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The linked insurance product do not offer any liquidity during the first five years of the contract. The policy holder will not be able to surrender/withdraw the monies invested in linked insurance products completely or partially till the end of the fifth year.
Health insurance plans offer financial protection against expenses arising from medical treatments and emergencies. In this fast-paced world, changing lifestyles prove health insurance is not just an option but an ultimate necessity!
Tata AIA Life brings you a host of health insurance plans along with life insurance cover to protect you and your family. Choose a Tata AIA health cover and ensure complete financial preparedness in case of any medical expenses - big or small, planned, or unplanned.
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Health insurance is a financial product that offers coverage against any of your medical or surgical expenses. These can include hospitalisation and treatment costs for injuries, minor infections, and critical illnesses. Simply put, it acts as a financial shield during times of medical emergencies.
Health insurance plans offered by life insurance providers like Tata AIA offer a life cover in addition to health insurance policy coverage. The insurance/medical coverage is offered in exchange for timely premium payments, like all other insurance plans. Health insurance benefits can be accessed through cashless claims or reimbursement claims based on your preference. Furthermore, you can customize the health insurance policy to your advantage by choosing the features based on your budget.
Health Insurance at a Glance
Features |
Details |
Claims |
Cashless Claims Reimbursement Claims |
Coverage |
|
Fixed Benefit Payout including pre and post hospitalisation, diagnostic benefit, etc. |
Covered |
Day Care Procedures |
Covered |
OPD Cover |
Available |
ICU Charges |
Covered |
Free Health Check-ups |
Available |
Pre-existing Diseases |
Covered* |
Ambulance Cover |
Available |
Critical Illness Cover |
Available |
Benefits |
|
Tax Benefits5 |
Up to ₹1,00,000 per financial year under Section 80D |
*Pre-existing diseases are only covered after their waiting period has been completed.
Add Riders6 to increase your policy coverage
For Financial Security
No one can predict the future when it comes to their health and well-being. Regardless of how well you take care of yourselves and lead healthy lifestyles, injuries, and critical illnesses can affect you at any time and can be financially taxing.
However, getting a health insurance policy can help you exercise a great degree of control over your medical expenses and offers a way to safeguard yourself and your family financially.
For Changing Lifestyles
With the ever-changing nature of our world, today's lifestyles bring a range of health issues, from lifestyle disorders like obesity and diabetes to pollution-induced illnesses like asthma and lung cancer.
Therefore, buying the best health insurance plan that covers your emergency medical expenses and provides opportunities to improve your current lifestyle issues through annual check-ups or wellness programs becomes crucial.
For Rising Medical Costs
Medical inflation has become a significant issue over the recent years, and nearly everyone has felt its impact. If you live in a large metropolitan city, you are already aware of how much hospitalizations, medicines, and medical examinations can cost.
For Tax Benefits
Not only does health insurance financially shield you during a medical emergency, but it also offers significant tax benefits under old tax regime. These benefits can be availed annually under your health insurance premium payments.
You can get a maximum deduction of ₹25,000 or ₹50,000 depending on your age and the age of your dependents included under the policy. You can avail a preventive health check-up deduction of up to ₹5,000, which is included and counted toward your overall deduction limit of ₹25,000/₹50,000. These health insurance tax5 benefits can be availed under Section 80D of the Income Tax Act 1961, by opting for old tax regime.
Offers Affordable Coverage
Health insurance plans offer wide-ranging benefits at an affordable premium rate. Furthermore, if you purchase a health insurance plan at an early age, you will be offered lower premium rates, granting you access to more affordable health insurance plans.
Covers Wide-Ranging Health Complications
With health insurance plans, you can ensure coverage against wide-ranging health complications and their treatments, including critical illnesses, surgeries, day care surgeries, and disability; wellness benefits, including free annual health check-ups, nutrition and weight loss consultations, chronic care coaching, etc.
The specific procedures covered and the limits on these benefits can vary depending on your chosen health plan.
The premiums paid for a health insurance policy in any mode other than cash will qualify for a tax deduction benefit under Section 80D of the Income Tax Act under old tax regime. The deduction applies to a health insurance plan purchased by an Individual or Hindu Undivided Family (HUF) for self, spouse, and dependent children. Furthermore, if you have purchased a health insurance policy for your dependent parents. You can claim a tax deduction in addition to the tax deduction benefit applicable to yourself and your family. Also, you can avail a tax deduction of up to ₹5,000 for payments made for a preventive health check-up for yourself, your family, and your dependent parents within the prescribed limits. The deduction is applicable to any mode of payment, including cash.
