Understanding health insurance types: Which One Is Best For You?

Navigating the complicated world of health insurance policies can be intimidating. From understanding the various health insurance types to evaluating different parameters, making an informed decision requires careful consideration. 

Over 550 million Indians were covered by health insurance programmes in the fiscal year 2023. Out of all of them, the largest proportion of persons had health insurance through government-sponsored programmes, while the smallest proportion came from individual insurance policies. India has a low health insurance penetration rate because of its low awareness, and affordability across different socio-economic strata. 

In this guide, we will delve into the importance of health insurance and explore the various plans available.

Importance of Health Insurance

Health insurance serves as a safety net, shielding you and your family from the financial burden of medical emergencies. It offers peace of mind, knowing that one’s health-related expenses are covered, thus allowing you to focus on recovery rather than worrying about the bills piling up. Even minor ailments can lead to significant financial strain. But some of the best health insurance policies can bring you relief.

Understanding the Types of Health Insurance

The best health insurance plans come in various forms, each designed to cater to different needs and preferences. Let’s explore them:

Based on the coverage type

• Comprehensive Hospitalisation Coverage: This plan offers broad coverage for hospitalisation expenses, including room charges, doctor’s fees, diagnostic tests, and surgical procedures. It provides comprehensive protection against a wide range of medical conditions and treatments.
• Arogya Sanjeevani: A standardised health insurance policy mandated by the IRDAI, Arogya Sanjeevani is a popular health insurance in India which offers primary coverage for hospitalisation expenses, making it affordable and accessible to a more significant segment of the population.
• Ayushman Bharat Yojna: Ayushman Bharat Yojana is a nationwide health insurance program initiated by the Indian government’s Ministry of Health and Family Welfare. It aims to offer free healthcare services to over 40% of the country’s population. The scheme encompasses medical expenses, diagnostics, and pre-hospitalisation costs, benefiting the most economically vulnerable families in India.
• Personal Accident Insurance: This health insurance type provides coverage for accidental injuries or death. It offers compensation for disability, medical expenses, and loss of income resulting from accidents, ensuring financial security for the policyholder and their family.
• Critical Illness Insurance: Critical illness insurance provides a lump sum payout upon diagnosis of specified critical illnesses such as cancer, heart attack, stroke, or organ failure. It helps cover the high costs of treatment and other expenses associated with critical illnesses, offering financial support during challenging times.

Based on insured members

• Individual Health Insurance: As the name suggests, individual health insurance offers personalised protection tailored to an individual’s healthcare needs and preferences.
• Senior Citizen Health Insurance: Specifically designed for elderly individuals, senior citizen health insurance offers comprehensive coverage for age-related ailments and medical expenses. It addresses the unique healthcare needs of senior citizens, ensuring their well-being in their golden years.
• Corporate or Group Plans: Employers offer their employees corporate or group health insurance policies as part of employee benefits packages. These plans provide coverage for a group of individuals. They often offer more comprehensive coverage and lower premiums than individual plans, making them an attractive option for employees.
• Women’s Care Health Insurance: Tailored to meet women’s healthcare needs, women’s care health insurance in India plans offer coverage for maternity expenses, gynaecological treatments, and other women’s specific health issues. They provide comprehensive protection for women’s health and well-being. These are also termed as maternity health insurance plans if created for married women’s specifically. 
• Plans for young couples: As the name suggests, certain health insurance plans are created to meet the specific needs of young couples. These plans cover OPD coverage, have lower waiting periods, and come with value-added benefits like regular health check-ups and higher cumulative bonuses since the probability of claiming plans is lower. 

How to evaluate health insurance plans before buying?

Here are some key parameters for choosing the best health insurance plan:

• Coverage: Assess the extent of coverage the plan offers, including hospitalisation expenses, pre and post-hospitalisation expenses, ambulance charges, and more.
• Sum Insured: Determine the sum insured or coverage limit the plan provides, ensuring it adequately meets your healthcare needs and financial capabilities.
• Network Hospitals: Check the list of network hospitals associated with the insurance provider to ensure easy access to quality healthcare facilities in your area.
• Waiting Periods: Understand the periods associated with pre-existing illnesses, maternity benefits, and specific treatments to avoid surprises during claims.
• Claim Settlement Ratio: Consider the insurer’s claim settlement ratio, which indicates the percentage of claims settled by the insurer against the total number of claims received. A higher claim settlement ratio signifies better reliability and efficiency in claims processing.

Key Takeaways

In conclusion, health insurance is crucial for protecting individuals and families from the financial burden of medical emergencies and planned treatments for chronic illnesses. It is vital to compare the available health insurance types and evaluate them based on the critical parameters highlighted in this article. For a hassle-free way to compare and choose the right health insurance plan, use PhonePe and ensure comprehensive coverage for your family.