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Why Should You Buy Individual Health Insurance

Understand why you need individual health insurance

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Health insurance exists in a variety of shapes and sizes, but their main goal is to give the policyholder adequate financial coverage against rising medical inflation. When it comes to individual health insurance coverage and family health plan, there are some differences.

Let’s discuss how they work to determine which plan is more suitable for you!

What is Individual Health Insurance? 

An individual health insurance plan is a policy that covers a single person under the policy against medical bills and hospitalization costs. You can purchase an individual health insurance policy for yourself, your spouse, your children, or even your ageing parents.

Usually, the premium rate is determined by the policyholder's age, gender, medical history, and a variety of other factors. With such plans, you can get a more comprehensive coverage that is tailored to your specific needs and health conditions. Moreover, add-ons can be purchased to expand the coverage of the individual health insurance plan.

Key Features of Individual Health Insurance 

You can purchase an individual health insurance policy for each member of your family separately. If you have a family member who requires additional health coverage and there is a potential that his or her medical bills will exceed your budget, it is always a good idea to purchase an individual health insurance policy for them. It will be more helpful from both a financial and health standpoint if you do so.

What is Mediclaim policy - Max Life Insurance

Here are some features of an individual health insurance you should know:

Coverage

An individual health insurance policy provides coverage solely for the person insured. Based on the terms of the individual health insurance policy, the insurance provider pays a certain sum of the medical costs incurred by the policyholder.

Co-Payment

For certain health-care services, the insured must pay a specified fee. This is referred to as co-payment.

Inclusions

Depending on the policy terms, the individual health insurance policy covers both pre- and post-hospitalization expenses. Most individual health insurance plans cover costs of operation, room rent, physician's fee, and laboratory testing.

Renewability

Individual health insurance also comes with lifetime renewability so you ca stay covered for an extended period.

Additional Coverage

You can also get coverage for critical illnesses with individual health insurance.

Benefits of Buying Individual Health Insurance

Individual health insurance policies have numerous advantages. Take a look at some of the most significant advantages listed below:

1. Medical expenses are covered 

The most significant and primary reason of purchasing individual health insurance is for protection from unforeseen medical costs. It protects you from facing serious financial trouble if you have a health problem by relieving the burden of medical expenses, allowing you to concentrate on getting better.

2. Cashless Claim Facility

In a cashless hospitalisation scenario, the insurance company pays the hospital or nursing home directly. You can use the cashless benefit offered by your insurance in the case of a medical emergency or a circumstance when you are expected to be hospitalised.

Under an individual health insurance policy, a cashless hospitalisation facility given by health insurance companies allows an individual to receive medical care without having to pay for it at the hospital. However, this service is only provided in hospitals that are enlisted in the network hospitals of the provider.

3. Daily Hospitalisation Allowance

Some insurance companies pay the insured a predetermined amount for each day he or she spends in the hospital. This, however, only applies after the insured has spent a few days in the hospital.

The number of days spent in the hospital is always pre-determined in the individual health insurance policy, and it may differ from one firm to the next. If you are the primary breadwinner in your family, this allowance can be beneficial.

4. Tax Benefits

When you look at your yearly tax benefits, you will see that individual health insurance is on the list. This helps you preserve not just your financial plans, but also your most valuable asset: your health. Section 80D of the Income Tax Act, 1961 allows you to deduct the premiums paid for an individual health insurance coverage.

Family Health Plan vs. Individual Health Insurance

Though both individual insurance and family health plans have the same goal of providing insurance coverage for the protection of your assets and the needs of your family, there are significant differences between them.

As a policy buyer, you should know the following things before choosing an individual health insurance plan or the best medical policy for family:

Family Health Plan vs. Individual Health Insurance

Though both individual insurance and family health plans have the same goal of providing insurance coverage for the protection of your assets and the needs of your family, there are significant differences between them.

As a policy buyer, you should know the following things before choosing an individual health insurance plan or the best medical policy for family:

 

Criterion

Individual Health Insurance

Family Health Plan

Who is covered?