Here is a table detailing applicable annual tax deductions under old tax regime on
Health Insurance Policy Purchased for |
Deduction Applicable to Self and Family |
Deduction Applicable to Parents |
Preventive Health Check-up |
Maximum Deduction Under Section 80D |
Self, Spouse, and Dependent Children |
₹25,000 |
- |
₹5,000 |
₹25,000 |
Self, Spouse, and Dependent Children + Parents |
₹25,000 |
₹25,000 |
₹5,000 |
₹50,000 |
Self, Spouse, and Dependent Children + Parents (Above 60 years) |
₹25,000 |
₹50,000 |
₹5,000 |
₹75,000 |
Self, Spouse, and Dependent Children (Above 60 years) + Parents (Above 60 years) |
₹50,000 |
₹50,000 |
₹5,000 |
₹1,00,000 |
Members of HUF (below 60 years) |
₹25,000 |
₹25,000 |
₹5,000 |
₹25,000 |
Members of HUF (a member is above 60 years) |
₹50,000 |
₹50,000 |
₹5,000 |
₹50,000 |
Therefore, you can receive a maximum of up to ₹1,00,000 for the health insurance premiums paid under Section 80D in a financial year.
An ideal health insurance plan caters to healthcare requirements specific to you and your family. Hence, you must choose the right type of health insurance policy for adequate coverage and exclusive benefits. Here are the most common types:
It is one of the most common types of health insurance plans. As the name suggests, it offers coverage for one person, i.e., the policyholder. Therefore, all the medical or hospitalisation expenses are reimbursed for the policyholder.
However, a few health insurance plans for individuals allow you to include a certain number of family members as dependents under the same plan at an additional premium.
Family health insurance offers coverage for your whole family. You can raise claims for individual family members or multiple family members simultaneously until the sum insured is exhausted.
The family health insurance premium is based on the age of individual family members and related health concerns.
Since most basic health policies have a maximum entry age of 65 years, insurers offer a separate policy type for senior citizens. These are called senior citizen health insurance policies and can be bought by anyone over the age of 60.
It offers specialized medical coverage for health concerns that come with old age and usually includes additional features like lifetime renewability and free annual health check-ups.
A critical illness cover gives you comprehensive coverage in the form of upfront payouts upon diagnosis of life-threatening illnesses such as cancer, myocardial infarction, cardiac arrest requiring permanent cardiac pacemaker or ICD insertion, benign brain tumor, open heart replacement or repair of heart valves, etc.
These plans provide enhanced coverage for medical treatments and procedures, medicines, and hospitalisation costs through lump sum payments.
Cancer insurance plans are specifically built to cover medical costs related to cancer treatments, procedures, surgeries, and medication. This insurance coverage is usually included as an optional cover under other health plans for an additional premium.
Here are some key points to look into to ensure you pick the best health insurance plan that suits you and your family:
Coverage
The first thing you need to check when browsing health insurance plans is the sum insured ranges offered and the medical treatments covered under the plan. The sum insured should be enough to cover most if not all, your medical expenses – including emergencies.
Look for medical coverage that is relevant to your health status. For example, coverage for hospitalisation, ambulance charges, day care treatments, maternity treatments, AYUSH treatments, etc., are some common inclusions to look for.
Premiums
The affordability of the health insurance plan is the next thing to look for. Does it offer the best bang for its buck?
We recommend using tools like online health insurance premium calculators as they offer real-time, accurate quotes and let you play around with the configuration of your health policy.
In addition, if you purchase it at a younger age, you can benefit from even lower premium rates.
Furthermore, most online insurers will also offer discounts on their best health plans when you buy them online from their website and even have preferential rates for certain demographics.
For example, Tata AIA offers preferential rates and discounts for women policyholders.
Co-Payments, Sub-Limits, and Deductibles
These will also play into your health insurance policy's affordability. Depending on the insurer, they can be mandatory or optional. They allow you to pay for a part of the medical treatment while your insurer covers the rest of the expense. Opting for them can help reduce your premiums.
