Well, Individual Health Insurance or personal medical insurance is a type of insurance that provides medical coverage to people on an individual amount insured basis. It implies the sort of medical insurance that must be obtained separately for each member of the family. It enables you to tailor your policy coverage to your health requirements rather than your whole family.
Almost all personal mediclaim insurance policies cover a person's emergency medical expenses incurred as a result of hospitalisation, day care processes, alternative treatment, road ambulance services, organ donor charges, and so on. Personal medical insurance premiums and coverage, on the other hand, can't be shared among family members.
Who Should Buy Individual Health Insurance Policy?
While the policy is suitable for people from all walks of life, individuals under the following circumstances should certainly consider buying an individual health insurance policy
People at a Higher Health Risk
People who are Ausceptible to increased health risks owing to an unhealthy festyle and stressful occupations
Ageing Parents
Elderly parents and family members with specific medical conditions, like diabetes, hypertension,
Uninsured Individuals
If you are uninsured while your family is already insured under a policy, you should get a personal health cover
People Needing Separate Coverage
Individuals who need a separate sum insured and benefits instead of a shared policy under family finater
Individuals Suspecting Critical Iinesses
If you have a family history of serious diseases like cancer, etc., you should opt for a policy covering similar conditions individually.
Individual or personal health insurance policies can be subdivided into the following forms of medical insurance:
Critical Illness Insurance:
If you have a family history of severe health issues, you might think about obtaining critical illness coverage, which covers a range of risky disorders.
Health insurance for senior citizens:
These policies are specifically designed to meet the healthcare wants of those over the age of 55. This insurance covers a variety of health issues that senior citizens are more likely to experience. Such plans are available to anybody between the ages of 55 and 80.
Personal Accident Insurance:
In India, road accidents are fairly prevalent. If you regularly travel for personal or business purposes, personal accident insurance coverage may be a good option. These policies are designed to safeguard policyholders from accidents. In general, the policies encompass the policyholder's medical and hospitalisation expenditures in the event of an accident.
What Is The Function Of An Individual Health Insurance Policy?
When you get personal medical insurance, you enter into a contract with the expenditures up to the sum covered in accordance with the insurance policy terms. In exchange, you have to pay regular premiums.
Assume you've got the best medical insurance coverage with an amount covered of ₹ 5 lakhs. If you're hospitalised after acquiring the insurance, the insurer is obligated to pay your hospital fees in accordance with the terms and conditions of the medical insurance policy.
Let us say the hospital cost was ₹2 lakhs. Your insurance provider will pay the hospital's charge, and your annual sum covered will be cut to ₹ 3 lakhs.
Sum total insured - ₹5 lakhs
Hospital charge paid by your insurance provider - ₹2 lakhs
Futures Of Health Insurance For Individual
Individual Health Insurance Plan: Exclusions And Inclusions
The exclusions and inclusions of a personal medical insurance policy will be determined by the kind of insurance and insurer you choose. Here is the typical list of exclusions and inclusions:
Exclusions under the Tata AIG Individual Health Insurance Cover
Vision, Hearing, and Dental-related expenses
Pre-existing conditions
Abuse of drugs or alcohol
Cosmetic surgery
Alternative therapies
Infertility treatment
Obesity treatment
HIV AIDS
Illness or injuries as a result of nuclear perils
Self-Inflicted injuries
Pregnancy and Associated Conditions
Pre and Post-Hospitalisation
Hospitalisation
Ambulance Costs
COVID-19 Treatment
Day Care Procedures
Domiciliary Hospitalisation
Preventive Health Check-up
Organ Donor Expenses
Why Should You Purchase An Individual Health Insurance Policy?
Inflation is an unavoidable occurrence. You might be astonished to learn that healthcare inflation in our country is expanding twice as fast as total inflation. Even though savings instruments offer appealing interest rates, they are insufficient to pay the expenses of medical operations when inflation is included.
As a result, individuals falling in the age group of 40 and 50, as well as those in their 20s, have begun to recognise the significance of having a health insurance plan in place and are looking to buy individual health insurance in order to protect their pockets from getting punctured due to heavy medical bills.
Personal Medical Insurance is a valuable instrument that can assist you in meeting your anticipated medical expenses. Medical insurance covers a range of charges and helps you fight the consequences of inflation, from the equipment cost to the treatment cost, diagnosis, and medicines. During medical crises, a personal medical insurance policy provides substantial financial help. To put it simply, an Individual Health Insurance must be an essential component of your financial portfolio.
Protection Against Medical Emergencies
By purchasing a personal medical insurance plan, you may simply supplement the coverage offered by your current medical insurance plan. As a consequence, you'll have the appropriate financial backing not only against common maladies but also against serious ones like renal failure, cardiovascular disease, cancer, and so on.
Savings Security
In the absence of individual health insurance, you'll be responsible for hefty medical expenditures resulting from your medical treatment. It would require you to dip into your savings or go into debt, neither of which are viable alternatives for the financial security of your future. Because your savings are your life's hard-earned belongings, you should not allow them to be depleted by the financial effect of diagnosis. Thus, having personal medical insurance in place can assist you in saving your hard-earned money.
What To Consider When Purchasing An Individual Health Insurance
Each time you browse for a medical insurance policy for you or your family, you question which one is the best. How can I find the most excellent individual health insurance policy online? What kind of coverage should the policy have? To address all of your questions, continue reading to decipher the secrets to finding the best individual health insurance policy.
Get an Adequate Amount Insured for Yourself
Because the treatment cost in metro areas is considerable, a person's total insured must preferably vary between 7 and 10 lakhs. If you're seeking a family plan in order to insure your kids and spouse, an amount insured or 8 to 15 lakhs on a floater basis is ideal. It must be sufficient to cover more than a single hospitalisation in a year.
Affordability
If you want to save money on medical insurance premiums, co-pay your hospital costs. You end up splitting the medical costs with your medical insurance, so you don't have to pay a high premium.
Extensive Hospital Network
You should always check to see if the insurance provider has a large network of hospitals. If your insurance carrier lists the medical facility or local hospital, you'll be able to receive cashless care.
No Sub-Limits Assistance
Typically, your medical charges are determined by your disease and room type. It's advised that you pick a personal medical insurance policy that doesn't have sub-limits regarding hospital room charges so that you may select the hospital room that best suits your needs. Nearly all of our plans also do not indicate illness limitation; it's a crucial consideration to bear in mind.
Examine the Waiting Periods
While your waiting period is active, your personal medical insurance policy doesn't kick in. Before purchasing individual health insurance online, you should always look for plans with shorter waiting periods when it comes to maternity benefits and pre-existing conditions.
Reliable Brand
Always go with an insurance carrier with a strong reputation in the industry. You should also consider the claims-paying capabilities and customer base to determine if the brand will respect future claims.
Claiming Individual Health Insurance Policy: Documents Required
When making an Individual Health Insurance claim, you should have specific documents on hand. The following is a list of the papers required to file a Personal Medical Insurance claim:
Other Vital Documents: Following receipt of your essential personal medical insurance plan claim form, we will request that you or whoever is submitting the insurance claim on your behalf produce the following documents:
All necessary medical reports, investigation results, case history, hospital discharge summary, and treatment documents.
A thorough and precise diagnosis of the therapy for which the insurance claim is being made.
Any additional document is considered essential by our expert claims department for the claims procedure.
We will confirm the authenticity of the facts surrounding your Individual Health Insurance policy claim within 15 days of your hospital discharge or treatment completion. We will pay the approved insurance claim within one month (30 days) of receiving all essential paperwork if we are pleased with your Individual Health Insurance plan claim and accompanying documents.
ADB