Health insurance premium and the total insured are for one person only

Family members are covered under the same policy

Sum Insured

You can select a specific sum insured to cover the insured individual.

A family health plan covers the entire family for a single premium.

Affordability

Higher premium rates

Substantially less expensive

Advantages

Comprehensive coverage

premium is affordable because it is paid once for all family members.

Who Should Buy Individual Health Insurance? 

While it is widely acknowledged that in today's fast-paced and stressful world, everyone should benefit from health insurance, it is critical to emphasize that you should do your study before purchasing any such policy. 

If you fall into any of the following categories, you should consider buying individual health insurance:

  • Individuals with higher health risks are best suited for the plan.
  • Individuals who are uninsured but have family members who are.
  • A person who prefers a fixed sum insured over a floating sum insured.
  • Individuals who choose to renew their insurance policy without regard to their age.
  • An individual who requires more protection than a family floater plan can provide.
  • An individual who prefers cashless and quick claim settlements.
  • Individual health insurance is also applicable for student, self-employed and people of ages 18 and 26 years.

It is in your best interest to get an individual health insurance policy after learning and comprehending the benefits, exclusions and inclusions. It is vital to understand what your health insurance policy covers, but it is also critical to understand what it doesn't cover. Simultaneously, examine the terms and conditions listed in the policy wording carefully before selecting the coverage for the individual health insurance.

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  • Individuals who are uninsured but have family members who are.
  • A person who prefers a fixed sum insured over a floating sum insured.
  • Individuals who choose to renew their insurance policy without regard to their age.
  • An individual who requires more protection than a family floater plan can provide.
  • An individual who prefers cashless and quick claim settlements.
  • Individual health insurance is also applicable for student, self-employed and people of ages 18 and 26 years.

It is in your best interest to get an individual health insurance policy after learning and comprehending the benefits, exclusions and inclusions. It is vital to understand what your health insurance policy covers, but it is also critical to understand what it doesn't cover. Simultaneously, examine the terms and conditions listed in the policy wording carefully before selecting the coverage for the individual health insurance.

 

Why Individual Health Insurance? 

An Individual Health Insurance plan provides financial assistance in the event of a single person's medical emergency. These plans are extremely comprehensive and can be purchased to cover each individual based on the plan's entry age. Individual health insurance plans can be customized to meet one's specific needs.

Customized Benefits

A policyholder can choose the level of coverage that best suits his or her medical needs. This may also be determined by the policyholder's budget. A comprehensive plan can be chosen and customized with the inclusion of extra coverages (add-ons).

Personal Sum Insured

Each health insurance coverage has a maximum amount that can be paid out. In a group policy, this sum covered may have to be shared with other plan members. An individual health insurance plan, on the other hand, devotes the whole sum insured to covering only the policyholder.

Cost-Efficient

Individual health insurance plans are less expensive than group health insurance coverage. This is because the cost of a Family Floater plan, for example, is determined by the number of people insured by the policy. In this case, the cost of medical insurance is limited to the coverage and services provided by the insurance company. Dedicated coverage is less expensive.

Individual Health Insurance: Documents Required 

Some documents that are required to purchase individual health insurance include:

  • Age Proof – Voter ID card, Driving License, PAN card, Aadhar Card, Passport, Birth Certificate
  • Identity Proof- Voter ID card, Passport, Aadhar Card, Driving License
  • Address Proof – Ration Card, Driving License, Passport, Rent Agreement, Utility Bills, PAN Card, Aadhar Card.
  • Passport-Sized Photographs
  • Medical reports, if necessary
  • Proposal form duly filled in and signed

Individual Health Insurance| Things to Keep In Mind 

Buying a individual health insurance policy should not be a random or spontaneous decision. To get the most out of your coverage, you must first understand your needs and the fundamentals of health insurance. Then and only then will you be able to get a good policy for yourself. Continue reading to learn about considerations to make while purchasing health insurance:

Coverage Amount 

The amount of money insured will be the most important factor to consider when purchasing your policy. This will determine the scope of your coverage in the event of an unpleasant event. Keep in mind that the bigger the sum covered, the more expensive your health insurance policy will be.