However, only go for these if you are sure of your ability to pay each time, as they are fixed at the time of policy purchase. Generally, we recommend going for plans that do not have mandatory sub-limit or co-payment clauses to avoid any financial burden during claim settlements. For example, Tata AIA Pro-Fit has no co-payment or deductible clauses.
Insurer's Reputation and Claim Settlement Ratio
Your insurer is as important as your health insurance policy. Checking the insurance provider's reputation through reviews and testimonials can give you a good idea of their after-sales services.
Moreover, the insurer's Claims Settlement Ratio (CSR) can also give you a peek into their ability to acknowledge and settle claims. Look for insurers with high CSRs and good customer reviews. For reference, Tata AIA's Individual Death Claim Settlement Ratio7 is 99.13% for FY 2023 - 24.
Lifetime Renewability
The best health insurance policies offer lifetime renewability. Check if your chosen plan offers this feature or if it has a maximum cut-off age for renewals. This is because you will most likely need a medical insurance plan when you are older.
Buying a new policy as a senior citizen can be expensive and difficult. Hence, check if your plan comes with this feature so you can continue with the same plan in your older years. Our Tata AIA Pro-Fit plan offers health coverage for a whole life, which means it is a lifetime plan offering coverage for up to 100 years. It avoids the hassle of yearly renewals.
Pre-Existing Disease Coverage
Check if your health plan has pre-existing disease coverage and the corresponding waiting time to claim that coverage.
Add-On Covers
Check if the health insurance plan offers add-on riders6, as these can help extend your plan's coverage. Some common add-ons you should check for are critical illness cover, maternity cover, personal accident cover, OPD cover, accidental death cover, etc.
Family Coverage
Check if the plan offers family floater options or variants, as these tend to be cheaper if you want to insure your family members as well. They are also easier to maintain as you will only need to pay health insurance premiums and track paperwork for one plan rather than multiple plans.
The coverage options differ between the individual insurance providers and their policy options.
The list of exclusions under a health insurance plan will vary depending on your insurer and the individual policy options. Here are some standard exclusions under most health insurance policies:
The eligibility criteria to buy health insurance differs depending on the type of health insurance plan Policy Term - Traditional health insurance plans offer coverage for one policy year or up to three years and have to be renewed regularly after this period for continued coverage.
Mandatory pre-medical screenings are mostly only required for candidates over the age of 45 and senior citizen health insurance plans before policy purchase.
Pre-existing illnesses almost always have a waiting period under health insurance plans and are only covered upon completion of the waiting period.
The waiting period can be at least 2 years and, however, depends on the type of disease and the insurer's specific policy terms and conditions.
Now that you have understood the importance and benefits of health insurance, making a well-informed decision is crucial for ensuring its coverage at an affordable premium.
Here is how you can use a health insurance premium calculator to determine the premium for your health insurance coverage based on your requirements.
Health insurance plans do not require mandatory health check-ups from younger applicants below a certain age – under 45 years, because they are less likely to have poor health or require extensive coverage.
The only exception to this is, of course, if they happen to have a pre-existing illness.
Health insurance plans do not require mandatory health check-ups from younger applicants below a certain age – under 45 years, because they are less likely to have poor health or require extensive coverage.
The only exception to this is, of course, if they happen to have a pre-existing illness.
Health insurance policies allow you to claim compensation or insured medical treatments by filing claims. You can file two types of claims:
Reimbursement claims where you pay for the expenses, and your insurer will reimburse you for the payments later. So, if you are wondering how to claim health insurance with Tata AIA, we have provided step-by-step instructions for both claims processes below
If you are receiving treatment and paying at a hospital for an insured treatment or procedure, you file for a reimbursement claim through our website.
Ensure that you maintain all original bills and receipts, as you must submit them for reimbursement.
Here is how you can file for a reimbursement claim online:
For a more detailed list of documents for each claim type under Tata AIA, click here.
Lastly, let us clear a few presumptions you may have about health insurance policies.
Despite growing awareness, health insurance penetration in India is low. Moreover, with increasing awareness, there are many health insurance myths. Some common misconceptions include
Wide-ranging Health Cover benefits
Health cover applies to different types of medical expenses such as Surgical Cover, Daycare Cover, Hospital Cover, Disability Cover, OPD etc.
