Loading article content...
The health insurance market is flooded with numerous plans, making it challenging to choose the right one that meets your healthcare needs. This critical illness health insurance is designed to provide financial protection against severe, life-threatening conditions such as heart attacks, strokes, cancer, and kidney failure. Our critical illness insurance operates on an indemnity basis, meaning it reimburses your actual medical expenses related to the critical illness up to the specified limit, helping cover the cost of treatments and recovery. With the rising cost of healthcare, this type of coverage ensures that you're not financially burdened in the face of a serious health crisis, offering peace of mind and crucial support when needed most.
What is Critical Illness Insurance?
Critical illness insurance is a type of health insurance designed to provide financial protection in the event you're diagnosed with a serious illness, such as cancer, heart attack, stroke, or kidney failure. Unlike a lump sum scheme, it operates on an indemnity basis, meaning it reimburses your actual medical expenses related to the critical illness up to the specified limit. This coverage helps reduce the financial burden associated with severe illnesses, ensuring you have the resources to focus on your recovery without worrying about money.
Why Do You Need Critical Illness Coverage?
Critical illness coverage provides financial support by reimbursing your medical expenses if you are diagnosed with a serious illness. It helps you cover the cost of treatment without significantly depleting your savings or investments.
Below are some of the reasons why you need critical illness coverage:
- Financial Security: Critical illness coverage helps to avoid a financial crisis during any medical emergency.
- Peace of Mind: Knowing you're financially prepared for a life-threatening illness reduces stress and allows you to focus on your recovery.
- Rising Healthcare Costs: With medical expenses continuously increasing, this coverage helps mitigate the financial burden of treatment.
- Coverage for Severe Illnesses: It covers critical conditions like cancer, heart attack, stroke, etc., that could otherwise lead to significant out-of-pocket expenses.
- Comprehensive Support: The reimbursement helps cover a wide range of medical costs associated with the critical illness, ensuring you don't have to bear the full expense.
5 Diseases Causing Critical Illnesses
Knowing the importance of critical illness insurance has become much more crucial considering the kind of life we all have been living.
Let us discuss the 5 major diseases that cause critical illnesses and require timely treatment:
- Heart Diseases: Heart diseases include coronary artery diseases such as heart attack, stroke, and hypertensive heart disease. It becomes essential to know the seriousness of such critical illnesses and get the right critical illness health insurance on time.
- Cancer: It is considered the most frightening disease and should be taken care of on time. According to a report by WHO, one in 10 Indians will develop cancer during their lifetime, and one in 15 will die of the disease.
- Renal Failure: Renal failure is caused due to the malfunctioning of the kidneys. They fail to lose the ability to work and filter waste from our blood, which leads to an overload of toxins in the body, increasing the risk of getting infections.
- Paralysis: It is a medical condition where muscle stops functioning in any part of our body. It could either be partial, complete, temporary, or permanent. It needs timely attention so that it doesn’t get even more contagious to our system.
- Lung Ailments: Lung ailments can be critical illnesses if they cause respiratory failure, nonpulmonary organ failure, or other conditions that impair respiratory function
How Does Critical Illness Cover Work?
A critical illness cover is an indemnity-based health cover that provides comprehensive coverage for various critical illnesses.
By paying an affordable premium, you can avail coverage for various medical treatment expenses, including in-patient hospitalisation, pre-and-post hospitalisation medical expenses, ambulance, day care treatment, etc. In the event of a hospitalisation, you can opt for the cashless facility at the nearest network hospital and skip the hassle of paying hospital bills. The insurer will pay the bills directly to the hospital. If you select a non-network hospital for treatment, you should apply for a reimbursement claim.
Benefits of Having a Critical Illness Cover in a Mediclaim Policy
The most significant benefit of critical illness insurance plans is the financial security they offer during times of medical crisis. Let us discuss in detail the benefits of having a critical illness cover in a mediclaim policy:
- Provides Cashless Treatment: One of the most important benefits of a critical illness policy is the instant treatment provided to the patient without any delays. That is, the insured person can avail of cashless treatment at any network hospital.
- Covers Expensive Medical Treatments: A critical illness policy will provide adequate coverage for various treatments. It will cover expenses related to in-patient care, pre-and post-hospitalisation medical expenses, OPD expenses, ambulance, day care treatment, organ donor cover, chemotherapy, and radiotherapy.
- Guarantees Financial Protection: With a critical illness cover in place, an individual can stay financially strong if diagnosed with a critical ailment. The policy will help the person bear the high medical expenses incurred due to long-term treatment of such illnesses, thus averting any financial implications.
- Allows Tax Benefit: The policyholder can look forward to saving tax under Section 80D on the premium paid on such a policy. One can avail of a maximum deduction of up to Rs 1 lakh if the proposer and insured are over 60.
- Annual Health Check-Up: A health check-up once during the policy year is provided at a network hospital or medical facility empanelled with the health insurance company.
Scope of Coverage under Critical Illnesses Health Insurance
Under critical illness, you get extensive coverage after you submit the diagnosis to the respective team. This coverage provides reimbursement for expenses related to in-patient hospitalisation, diagnosis, and medication. It also covers costs such as air ambulance, chemotherapy and radiotherapy, dialysis, organ donor cover, second opinion, and annual health check-ups.
