DOI : 10.17577/Health insurance in India acts as a financial safety net, covering medical expenses like hospitalisation, surgeries, and treatments. You pay a premium to your insurer, and in return, they pay or reimburse your healthcare costs.
For example, you can pay a yearly premium of Rs. 10,000 and get a coverage of Rs. 5 lakh. Are you curious how you can get these benefits? Let us dive into the health insurance process in India.
Working of Health Insurance in India
Here is a detailed process on how health insurance works in India, with an example:
1. You Pay a Premium
To get the various health insurance benefits, you need to pay a premium regularly. This can be monthly, half-yearly, quarterly or annual basis. In general, the premium for an individual health insurance can start at Rs. 8,361/year (approximately) for a coverage of Rs. 10 lakh.
2. You Get Financial Protection
Did you know, the average cost of a bypass surgery (CABG) in India ranges from Rs. 1.8 lakh to Rs. 3.6 lakh. Arranging such a huge amount of money during an emergency can be difficult. A health insurance policy helps you avoid financial strain by covering such operations and other associated costs at an affordable premium.
3. You Get Cashless Medical Assistance
Lastly, buying health insurance provides access to cashless claims at network hospitals. It entails that you get complete care without compromising your family’s well-being. Your insurance provider covers the hospital cost directly, minimising your out-of-pocket expenses. To get this, you need to file a claim with your insurer.
4. Access Preventive Health Checkups
Preventive health checkups play an important part in staying healthy. These tests can identify potential diseases or illnesses early on and help save you money. Many health insurance policies cover the cost of preventive checkups, including vaccinations, wellness visits or screenings. However, you have to visit the network diagnostic centre to get this.
How to Buy a Health Insurance Policy in India?
Knowing how health insurance works in India starts with understanding the purchase process. Follow these steps below:
1. Evaluate Your Needs
The first step is to be clear about why you need a health insurance policy. Think about any specific medical needs or critical illnesses that you need to get covered. You must also determine whether you want a health insurance for individual, family or senior citizen.
2. Financial Planning
Your next step is to set your budget. This step helps you save money so you can avoid spending more on unaffordable health insurance. You can use a health insurance premium calculator so that you get an idea about how much a policy could cost you.
3. Compare Different Plans
After you figure out your needs and set a budget, compare different plans from various insurance providers. Look for companies with a high claim-settlement ratio (CSR), preferred network hospitals and customisable add-ons. Also, make sure to check what illnesses are covered.
4. Make Your Purchase
After you find a suitable policy, read the policy documents carefully. Check the premium and if it is satisfactory, make the payment through a secure payment gateway.
Pro Tip: If you buy health insurance online, you are eligible for more discounts on your premium.
What is the Renewal Process of Health Insurance?
When looking for a health policy working guide, it is important that you know how to renew your existing policy as well. The steps to do so online are:
- Visit Your Insurer app or website
- Enter your policy number and mobile number
- Review your existing policy and make any changes if needed
- Pay your premium and secure your new policy documents
This is an important aspect of the health insurance process. Once you buy a policy, you have to renew it to continue getting all the benefits.
Note: This is a general instruction and may be slightly different for different insurance companies.
How Can You Claim Health Insurance in India?
The last step in the health insurance process is the claim procedure. There are 2 types of claim procedure:
1. Cashless Claim Process
In this, you do not need to pay anything out of your own pocket in an emergency. You just need to inform your insurer and visit a network hospital. The hospital will directly charge your insurer, giving you peace of mind.
2. Reimbursement Claim Process
In the reimbursement process, you have to pay for the medical expenses out of your own pocket. However, your insurer will reimburse you the amount, provided you can show them proper bills and receipts.
The Bottom Line
To ensure a smooth claim experience, it’s wise to choose from the best health insurance in India—plans that offer high claim settlement ratios, wide hospital networks, and hassle-free digital claim services. Understanding the health insurance process helps you use it wisely. From choosing the right plan to claiming benefits smoothly, you can easily get peace of mind. Plus, with the new 0% GST rule on health insurance premiums, you can save like never before.
