What is a Comprehensive Health Insurance?

Posted on: Aug 2, 2024 | 3 mins | Written by: HDFC ERGO Team

What is a Comprehensive Health Insurance?

With so many options offered by insurance companies, choosing the right healthcare policy is never an easy choice. Especially first-time policy buyers have little clue about the approach they should take. Well, one must evaluate the needs and budget to find a plan that can meet their requirements. Still, many people opt for basic plans because they are cheaper. On the contrary, experts always recommend comprehensive health insurance. Do you know why? It’s because buying a plan that doesn’t offer adequate coverage is as good as not buying it. So, what is comprehensive health insurance? Let’s explore.

What is a Comprehensive Health Insurance Plan?

A comprehensive health insurance policy provides extensive coverage for a wide range of medical conditions, procedures, and expenses. It covers the costs incurred on hospitalisation, pre- and post-hospitalisation, domiciliary care, daycare treatments, ambulance charges, organ donation, AYUSH treatments, etc. Due to broader coverage, comprehensive plans have higher premiums as compared to basic health insurance plans or individual health insurance.

Key Features of Comprehensive Health Insurance

Some key features of comprehensive health insurance include –

• Hospitalisation benefits:

The expenses related to hospitalisation, such as doctor’s fees, room rent, OT charges, ICU charges, nursing fees, diagnostic tests, etc., are covered.

• Pre- and post-hospitalisation:

A comprehensive health plan covers cost incurred before you get admitted to the hospital and after you get discharged. The duration of coverage can vary from insurer to insurer.

• Daycare treatments:

Procedures which do not require more than 24 hours of hospitalisation, like chemotherapy, dialysis, and cataract surgery, are covered.

• Domiciliary care:

If your doctor recommends home care because the patient is unable to be shifted to a hospital or there are no beds available, you can claim the expenses.

• Other benefits:

These include emergency ambulance coverage, organ donation, alternative treatments, free annual check-ups, and lifetime renewability.

Benefits of Comprehensive Health Insurance

A comprehensive health insurance plan comes with several benefits –

1. Wide coverage:

Comprehensive health insurance plans cover a wide range of medical services and treatments, such as hospitalisation, room rent, outpatient services, pre- and post-hospitalisation, daycare procedures, domiciliary care, treatment for critical illnesses, organ donor expenses, ambulance charges, etc.

2. Lifetime renewability:

Many healthcare policies have an exit age, but comprehensive plans offer lifetime renewability. As long as you pay the premium and renew the policy on time, you can continue to avail of the coverage lifelong.

3. Cumulative bonus:

If you don’t make any claims during a policy period, you will get a cumulative bonus benefit, i.e., an increase in the sum insured by a certain percentage with no additional cost.

4. OPD treatment:

Unlike the basic policies, comprehensive plans cover outpatient services, such as doctor consultations, diagnostic tests, etc.

5. Tax benefits:

Under Section 80D of the Income Tax Act, you can claim tax benefits on the premium paid towards health insurance for yourself and your family members.

6. Choice of riders:

If you want to enhance the coverage, you can opt for riders, but you have to pay an additional premium.

7. Cashless claims:

Comprehensive health plans offer cashless claims for getting treated at network hospitals. This means the insurer will pay the bills directly to the hospital, and you don’t need to pay anything except the deductible or co-payment.

Who Should Consider Comprehensive Health Insurance?

Comprehensive health insurance is recommended for everyone because of the extensive coverage it offers. Although it costs more than basic plans, it reduces out-of-pocket expenses during a medical crisis or planned treatment. It is ideal for those with families or couples planning to start a family, people with chronic health conditions or critical illnesses, elderly people, and those who are not covered by group health insurance.

How to Choose the Right Comprehensive Health Insurance Plan?

While choosing a comprehensive healthcare policy, you must assess your health needs first. Then, shortlist plans and compare them based on parameters like coverage, premium, inclusions and exclusions, waiting periods, deductibles, network hospitals, claim settlement ratio, the claim process, and 24*7 customer support. Make sure you select an adequate sum insured based on the number of members insured and their health status. This will ensure every member has adequate protection during an emergency. You must also check customer ratings and reviews about the insurance company to get a clear picture of the credibility and reputation of the insurer. All these will help you choose the right comprehensive health plan that aligns with your specific needs and budget.

FAQs

1. What factors should I consider when purchasing a comprehensive health insurance plan?

You must consider several factors, such as coverage, cost, benefits, waiting periods, network hospitals, customer ratings, claim settlement ratio of the insurance provider, etc. Based on these parameters, you must compare quotes offered by multiple providers and select a plan that best suits your requirements and budget.

2. Does a comprehensive plan offer 100% coverage?

A comprehensive plan covers the majority of the expenses. Depending on the policy, you may have to pay only the deductible or co-payment. However, it’s better to check the inclusions and exclusions before purchasing the policy.

Conclusion

A comprehensive health insurance plan offers peace of mind because of the extensive coverage and financial security against a wide range of medical services. Before buying a comprehensive plan, it’s crucial to read the policy coverage, inclusions and exclusions, and other conditions to ensure maximum coverage for yourself and your loved ones.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.

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