In-Patient Hospitalisation
If your inpatient hospitalisation in the network hospital lasts more than 24 hours, we cover your hospitalisation expenses. These expenses include your room charges, nursing expenses, ICU, surgeon’s fee, doctor’s fee, blood, oxygen, and OT (operation theatre charges).
Day Care Treatments
Daycare treatment means the treatment where you do not need to be admitted to the hospital for a day. Critical illness policy also covers your daycare treatment. Cataract surgery, chemotherapy, dialysis, or treatment or therapy requires hospitalisation for a day. So, if you are going for it, the plan covers the associated costs, such as room rent, doctor’s visits, medicines, etc., either through cashless facility or reimbursement.
Pre and Post-hospitalisation
We cover your pre- and post-hospitalisation expenses, including diagnosis, treatment, and medicine expenses, along with doctors’ fees. Treatment costs, such as dialysis, daycare treatments, and surgeries, are also covered.
Additional Covers
The plan also offers additional coverage, such as air ambulance cover, international second opinion, alternative treatment, doctor on call, global coverage, and so on. You will also be reimbursed for these expenses.
Annual Health Check-up
Under a critical illness plan, you can also avail annual health check-ups. The package includes tests for blood sugar, urine routine, blood groups, kidney function, and ECG check-ups. This facility helps you to keep a track of your health.
Tax Exemption
Under section 80 D, of the Income Tax Act 1961, premium paid for critical illness health insurance either for self, dependent parents, spouse or children, is entitled for tax exemption. However, the taxable amount is subject to income, age, number of persons insured, and also income tax law.
What is the Difference Between Critical Illness Plan and a Health Insurance Plan?
While a Critical illness plan provides financial support for specific major illnesses, a health insurance plan is more comprehensive and covers a broad range of medical treatments and procedures.
| Feature | Critical Illness Plan | Health Insurance Plan |
|---|---|---|
| Coverage | Covers specific critical illnesses like cancer, heart attack, and stroke. | Covers a wide range of medical expenses, including hospitalisations, doctor visits, surgeries, and treatments. |
| Payout Type | Covers/reimburses actual medical expenses incurred related to the critical illness, up to the specified limit. | Covers actual medical expenses incurred, often with deductibles, copays, or limits. |
| Coverage Scope | Limited to certain severe illnesses as specified in the policy. | It covers a broad spectrum of healthcare services, including inpatient and outpatient treatments. |
| Claim Trigger | Medical treatments or services rendered related to the critical illness. | Medical treatments or services rendered, like doctor consultations or hospital stays. |
| Premium Amount | Generally lower premiums compared to health insurance. | Premiums can be higher due to broader coverage and ongoing medical expenses. |
| Survival Period | No such survival period is required; claims can be made during treatment or hospitalisation. | No such survival period is required; claims can be made during treatment or hospitalisation. |
| Renewability | Usually renewable, but premiums may increase with age or risk factors. | Usually, it is renewable, often with some restrictions on policy changes as you age. |
| Additional Benefits/Riders | It may offer riders coverage for other conditions or life insurance. | Often comes with additional options like maternity cover, wellness programs, or dental/vision plans. |
| Purpose | Provides financial support specifically for dealing with a critical illness. | Helps with covering a wide range of medical expenses during regular and emergency healthcare needs. |
7 Things to Consider Before Buying a Critical Illness Policy
You should opt for a comprehensive critical illness insurance policy. It can protect you from financial loss. Selecting & choosing the right critical illness insurance policy is very crucial; let us discuss 7 things to consider before buying a critical illness policy:
- Check How the Critical Illness Plan Works: Understand that this plan operates on an indemnity basis. This means it reimburses your actual medical expenses up to the sum insured, or provides cashless treatment at network hospitals, after you submit the necessary documents/diagnosis.
- Look for Maximum Coverage: When you are looking for the suitable health insurance, you should look for the critical illness cover that provides you maximum coverage. Ideally, a sound critical illness cover includes pre and post-hospitalisation expenses, diagnosis expenses, treatment, and medication.
- Premium: Premium is the sum of money that you have to pay to the insurer against the critical illness plan after specified intervals. You can opt for a plan that protects you from financial losses and supports you in your hard times.
- Check Exclusions: It is essential to check the exclusions before buying critical illness health insurance. Proper information about situations that the insurance company does not consider is essential.
- Waiting Period: It is advisable to ask for a waiting period before buying a critical illness plan. Critical illness is covered after 90 days of the policy period, and pre-existing diseases are covered for 36 months.
- Payout Structure: Understand how the reimbursement works in the event of a claim. Since this is an indemnity policy, it reimburses your actual medical expenses. Focus on the process for cashless claims at network hospitals and for reimbursement claims at non-network hospitals.
- Riders and Additional Benefits: Some critical illness policies offer additional benefits or riders, such as coverage for hospital stays, surgery costs, or the ability to convert the policy into a whole life or disability plan. Evaluate whether these extras would benefit you and whether they add to the cost.
In a Nutshell
Thus, a health insurance plan for Critical Illness is very helpful. It gives you financial assistance to bear your hospitalisation and treatment costs. You can opt for a critical illness plan offered by Care Health Insurance that covers around 32 life-threatening diseases and has a network of 22100+ cashless healthcare providers across the country. So you can get the best possible treatment and focus on your recovery with peace of mind.
Disclaimer: Underwriting of claims for critical illness is subject to policy terms and conditions. Please refer to the policy brochure to verify the policy benefits and terms and conditions correctly.
