10 Lakh Health Insurance Plan in India

The rapid expansion of the Indian healthcare system is driven by its comprehensive reach, enhanced services, and increased investment from both public and private sectors. Presently, Indian hospitals offer specialised care encompassing cancer treatments, advanced heart procedures, transplants, neurosurgery, trauma-related orthopaedic and spine surgeries, and IVF. This growth has led to a surge in medical expenses, with healthcare inflation outpacing the general inflation rate in India.

India sees high levels of out-of-pocket spending, directly contributing to elevated instances of catastrophic expenses and poverty. Therefore, securing a health insurance policy with a coverage of 10 lakhs is crucial, especially in metropolitan areas where treatment costs are higher. Several compelling reasons support opting for a health insurance policy with ₹10 lakh coverage in India such as:

• Escalating Healthcare Costs: The continuous rise in the cost of healthcare services and treatments in India necessitates a health insurance policy with a coverage of ₹10 lakhs to alleviate the financial strain of expensive medical procedures.

 

• Protection against Critical Illnesses: A policy offering coverage for ₹10 lakhs provides protection against critical illnesses such as cancer, heart attacks, and kidney failure, which often require costly treatments and extended care.

 

• Comprehensive Coverage for Health Expenditures: Opting for the right and best  health insurance plan ensures extensive coverage, including doctor fees, specialist fees, ambulance charges, medical and diagnostic test expenses, in-patient costs, hospital room rents, surgical expenses, and post-hospitalisation bills.

There are several benefits of health insurance 10 lakhs. Some of them are mentioned below.

Cashless Hospitalisation

10 lakh health insurance plans provide cashless hospitalisation facilities, eliminating the need for policyholders to pay upfront for medical expenses. This means policyholders can access medical treatment at any network hospital, both locally and nationally, without having to make immediate payments

Tax Benefits

Under Section 80D of Income Tax Act, health insurance plans for 10 lakhs offer tax advantages. Policyholders can reduce their taxable income by up to ₹25,000 by investing in medical insurance policies.

No Claim Bonus

With a ₹10 lakh Mediclaim policy, individuals who refrain from making any claims throughout the policy duration can enjoy a no-claim bonus. This bonus can come in the form of a reduced premium or an increase in the insured sum.

Below are the steps detailing the functioning of a 10 lakh medical insurance policy:

• Hospital Admission: The insured individual is admitted to either a network hospital or a non-network hospital. In the case of a non-network hospital, upfront payment of expenses is required, with subsequent reimbursement from the insurer.
• Pre-authorisation: If the hospital belongs to the insurer's network, the insured may seek pre-authorisation for medical treatment from the insurer.
• Treatment and Expenses: The insured undergoes necessary medical procedures, and the hospital submits the bills to the insurer for payment.
• Expense Settlement: The insurer covers eligible expenses up to the sum insured limit. Any expenses not covered by the policy, such as deductibles or copayments, are the responsibility of the policyholder.
• Claim Process: For non-network hospital visits, the insured must pay expenses upfront and then seek reimbursement from the insurer by submitting original bills, documents, and a claim form. The insurer evaluates the claim and settles eligible expenses accordingly.

To calculate the health insurance premium for coverage of 10 lakhs, the following information are required:

• Personal details such as age, gender, and location.
• The individual's medical history, including any pre-existing conditions.
• Chosen coverage benefits, such as outpatient care, hospitalisation, and critical illness coverage.
• Lifestyle habits, such as smoking, may also affect the premium.