Health Insurance Plans

Health insurance explained in simple language — what it is, what a policy can potentially cover, and what you should compare before making a decision.

What is Health Insurance?

Health insurance is a contract in which the insurer covers eligible medical expenses according to the policy's terms, conditions, exclusions and limits. In exchange, you pay a premium — usually yearly — for the chosen sum insured.

In simple words: it helps you manage the cost of medical treatment so that one hospital visit does not wipe out your family's savings. Because every policy is different, it is important to understand the specific terms of the plan you are considering.

Coverage varies by policy. Always check the policy wording, exclusions, waiting periods, sub-limits and terms before purchasing.

What Can a Policy Potentially Cover?

Depending on the plan you choose, a health insurance policy may provide coverage for:

Hospitalisation

Inpatient treatment expenses subject to policy limits.

Day-care Procedures

Certain procedures that do not require 24-hour hospital stay.

Pre / Post-hospitalisation

Eligible expenses before and after hospital stays, per policy.

Ambulance Expenses

Ambulance charges as allowed under the policy.

Certain Medical Treatments

Treatments covered under the plan's terms and conditions.

Other Benefits

Additional features supplied by the selected policy.

Remember: coverage differs from one insurer and plan to another. The list above is indicative — the actual policy wording defines exactly what is and is not covered.

Things to Compare

When comparing plans, ask your adviser to explain how each plan handles these points:

Sum Insured

The maximum the insurer pays for covered claims.

Premium

The yearly amount you pay for the cover.

Waiting Periods

The time before certain covers become active.

Network Hospitals

Where cashless treatment may be available.

Room-rent Conditions

Limits on room rent and related expenses.

Co-payment

The share of a claim you may need to pay.

Deductibles

An amount you pay before cover begins.

Exclusions

What a policy will not cover.

Restoration Benefits

Whether sum insured can get restored in a policy year.

No-claim Benefits

Benefits offered for claim-free years, if any.

Claim Process

How claims are filed, including cashless and reimbursement.

Health Insurance Can Be Simple — With the Right Guidance

Understand your options before you decide. Talk to Anandkumar today.

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