This article is all about Health insurance, its selection criteria for insurance company and the tax benefit received by the insurance holder from Income Tax perspective.

Checklist to Choose your Best Health Insurance Policy

1. Hospital Room Rent Eligibility

2. Co Payment and Sub Limits for diseases (if any)

3. Waiting Period for Pre Existing Disease

4. Waiting period for few specific diseases like Cataract, Hernia etc

5. Cover Amount and Premium charged as compared to other players with same features

6. Pre Hospitalisation and Post Hospitalisation Coverage

7. Free Preventive Health Checkup Facility

8. Coverage for Critical Illness – Basis:- family history, option for top ups

9. Restoration Benefits – Whether with or without extra premium

10. Ambulance charges – whether covered

11. Eye Care, Dental Care, AIDS/HIV and Suicide Attempts – Generally are not covered

12. Alternate Treatments – Whether Allowed like Ayurveda?

13. Daily Hospital Cash Benefit, Organ Donor Expenses, convalescence benefit (i.e. time spent recovering from an illness or medical treatment) – Generally covered by way of Add on Cover

14. Outpatient Benefits like Consultancy Fee, Pharmacy Fee – Generally covered upto Rs. 5000 p.a. as add on cover

15. Maternity Benefit – Normal, C Section coverage, pre and post natal coverage, new born baby vaccination coverage, waiting period (Generally waiting period of 3-4 years, high premium and coverage upto Rs. 30,000 to Rs. 40000/- only)

16. Network Hospitals and Claim Process including timelines (Cashless as well as reimbursement)

Selection of Health Insurance Company:

  • Incurred Claim Ratio
  • Claim Settlement Ratio
  • Network Hospital Coverage
  • Claim Process and timelines

The above ratios are available on IRDAI website (Annual Report). Also if you are not happy with the services or Policy of any company, IRDAI has mandatorily given option of free look up period for cancellation within 15 days of taking policy as well as Portability option is available near to renewal time of policy. Policy can be ported to another company without losing waiting period/NCB benefits , provided prior to 45 days of the date of renewal, a written request is sent to existing insurance company.

Tax Benefits of health insurance:

You can claim tax deductions under Section 80(D):

  • In case of the individual, Rs. 25,000 for himself and his family
  • If individual or spouse is 60 years old or more the deduction available is Rs 50,000
  • An additional deduction for insurance of parents (father or mother or both, whether dependent or not) is available to the extent of Rs. 25,000 if less than 60 years old and Rs 50,000 if parents are 60 years old or more.
  • For uninsured super senior citizens (80 years old or more) medical expenditure incurred up to Rs 50,000 shall be allowed
  • A deduction of Rs. 5000 will be allowed under this section for payment of preventive health check-up of either the individual himself or his family members which includes spouse, parents and dependent children.This deduction is NOT in addition to the deduction of Rs.25000/50000 stated above, but is included in the above deduction

Hope this article will help you in choosing best Health Insurance policy keeping several factors in mind.

Author of this article can be reached at [email protected]

(Republished with Amendments)

Author Bio

Qualification: CA in Practice
Company: N/A
Location: Faridabad, Haryana, IN
Member Since: 29 Aug 2017 | Total Posts: 2

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January 2021