What is Individual Health Plans
Individual Health Plan as the name suggests, covers a single person as insured under a health policy. With growing stress and hectic lifestyles, people are more prone to health disorders. Individual Health Plans cover an individual against the financial, medical expenses pertaining to the hospitalization. Individual health plans are all the more important for the only breadwinner of the family. Such plans provide comprehensive coverage related to the medical exigencies to the individual.
What kinds of Individual Health Plans can I opt from?
Individual Health Plans are of two kinds
1. Indemnity Plans
Under Indemnity based individual health plans, the claim or payout is paid as per the actual expenses sustained by the insured for getting the treatment done subject to the health cover taken. Indemnity plans don't pay you the total sum assured under the single event of hospitalization. The insured is indemnified to the extent of the actual payout.
2. Fixed Benefit Plans
Fixed benefit health plans are the plans which will offer you a fixed amount of benefits and are paid as lump sum benefits under your individual health plan. Fixed benefit individual health plans pay you’re the complete policy sum assured on the occurrence of the insured event without taking into account the actual hospitalization or treatment expenses. Examples of such plans are Critical Illness Plans or Individual Personal Accident Plans.
What are the Benefits of Buying an Individual Health Plan?
The benefits of buying an individual health insurance plan offer you vast coverage under your health plan which are:
Hospitalization Expenses
Individual health insurance plan safeguards the insured by paying the hospitalization expenses which include
- Inpatient Hospitalization Expenses
Your individual health plan will cover the medical expenses for a minimum of 24 hours of hospitalization. Typically, your health insurer will pay for room rent, nursing, medical practitioner, anesthesia, blood, oxygen, surgical appliances, operation theater charges, medicines, drugs, consumables, and other devices required during a surgical procedure.
- Pre Hospitalization Expenses
Related expenses which are covered 30 days (may vary from insurer to insurer) prior to the actual hospitalization which is related to your medical treatment under the scope of the plan which may include follow up visit charges of a doctor, medicine expenses, laboratory tests, etc.
- Post Hospitalization Expenses
Related expenses for your medical treatment for 60 days post-discharge from the hospital are also covered under the scope of individual health insurance policy like fees for a follow-up with doctor post-discharge, expenses done for diagnostic tests to ascertain the recovery of the treated medical illness, etc.
Daycare Procedure
Certain treatments which do not require a minimum of 24 hours of hospitalization and are treated in less time because of technological innovation are also part of the individual health insurance policy. There is an exhaustive list that every insurer has of covered daycare treatments under the scope of the plan.
Domiciliary Treatment
Expenses pertaining to the medical treatment done at home are also paid under the individual health insurance policy which otherwise requires hospitalization for the same. This treatment can be undertaken by the undertaking given by the medical practitioner for getting it done at home due to unavailability of space in I hospital or critical condition of the insured patient, etc.
Hospital Cash Benefit
A hospital cash allowance is payable on a day-to-day basis. The hospital cash benefit depends on the terms of the policy. A specified minimum stay in the hospital is required to avail of this facility.
Organ Donor
Expenses related to the treatment of the organ donor are also paid under your individual health insurance plan in the need of organ transplant.
Cashless Treatment
By taking an individual health insurance plan, you may avail cashless medical treatment for your illness or disease if you chose to get it done under the listed framework of the network hospitals of the insured.
No Claim Bonus
You are entitled to a no-claim bonus for your individual health insurance policy which is a benefit accrued in the event of a claim-free policy year. Your insurer will reduce your premium by the bonus amount or may enhance your health cover by the same.
Tax Benefits
The premium amount you pay for your own health policy or your family’s health plan is considered for tax benefit under section 80D of the Income Tax Act 1961. These benefits are subject to changes in tax laws.
Miscellaneous Benefits
Insurers also offer you to undertake free health checkups at the time of renewal of your policy or as an inbuilt add-on cover with your policy. Ambulance expenses are also paid by most of the insurers under the scope of your chosen individual health insurance plan.
(Note: The benefits mentioned above may differ from one insurer to another. Read your chosen Individual Health policy wordings carefully for more details)