Health Insurance: Features & benefits
Health Insurance guide: features & benefits.
Here is what a good health insurance typically offers. Exact benefits differ by insurer and product, so always read the policy wording.
Hospitalisation cover
Pays for room rent, nursing, doctor fees, surgery, ICU, medicines and diagnostics during an admission of 24 hours or more, within the sum insured and policy terms.
Cashless treatment
At network hospitals the insurer settles eligible bills directly with the hospital after pre-authorisation, so you do not have to arrange the full amount upfront.
Pre- and post-hospitalisation
Expenses before admission (tests, consultations) and after discharge (medicines, follow-ups) are usually covered for a fixed number of days, commonly around 30 and 60.
Day-care procedures
Treatments such as cataract surgery or dialysis that no longer need a 24-hour stay are covered under a list of day-care procedures.
Cumulative bonus
Many policies increase the sum insured for each claim-free year without raising the premium, within a stated cap.
Restore / recharge benefit
If the sum insured is used up in a year, some plans refill it for later unrelated claims in the same year.
Ambulance and AYUSH
Road ambulance charges and in-patient AYUSH treatment (Ayurveda, Yoga, Unani, Siddha, Homeopathy) are covered by many plans up to stated limits.
Free preventive health check-up
Several insurers include an annual check-up after a period of claim-free renewals.
Key terms to know
Cashless claimCo-paymentSum insuredWaiting periodMoratorium periodPortabilityTPA (Third Party Administrator)