What Does Your Typical Health Insurance Policy Cover? Can You Customize It?

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The Logical Indian Crew

What Does Your Typical Health Insurance Policy Cover? Can You Customize It?

Even the most diligent person cannot avoid health issues, which is why it is always better to prepare in advance for the unknown.

In the face of this pandemic, there is one lesson to be learned: health is wealth. Moreover, if you do not plan for medical issues early on, you might lose a big chunk of your savings. Here is where health insurance comes into play. A health insurance policy protects a person from unforeseen medical expenses. It protects you financially from future health problems. Let's understand briefly why health insurance is important before we look at what a health insurance policy covers.

What is the need for health insurance?

Even the most diligent person cannot avoid health issues. Thus, it is always better to prepare in advance for the unknown. The following list mentions some reasons as to why every individual needs health insurance :

Changing Lifestyles

The increasing complexity of life has also led to an increase in health disorders. Air pollution, adulterated food, and stressful schedules have made humans more susceptible to illnesses than in earlier times.


Accidents can either be fatal or lead to prolonged health problems. Nobody can predict them; that much is true. Thus, it is wise to buy a financial plan that covers these situations.

Tax Benefits

Investing in health insurance as soon as possible is always a good idea since premiums increase as the age of the insured increases. Furthermore, when you pay for your health insurance premium, you are eligible for a deduction under section 80D, Income Tax Act of 1961. An exemption of Rs. 25,000 is available to the self, spouse, and children, while an exemption of Rs. 50,000 is available if the health insurance is for their parents.

Cost Of Healthcare

Inflation has also contributed to rising medical costs. As a result, healthcare emergencies can have a detrimental effect on both savings and future plans.

Let's review some points a good health insurance policy should cover.

What does a health insurance policy usually cover?

Investing in a health insurance policy is as important as investing in a home, if not more so. To improve the nation's health care, the government has launched many health programs such as Ayushman Bharat Yojna. The following are some basic things every health insurance policy should cover:

Pre And Post Hospitalization Medical Costs

A hospitalization benefit includes reimbursement for all pre-hospitalization costs, such as medicines, doctor fees, diagnosis, and post-hospitalization medical checkups. Different health insurance policies may have different limits on the same. Regardless of the limit, it is one of the core factors of every health insurance policy.

Hospitalization Medical Costs

Most insurance companies offer 100 percent of hospitalization costs if the insured has to stay at the hospital for longer than 24 hours. As part of their policies, some insurance companies even offer a room rental policy. The policy may cover a classic room or a premium room. Some insurance companies may cap the room rent based on the assured sum, whereas others may have no cap.

Network Of Hospitals

Usually, health insurance companies work together with a network of hospitals so that their insured members can receive better medical care at the best hospitals. As a result, you can obtain cashless treatments at the best hospitals in the city if they are listed in your health insurance policy.

Day-care Health Treatment

A health insurance company should also cover small or common health day-care procedures apart from major illnesses. Modern medical technology allows many procedures to be performed in under 24 hours. Health insurance policies can easily cover day-care treatments like dialysis, chemotherapy, radiation, cataract surgery, and tonsillectomy.

Transportation Facilities

Finding an ambulance during an emergency can be hectic as well as costly. Many health insurance companies offer the benefit of transporting patients from home to the hospital or vice versa. As a result of this ambulance benefit, the insured can receive prompt medical assistance.

Preventive Tests

Many health insurance companies offer free preventive tests as part of their policies. These include vaccinations like coronavirus vaccines. Other tests may include checkups for pregnant women, senior citizens, or general breast cancer screenings.

Is it possible to customize a health insurance policy?

Medical needs are unique to each individual. Moreover, what may be suitable for one person may not be suitable for another; this is why companies offer different options for different age groups, illnesses, and more. Thus, yes, it is possible to customize a health insurance policy. Consider the following points when customizing your health insurance plan:

Family Floater Plans

Instead of buying individual health insurance plans for each member of your family, you can opt for a health insurance family plan. In addition to covering every member, it is more affordable than individual policies.

Critical Illnesses

If you or a family member suffer from a chronic health problem or are prone to critical illness based on family genetics, then you need to plan for long-term expenses. In such situations, critical illness insurance makes payments in a lump sum for the medical expenses incurred when the illness is diagnosed.

Lifetime Renewability

As illness can strike at any age, getting a health insurance policy as early as possible is advisable. However, most medical problems only occur later in life, so it is always better to purchase health insurance with lifetime renewability instead of limited renewability.

Fine Prints

In buying a health insurance policy, one should take the following factors also into account:

Waiting period: The period during which an insured with a pre-existing illness cannot claim benefits.

Co-payment: It is the portion of a claim that must be borne by the insured. This is most common in senior citizen plans.

Exclusions: A health insurance policy's exclusions list all conditions, treatments, and procedures that it does not cover. You can then top up or upgrade your basic health plans to include that procedure if you desire it.

Final Thoughts

We hope you have a clear idea of what a health insurance policy should cover with the above information. Since health conditions know no boundaries, it is best to acquire basic health insurance coverage followed by riders or other coverage. A financial advisor can aid you in finding the right health insurance policy for your needs.

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Writer : The Logical Indian Crew
Creatives : Abhishek M

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