Network Hospitals

An individual health insurance policy has two options for claim payout – cashless or reimbursement. When you have already paid your bills and want your insurer to pay you for your financial loss, you are in the latter category.

You must seek treatment exclusively at a network hospital to be eligible for a cashless claim. Because your insurer will have a network of hospitals through whom it will directly pay the bill with the authorities, this is the case.

Waiting Period

Before a policy can give financial assistance for a specific medical condition, many policies have a waiting or cooling period. You can make claims for the coverage once the waiting period is over.

Exclusions

The list of exclusions is one of the most important things to look over when purchasing health insurance. These are instances in which you are unable to file a claim. The insurer usually has a set of restrictions in place, but it's crucial to know which exclusions apply to your health insurance coverage. Reading the exclusions can help you avoid any chances of claim rejection.

Frequently Asked Questions (FAQs)

1. What Is Meant by Pre-Existing Conditions in Individual and Family Health Plans? 

Pre-existing health issues are medical conditions that you have already been diagnosed with, when you purchase a health insurance policy.

Pre-existing health issues are not covered by most top insurers for periods of time ranging from 2-4 years. This means that if you are admitted to the hospital because of a pre-existing ailment, your insurance company will not reimburse your costs for up to 2-4 years. Your pre-existing conditions will be covered by your health insurance policy once the waiting period is finished.

2. Should I Get Individual or Mediclaim Insurance for Family? 

This decision depends entirely on the financial and health history of you and your family members. In case you have loved ones with more complex health needs, it is best to opt for individual health insurance for them instead of relying on Mediclaim insurance for family.

3. Do I Get No Claim Bous with Individual and Family Health Plans?

In health insurance the policy's sum insured is increased by a percentage for each year without a claim. However, a few insurance companies use the No Claim Bonus as premium discounts for the next year.

4. How Does Tax Benefit Work for Family Health Plans?

You can claim a tax deduction of up to Rs. 25,000 on health insurance premiums paid under Section 80D of the Income Tax Act. For health insurance obtained by a senior adult above the age of 60, the limit is Rs. 50,000.

You can claim a deduction of up to Rs. 75,000 if you are under 60 years old and purchase an individual health plan for yourself as well as a separate individual plan for your senior parent. Similarly, you can claim a tax credit of up to Rs 1,000,000 if both of your parents are over 60 years old and you have paid for their health insurance.

5. What Are the Types of Individual Health Insurance Plans in India?

Individual health plans are further subdivided into the following forms of health insurance:

  • Senior Citizens Health Insurance
  • Critical Illness Insurance
  • Personal Accident Insurance
  • Maternity Health Insurance

6. Is cashless treatment available under individual health insurance?

Yes, you can get cashless treatment under individual health insurance if you get the treatment done at one of the network hospitals of the insurance provider.

7. Is there any waiting period available under individual health insurance plans?

A waiting period may be applicable on your individual health insurance plan in case a specific disease is covered under the policy. If not, then there will be a minimum waiting period before the coverage kicks in.

8. How much individual health insurance should you have?

The amount of cover for your individual health insurance plan depends on your health requirements and financial profile. It is best to understand and carefully assess your needs before you opt for the coverage.

9. What is covered under Individual Health Insurance?

Most individual health insurance policies cover an individual's emergency medical expenses, including those incurred as a result of hospitalisation, day care operations, ambulance services, alternative therapy, organ donor expenses, and so on.

9. What is not covered under Individual Health Insurance?

Your individual health insurance plan may not cover cosmetic surgery costs, pre-existing diseases, maternity benefits depending on the policy. However, it is best to consult with the insurance provider once before you purchase the policy to avoid any disappointments in the future.

 

Sources:

https://www.policyholder.gov.in/uploads/CEDocuments/Guidelines%20on%20Standardization%20in%20Health%20Insurance%202016.pdf

https://www.policyholder.gov.in/uploads/CEDocuments/Renewability%20of%20Health%20Ins.pdf

https://www.incometaxindia.gov.in/Pages/tools/deduction-under-section-80d.aspx

ARN No : Dec21/Bg/13

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