumulative bonus on renewal. A cumulative bonus is an increase in the sum insured for every year a claim is not made. This is only offered to a specified limit. Additionally, a cumulative bonus is offered by insurance providers on indemnity based health insurance plans and only when the policy is renewed by the policyholder without any breaks.

Question 25

Can I cancel my health insurance policy after purchasing?

Accepted Answer

Yes. If you are not satisfied with the terms of your purchased health insurance policy, you can apply for cancellation within 15 days of receiving the policy documents or before the insurance policy becomes active or as per a time specified in the insurance contract.

Question 26

What if I miss the premium renewal date?

Accepted Answer

Most insurance providers will offer a grace period of two to four weeks from the date of renewal in case the policyholder is unable to pay the premium in time. However, if the grace period has passed and the policyholder has not paid the premium, it could lead to the following possibilities - Cancellation of the health insurance policy Denial of health coverage Denial of policy renewal In case the insurance provider allows the renewal of the policy, there is a chance that the policyholder might have to serve the waiting period for specific medical treatment like maternity cover or pre-existing medical condition coverage from the beginning.

Question 27

Can policy be transferred from one insurance provider to another provider without losing the benefits?

Accepted Answer

Yes. Policyholders can choose to transfer their existing health insurance plan to another insurance provider as per a circular issued by the Insurance Regulatory and Development Authority (IRDA).

Question 28

What if I am not treated at a network hospital?

Accepted Answer

Sometimes, in case of a medical emergency, like an accident, it might not be possible to take the policyholder to an affiliated network hospital. In such a scenario, health insurance can still be claimed but cashless hospitalisation is unlikely to be available. The policyholder will be required to bear the cost of medical treatment and submit the bills to the insurance provider for reimbursement.

Question 29

What are the documents required for claiming health insurance?

Accepted Answer

While making a health insurance claim, the policyholder is expected to have the following documents - Proof of identity Proof of insurance Health card Hospital bills

Question 30

What is no claim bonus in health insurance?

Accepted Answer

A no claim bonus could mean that the policyholder can either receive a discount on the premium or a cumulative benefit which refers to increased sum insured without actually paying for it. Most insurance providers will offer a 5% cumulative bonus on your sum insured with each year of no claim. For instance, if the sum insured is for ₹5 lakhs, the policyholder will receive added coverage worth ₹25,000 after the first year of not making a claim. Similarly, they will receive added coverage worth another ₹25,000 for two consecutive years of no claims and so on. A no claim bonus can double a health insurance policy holder's sum insured by 50% in consecutive years of no claims.

Question 31

Will I get a refund on my health insurance premium?

Accepted Answer

When you buy health insurance, you are offered a free look period or a time when you can cancel the policy if you aren’t happy with the benefits offered. This period is usually for 15 days and sometimes has the option to extend for 30 days. It is only after this period that your health insurance policy kicks in.

Question 32

What documents do I need if I want to buy health insurance?

Accepted Answer

Buying a health insurance policy online or offline is fairly simple. You just need to submit the following documents - Proof of identity and age Aadhar, PAN, Passport, Voter ID card, Driving license Proof of residence Aadhaar, Passport, Voter ID card Documents proving medical check up.

Question 33

Is there a limit on the number of claims that I can avail in one year?

Accepted Answer

Your health insurance policy usually covers the cost of medical treatment for a fixed amount. Until this cost is not exceeded, you can claim your health insurance policy as many times as you like.

Surrosafe Health Insurance

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This product is specially designed to cover Surrogate mother and Oocyte donor for complications arising out of pregnancy.

The key features are as mentioned below:

UIN-RSAHLIP24110V012324

Health Insurance Policy terms and conditions: