Health
Insurance
What is Health Insurance?
During medical emergency, health insurance protects against unstable finances. Medical insurance is crucial for people of all ages, despite the widespread belief that it is primarily important for the elderly or those with current health issues. By covering your medical expenses, the top health insurance plan in India provides comfort throughout hospital stays.
Every year, medical expenses rise, raising concerns about the need for health insurance. Your safety net could be a health insurance plan that covers unforeseen medical expenses or provides cashless treatments. Because it can be purchased on an individual or floater basis to offer full coverage, health insurance offers flexibility.
Health Insurance for Everyone
Investing in your health is an investment rather than a cost. Everyone, regardless of age, needs medical insurance due to the rising health threats. In order to protect you and your family from financial difficulties and ensure that you never compromise on your health, we provide one of the top health insurance plans in India.
We offer health insurance in India that gives people prompt assistance throughout the whole claim settlement procedure and gives people and families professional advice. The safest method to protect your physical and emotional health in the event of a medical emergency is to purchase medical insurance coverage.
Types of Health Insurance Plans
Indemnity Health Insurance Plans
Indemnity health insurance plans usually cover the actual medical outgo you incur, whether you get treatment through cashless facilities or you later request a reimbursement. These kinds of mediclaim plans tend to be offered on an individual basis, as well as on a floater basis. In general, they give protection up to the opted sum insured.
Fixed Benefit Health Insurance Plans
Fixed benefit health insurance plans offer a lump sum cover for major critical illnesses like cancer, chronic kidney disease, brain tumour, and similar conditions. Considering the financial strain a person might face during a life-threatening critical illness, the policy pays the insured amount in one go. So it becomes a sort of immediate relief during stressful times.
Top-Up Health Insurance Plans
Top-up health insurance plans offer extra coverage even after the sum insured under your current policy is exhausted. Often the opted cover can feel just a bit short for real medical requirements. In those situations, a top-up plan can step in and strengthen your financial safeguards by adding additional coverage beyond what was already available.
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What Health Insurance Covers and Doesn’t Cover
Inclusions
Hospitalisation Expenses
Most medical insurance plans usually take care of hospitalisation expenses, like room rents, ICU charges, surgery expenses, doctor consultations, and the rest of it, when these are linked to illness, injury or accidents in general.
Pre & Post-Hospitalisation
Due to how medical expenses keep going up, most medical insurance policies now also cover pre and post hospitalisation expenses, especially when it’s an inpatient hospitalisation situation, you know, the period before and after.
Day Care Treatment
Because technology has improved a lot, surgeries and treatments that once needed a long time now often finish faster. So, a medical insurance policy will cover day care treatments and procedures.
Domiciliary Hospitalisation
Some policies go further and cover domiciliary treatments, meaning treatment at home, on the advice of a medical practitioner.
Organ Donor Expenses
Most medical insurance plans cover organ donor expenses too. Organ harvesting and the transplantation costs are included if the insured person is the recipient
Road Traffic Accident
Accidents are unpredictable, full stop. Therefore, most mediclaim plans cover in-patient hospitalisations that happen due to road traffic accidents
AYUSH Cover
Along with allopathic treatment, many medical insurance plans also cover alternative medicine systems like Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homoeopathy.
Health Check-up
Along with hospitalisation and other benefits, medical insurance policies also reimburse the expenses incurred for health check-ups, which feels pretty helpful.
Automatic Restoration
But what if your medical expenses cross the sum insured? In those cases, the restoration benefit of your health insurance policy works in an automatic way, and it restores 100% of your sum insured after it is fully or partly used up.
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Exclusion
Self-Inflicted Injuries
Any kind of self-inflicted injury will not be covered under medical insurance policies, even if it seems minor or temporary.
Obesity / Weight Control
Most medical insurance policies will not cover costs that come up from obesity treatment or weight control programs, including related therapies.
Hazardous or Adventure Sports
Medical insurance policies will not cover expenses tied to health complications that happen while indulging in hazardous or adventure sports.
Dental Treatments
Most medical insurance plans will not cover dental treatment or surgery unless it is required due to accidental injuries and it involves hospitalisation.
Medical Aid
Medical insurance policies typically will not cover the costs of spectacles, hearing aids, wheelchairs, walkers, crutches and other similar medical aids.
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Waiting Period
Specific Diseases
Specific diseases are basically a sort of shortlist of illnesses or sicknesses for which the Health Insurance Company keeps a waiting period. The medical costs that happen because of these issues will be taken care of only after the waiting period ends.
Maternity Benefit
Most Medical Insurance plans include maternity benefits along with a newborn cover. These types of benefits can usually be claimed once the waiting period has been completed.
Initial Waiting Period
The initial waiting period means the stretch of time when the policyholder is required to wait before they can use the policy benefits. But this rule will not apply for hospitalisation costs related to accidents, as those expenses will be covered starting from day 1.
Pre-Existing Diseases
Pre-Existing Diseases, often called PED, are the current health condition of the person before buying the policy. Every Health Insurance Company keeps its own PED waiting duration. The PED will be covered only after the completion of the waiting period.
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How Does Our Claim Process Work?
Cashless
Claim Notification: Fill out the pre-authorisation form at our network hospital to notify us of the claim.
Claim Status: We update the claim status following the claim notification.
Hospitalisation: Network hospitals offer cashless care after the claim is accepted.
Claim Settlement: We work directly with the network hospital to resolve the issue.
Reimbursement
Hospitalisation: If you are admitted to a non-network hospital, you are responsible for covering your initial medical costs.
Claim Intimation: Send in your claim form, hospital bills, and any other necessary paperwork.
Claim Verification: We update the claim status after confirming the papers.
Claim Settlement: We will handle the compensation after the claim is accepted.
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Athworth Wealth Pvt Ltd is a leading financial services firm dedicated to empowering clients and channel partners through innovative investment solutions and cutting-edge technology.
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Contact Info
- 14/3 Ideashacks Near Mewla Maharajpur Metro Station, Sector 31, Faridabad, Haryana 121003
- 3rd Floor B, D Block, Sector 2, Noida, Uttar Pradesh 201301
- +91 9821286788
- info@athworth.com
- Office Hours: 9AM - 6PM