Global Coverage
The health cover benefits apply to worldwide treatment, providing the opportunity to avail of best-in-class treatment for your health issues.
Life Cover
In addition to health coverage, you will also get life insurance coverage to secure your family in the event of your unexpected demise.
Market-Linked Returns
With our various fund options, you get the opportunity to invest for the long term and earn market-linked returns3 to build your health corpus.
Discounts
You also have options to save funds with different types of discounts such as No Claim Rewards, Smart Lady benefits for female/girl child life assured, Digital Discount, Auto-Debit Discount, Super 30 Discount for life assured less than or equal to 30 years, Existing Customer Discount, etc., that can reduce your applicable premium.
Our experts are happy to help you!
Why is health insurance important?
There are several reasons why you should get health insurance, but the main reason would be to safeguard your finances from future medical emergencies and to ensure that you and your family stay covered.
Which health insurance is best in India?
The best health insurance plans are ones that will suit your needs and medical requirements. They are exclusive to your needs and specifications. But, if you are looking for health plans that offer comprehensive healthcare coverage, consider exploring Tata AIA Health Plans.
We offer a variety of plans and add-on health riders that you can attach to your basic policy to enhance coverage. Moreover, you can choose between linked and non-linked plans that offer a choice between 3market-linked returns and guaranteed returns.
Which health insurance is best for a family?
A family floater or family health insurance plan is ideal if you want comprehensive medical insurance for your family members — all under one plan. It is a much cheaper option than getting individual plans for all your family members.
In case one of your family members suffers from a critical illness, we recommend getting a separate individual plan with a critical illness cover to cover their medical expenses to prevent exhaustion of the sum insured under your family floater plan.
Is health insurance tax deductible?
Yes, you can claim a tax deduction on your annual health insurance premiums under Section 80D of the Income Tax Act 1961. You can claim additional deductions under Section 80DDB.
Which scheme of ACT provides health insurance requirements for workers?
The Employees State Insurance (ESI) Act of 1948 offers health benefits to workers and their dependents in case of any unfortunate eventualities at work.
Under this Act, employees or workers working in factories, businesses, and organizations such as hotels, road transport, cinemas, educational or medical institutions, and shops that employ 10 or more persons earning up to ₹21,000 per month are covered.
How does health insurance work?
A health insurance plan is a legal contract between the insurer and the policyholder. The insurer promises to cover the insured individual's medical expenses in exchange for regular premium payments.
The medical expenses covered under health insurance will vary depending on the type of health insurance plan you opt for. Always check your policy terms to know what illnesses and procedures your health insurance policy covers.
How many health insurance companies are there in India?
There are about 5 insurance companies that are registered under the IRDAI as health insurance providers. Apart from these companies, 26 other general insurance providers are registered under the IRDAI.
Many of them have health insurance policies to offer. Tata AIA is a joint venture company that provides both life insurance and health insurance products.
Is a medical check-up needed when buying health insurance in India?
Not always. For younger individuals (below 45 years), a pre-policy medical check is often waived. They can proceed straight to buying their health insurance plan.
The only exception is if they suffer from a pre-existing illness. In this case, they will be required to present their past medical reports and undergo a medical screening to assess their current health status.
What are the 4 recommended types of health insurance?
The 4 most purchased types of health insurance plans in India are individual health insurance, family health insurance, group health insurance and senior citizen health insurance.
Can I have more than one health insurance plan?
Yes, you can buy more than one health insurance plan. For enhanced benefits, you can buy a traditional health insurance plan coupled with a fixed-benefit health plan such as our Tata AIA Life Insurance Pro-Fit.If you require more medical coverage, we recommend looking into 6add-on covers or top-up plans as they are less expensive than buying a separate policy.
Can I buy health insurance if I am not an Indian national but live in India?
Yes, you do not have to be an Indian citizen to buy health insurance. Foreign nationals and NRIs residing in India are eligible to buy health insurance subject to the insurer's terms and conditions.
Can cancer patients buy a health insurance policy after diagnosis?
No, individuals already diagnosed with cancer cannot get insured under a new health plan unless it is a group health insurance policy under an employer.
Hence, we recommend buying and maintaining a health policy that offers cancer or critical illness coverage if you think you may be liable to develop any type of cancer in the future.
How much health insurance is sufficient?
