5 lesser known features of health insurance

Health insurance buying online is steadily picking up steam. However, since long, having a health insurance policy is always considered to be the first step of financial planning even before one starts to save. In these times, when COVID-19 pandemic has brought the focus on health care costs, the importance of keeping a health plan has increased manifold. While buying when you check health insurance features, benefits and make a comparison, there are a few lesser-known features that you need to be aware of.

1. Tax benefit on health insurance premium

If you want to buy health cover by paying cash, you can do so but tax benefits will not be available on it. The tax benefit on health insurance premium is available only when the premium is paid through a non-cash mode such as cheque, net banking or any other digital mode. However, tax benefit on payment made towards preventive health check-up up to Rs 5,000 is allowed even if paid in cash.

2. Pre-existing diseases

Health insurance plans allow coverage of pre-existing ailments after 36 or 48 months of the policy. However, that does not mean, not disclosing them at the time of applying will help. The claim settlement may get delayed or even the claim may be repudiated if the buyer hides any pertinent medical information and existing ailments while filling the application form.

3. Sub-Limits in health plans

The claim during hospitalization may be linked to the room rent which is determined by the sum insured in the health insurance policy that you won. For example, if your sum insured is Rs 6 lakh, the room rent is capped at 1 per cent per day which is Rs 6,000. if you choose to opt for a room with a higher room rent, the other medical expenses in the hospital bill gets proportionately reduced. In such a case, you end up paying from your own pocket even though you carry a cashless medical insurance plan. Its good to ask the insurers about the sub-limits, how it works and its impact before buying.

4. Health check-ups

Most insurers offer free health check-up once every 3 or four year provided there is no claim made on the policy. Use it to your advantage to get a full-body check-up. The amount is capped at 1 per cent of the sum insured and hence pay the amount exceeding the bill but better to get a full-body check-up. The additional amount may get a tax benefit too. There is a tax benefit under section 80D on the premium paid for preventive health check-up up to Rs 5,000 within the overall limit of Rs 25,000 or Rs 50,000 depending on age.

5. Medical tests up to 45 not required

Before issuing the health insurance policy, insurers conduct medical tests of the buyer. Most insurers do this for those who are above age 45. However, for a larger sum insured the insurers may ask for a medical examination even for those who are below 45. It was always better to disclose all medical and family history of health-related issues in the application form while buying. Also, better if medical tests are conducted as it will keep the claim settlement process smooth.

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