Health InsuranceHealth Insurance
What is Health Insurance?
Health insurance, also kinda referred to as medical insurance, is a financial contract where the insurer covers your medical expenses across the policy period in return for the premium you pay. It generally covers a broad set of medical costs like pre and post-hospitalisation, hospitalisation, OPD treatment, AYUSH treatment, surgical procedures, and plenty of other related needs.
If you get injured or you’re diagnosed with an illness, then your health insurance policy covers the related medical expenses for your treatment. This can include doctor consultations and diagnostic tests, along with the actual treatments and follow-up, so most of what you need medically is already looked after, without too much hassle.
With 13,000+ cashless hospitals, premiums that stay fairly affordable, and quick claims, we make sure you get smooth assistance when you need it most, like right at the moment.
To encourage more people to buy health insurance, the Indian government provides tax savings under Section 80D of the Income Tax Act, 1961.
Health Insurance from Arthworth Wealth
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.
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Why Choose Athworth Wealth?
Personalised Health Risk Analysis
We analyse your profile, age, family history, and coverage requirements to identify future risks and protection gaps.
Expert Guidance, Not Just Policy Selling
Our team explains every feature, benefit, waiting period, exclusion, claim process, and renewal condition in simple language so you can make an informed decision.
Premium According to Your Profile
Whether you need basic protection or comprehensive coverage, we compare plans from leading insurance companies and try to provide the most suitable premium and benefits according to your profile and budget.
Solutions for Individuals, Families & Companies
From individual health insurance to family floater plans and corporate employee health coverage, we help secure everyone under one trusted platform.
Dedicated Claim & Renewal Support
Our relationship doesn’t end after policy issuance. We assist with claims, renewals, upgrades, and policy reviews whenever required.
Don't Let Medical Emergencies Drain Your Savings
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.
Benefits of Buying Medical Insurance at an Early Age
Reduced Premium
When determining a medical insurance premium, age plays a significant role. Your premium will be lower if you are younger.
Constant Coverage
You can get through the waiting period for specific and pre-existing diseases (PED) with ongoing coverage through renewals.
Medical Test
If you buy health insurance at a young age, pre-insurance medical screening is not necessary.
No-Claim Bonus
For each year that you have no claims, you are eligible for a no-claim incentive. It will increase the amount covered, which will help you later.
Co-Payment
When you get medical insurance coverage at a young age, there is no need to share your medical expenditures because there is no co-payment.
What Health Insurance Covers and Doesn’t Cover
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.
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.
Cosmetic or Plastic Surgery
Medical insurance policies generally will not cover expenses connected to cosmetic or plastic surgery, especially when the procedure is done purely to enhance one’s appearance.
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.
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 period. The PED will be covered only after the completion of the waiting period.
How Does Our Claim Process Work?
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.
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.
Which Factors Affect Health Insurance Premium?
Age
Because older people are more likely to experience health problems, health insurance rates often rise with age.
Gender
Because certain medical issues are more common in men, premiums may also differ depending on a person's gender.
Policy Type
The elements of the health insurance policy you select will have a big impact on the rate.
Policy Duration
The length of time you have selected for your health insurance coverage may also affect the premium.
Total Amount Covered
As the amount insured increases, so does the premium for your health insurance policy.
Number of Members Covered
The premium for a family health insurance coverage rises as more members are covered.
Health Condition
Pre-existing conditions and your general health can have a big influence on the cost of your health insurance.
Medical History in the Family
Due to elevated health risks, a family history of inherited diseases may result in a higher health insurance premium.
Documents Required to Buy Health Insurance
- Identity Verification: Aadhaar card, passport, driver’s license, etc.
- Proof of Address: Voter ID, passport, Aadhaar card, etc.
- Proof of Age: Birth certificates, passports, Aadhaar cards, and other documents are examples of proof of age.
- Proof of Income: Bank statements, salary pay stubs, income tax return forms, etc. are examples of proof of income.
- Medical Records: Past medical records, prescriptions, etc.
- Prior Health Insurance Records, if any
What Athworth Wealth Provides?
- Free Insurance Consultation
- Health Risk Assessment
- Comparison of Multiple Insurance Companies
- Customised Coverage Recommendations
- Claim Assistance & Support
- Corporate & Employee Health Insurance Solutions
FAQ's
Why is medical insurance important?
In the event of an unanticipated medical emergency, medical insurance provides financial security. In these situations, medical insurance can cover hospital expenses so you can concentrate on your own and your loved ones’ health.
Can I have multiple health insurance plans?
In order to prevent misunderstandings during the claim procedure, it is possible to have more than one Mediclaim policy as long as you are aware of the terms and restrictions.
Why do I need medical insurance?
Medical insurance plans help you shield yourself and your dear ones from all sorts of financial risk or those weird uncertainties that pop up during a medical emergency. With the right health insurance plan from a trustworthy insurance provider, you can safeguard your hard-earned savings and the assets you’ve built up, especially when medical urgencies are rising all around.
Does health insurance cover diagnostic charges like X-Rays, MRI or ultrasound?
Health Insurance policies generally cover various diagnostic tests, like X-rays, MRI scans, blood tests, and others, but only when the diagnosed reason is actually carried out during inpatient hospitalisation of the insured person. If the diagnostic tests are done simply for evaluation or investigation, without a real positive existence of an illness, then those costs are not payable.
How does planned hospitalisation work under health insurance plans?
Approach the hospital before the date of admission for scheduled surgery and submit the filled-out pre-authorisation form. It is possible to give seven to ten days’ notice of a planned hospital stay.