While there is no standard coverage amount for health insurance, there are two broadly accepted rules:
First, your health coverage should be at least 50% of your annual income.
Second, your health insurance should cover the total cost of a coronary artery bypass graft in a hospital of your choice. Most personal finance experts recommend at least ₹5 lakhs of health coverage.
Is Rs 5 lakh health insurance enough?
Today, a 5 lakh MediClaim policy may only be enough to cover one person living in a Tier-3 city. This is because medical expenses can get extremely expensive in Tier 1 and 2 cities. Moreover, factors like medical inflation can exacerbate this issue as well.
We recommend getting a policy with a minimum sum insured of ₹10 lakhs if you live in a Tier 1 or 2 city. If you are a senior citizen or want to insure your whole family, you will need to opt for a sum insured much higher than ₹10 lakhs.
Does a basic health insurance plan cover critical illness?
Generally, basic plans will only cover hospitalisation expenses and pre-existing diseases (after a waiting period). If you need critical illness insurance, we recommend looking for plans that offer 6add-on critical illness cover or built-in critical illness coverage.
Is home isolation covered under health insurance?
Generally, only home isolations under the prescription of a doctor or certified healthcare professional through in-person or telemedicine consultations are covered by health insurance plans subject to the policy's terms and conditions.
What is waiting period in health insurance?
The waiting period in health insurance is a time frame within which you will not receive coverage even if your policy tenure has been initiated. Most health insurance policies have a waiting period of 30 days, after which they will receive coverage.
For existing diseases (pre-disclosed), the waiting period may vary from 2-4 years. It means that the insured will not get coverage for a disease that they already had before buying the health insurance coverage.
The waiting period will also vary for different add-on covers. For example, the waiting period for critical illness is usually 90 - 180 days, and maternity covers have a waiting period of 2 - 4 years.
The 30-day waiting period under health insurance is only waived for emergency medical procedures that occur due to accidents.
What is a pre-existing disease in health insurance?
In health insurance, a pre-existing disease (PED) is a health condition or illness you already would have been diagnosed with before buying the health insurance plan. These can be ailments like asthma, diabetes, high blood pressure, etc.
Insurers also consider pregnancy to be a pre-existing condition, and severe cases of physical injury are also considered PEDs by some insurers under specific plans.
Is dental treatment covered under health insurance?
Generally, no, they are considered cosmetic procedures and are not covered under basic health insurance plans. Most insurers will only cover dental treatments or surgery if the damage to your teeth was the result of an accident or insured illness.
However, some health insurance plans offer coverage for dental treatments under an add-on cover.
Can I claim health insurance coverage immediately?
Generally, no, insurers have a general/overall waiting period of 30 days before you can file any medical insurance claims. This waiting period is only waived in the case of accidents and other medical emergencies.
What can I do if my claim request has been rejected?
The first thing you can do is contact us, find out the reason for your claim refusal and file a complaint under our grievance redressal mechanism. If this does not work, you can always approach the IRDAI's Grievance Redressal Cell under their Consumer Affairs Department.
What is the health insurance claim process for non-network hospitals?
If you wish to get treated at a non-network hospital, you can file for cashless claims or reimbursement claims. You need to inform and follow the process for cashless claims. For reimbursement claims, first, you will need to get treated at the hospital , pay for your treatment expenses, and then contact us to initiate your claims process.
Make sure you maintain any and all receipts/bills relating to your treatment, as you will need to submit them to us during your claims process.
What is a No Claim Bonus (NCB) in health insurance?
A No Claim Bonus or No Claim Discount in health insurance is a percentage discount that is applied to your overall premium amount on renewal in the next policy year if you have not filed any claims in the previous policy year.
This discount can be accrued for consecutive policy years if you have not filed any claims in those years. Depending on the insurer (if they allow NCB transfers), it can also be transferred to a different policy when switching insurance providers.
What happens to my health insurance policy after a claim is filed?
After your health insurance claim with Tata AIA has been filed and settled, your policy coverage (sum insured) will be reduced by your claim amount. For example, if you have a policy with a sum insured of ₹5 lakhs and raise a claim for ₹3 lakhs.
Your health policy coverage will be ₹2 lakhs after your insurer files and settles the claim. In cases where you exhaust the full amount, you will not be able to raise any more claims for the remaining policy year until renewal where your sum insured gets replenished/re-instated.
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