It is rightly said that necessity is the mother of invention. This applies to health insurance as well. The deterioration of lifestyle patterns and the rising cost of health care in India paved the way for health insurance services. This need has been further aggravated by the fact that, unlike in the West, social security systems are non-existent in India. Governments have made every provision to extract taxes from citizens at every possible point, but when it comes to health care and social security, they have done nothing at all.

Therefore, it is the responsibility of the citizen to protect himself. But it’s not that easy to get the right health insurance policy. There are more than two dozen general insurance companies offering different types of health insurance plans in India. Many times, people end up buying health insurance plans that are not relevant to them and that do not help them during their time of need.

Therefore, it is of crucial importance that you understand the nuances of health insurance plans and then just make a decision. Here is a quick list for you.

What do all health insurance plans cover?

Health insurance plans are primarily intended to provide you with coverage against hospitalization and critical illness. Most plans cover this. However, there are many plans that do not cover certain types of healthy foods. For example, you can find several mediclaim plans that do not cover problems related to blood pressure and diabetes.

The scope of coverage may also be different. For example, not all plans cover expenses after a hospital stay. In some, the period of coverage can be up to 45 days and in some, the period can be as little as one week.

It is your responsibility to verify these matters. If you trust the insurance agent going after you, it can cost you dearly later on. Agents are interested in making sales and commissions. They may show their concern and tend to offer you the best plans, but the reality can be very different. So, just take care of these aspects.

The development of the health insurance industry in India has motivated insurance companies to introduce comprehensive plans. A wide range of riders is also available at your disposal. So if you buy a standard policy, you can add additional riders that can give you coverage against many other risks, such as permanent disability benefit, diabetes coverage, etc.

Do they cover pre-existing conditions?

Most Mediclaim plans in India do not cover pre-existing conditions unless otherwise specified. Do not assume on this matter. If you are looking for coverage against a pre-existing medical condition, clarify it first. You can compare health insurance plans online and consult with the customer service center through the option of online chat or phone call.

There are plans that cover pre-existing conditions under certain conditions. Generally, there is a set period under which pre-existing conditions are covered. The cost of such plans is naturally higher than the standard ones.

Can multiple family members be covered by one plan?

If possible. You can simply opt for a family floating plan and get coverage for your family members in one plan. There are countless benefits of these plans. The premium is a bit higher but quite a bit lower if you opt for different health insurance plans for multiple family members. The collective cost for multiple plans is much higher.

Family floating plans, on the other extreme, are profitable. The most frequently asked question about family floating plans is what happens if one member uses up the coverage limit and another member gets sick. There are solutions for these conditions.

You can top up the coverage limit during the policy period. Of course, you have to pay an additional premium to get the extended coverage.

Can you change from one health insurance plan to another?

Portability is not just limited to the telecommunications sector. The Insurance Regulatory and Development Authority of India (IRDAI) has made portability possible in the health insurance sector.

If for any reason you want to change your health insurance services company, you can submit a change request. Health insurance is offered by general insurance companies, so far, and they cannot deny your portability claim.

They may try to hold you back, but in the end, it is your prerogative to make the final decision. If you encounter a problem related to your health insurance plan, you can file a complaint on IRDAI’s online consumer complaint redress system. It is incredibly efficient and you can expect an action within a period of 15 to 45 days.

However, the IRDAI has taken tough measures to protect consumer rights and there is every chance that your complaints will be resolved by the insurance company itself at the first stage and you do not need to approach the IRDAI in that case.

What about tax exemptions?

In the current tax year ending March 2015, you can claim a tax deduction up to the limit of Rs 15,000 for the payment of health insurance premium, under Section 80D of the Income Tax Act. From the next fiscal year, this limit is set at Rs 25,000 per year.