InvestorQ : Can you please tell me about individual health insurance plans in detail?
nishi Shah made post

Can you please tell me about individual health insurance plans in detail?

Swapnil Sarang answered.
3 years ago
Individual health plans, as the name suggests, are designed to protect the policyholder from expensive medical expenses. It is an agreement between an insurance company and an individual under which the insurer promises to cover the medical cost incurred by the insured person in return for a premium amount paid by the policyholder.
Most individual health insurance plans cover hospitalisation expenses, both pre- and post-hospitalisation expenses, medical examinations charges, laboratory charges, maternity care expenses, and consultation fees.
A few advantages of taking an individual health plan are:
- The policyholder gets all the benefits that are available in the plan under the individual health insurance policies.
- The sum assured amount can be completely used by the policyholder (or the insured person) without distributing it to anyone.
- The individual policyholder can add his/her immediate family members to the policy in the future, if the insured person wishes to.
- Unlike a family floater plan, there are no restrictions on the number of claims that can be made in one year. Thus, you can make as any number of claims as you want under this plan.
When it comes to insurance policies, it is as much important to know what is covered as it is to know what is excluded. Thus, a few exclusions from health insurance plans are:
- Pre-existing diseases: Some insurance companies do offer cover for pre-existing diseases, but only after a define waiting period is completed.
- Non-allopathic treatments: These treatments are not covered by individual health insurance plans but recently some insurers have started offering insurance cover for AYUSH treatment; AYUSH treatments include Ayurveda, Yoga, Unani, Siddha, and Homeopathy treatments.
- Substance abuse: Treatments for substance abuse such as alcohol and drugs are not covered.
- Cosmetic surgeries: Most companies don’t cover cosmetic surgeries in their insurance plans.
If you are okay with the aforementioned exclusions, then you should opt for a health insurance because it will help you receive the best healthcare possible at an affordable premium. You don’t want to make decisions regarding your health based on the price tag it comes with.
Furthermore, with the cashless facility, you don’t have to go through the hassle of initiating a claim or providing documents to get reimbursement. You can get tax benefits on premiums paid towards medical insurance under Section 80D of the Income Tax Act, 1961.
Section 80D deductions:
Section 80D will help you in getting tax deductions on medical insurance premiums only.
For you and your family:
- Maximum deduction of Rs. 25,000 per year on health insurance premium for yourself and your family.
- Maximum deduction of Rs. 50,000 per year if you are a senior citizen.
For your parents:
- Maximum deduction of Rs. 25,000 per year on health insurance premium paid on behalf of parents.
- Maximum deduction of Rs. 50,000 per year on premium payments for senior citizen parents.
Additional deduction:
A deduction of Rs. 5,000 can be claimed every year on expenses related to health check-ups. This limit includes the check-up expenses of all members in a family, including spouse, kids and parents.