Health insurance is a kind of insurance that covers whole or part of your medical expenses. Through health insurance, the insurer agrees to pay for the medical expenditure incurred by the policyholder. The insured pays out of his pocket for his medical expenses directly and is reimbursed later by the insurance company. In certain cases, the insurer pays the expenses directly to the hospital.
Types of health insurance
1. Individual Health Insurance –

It facilitates the health coverage of a single person. This implies that you can claim the premium for medical expenses of one person only. Its coverage is extensive, as the individual has their sum insured for themselves. It works better for senior parents.

2. Family floater health insurance

The entire family’s health expenses can be covered under a single policy, shared by all the family members. It is a cost-effective premium plan, as the premium is a one-time payment for all the family members.

3. Senior Citizens Health Insurance

Senior citizen plans address the medical needs and requirements of senior citizens. Few policies offer additional cover for hospitalization at home and psychiatric problems, etc. These insurance policies could be pricey and also might need a prior health check-up.

4. Critical Illness Insurance

It covers lifestyle-related diseases such as cancer, stroke, kidney failure, and cardiac diseases. Insurance seekers subscribe to them as an add-on with the regular health insurance policies or separately. They offer insurance for specific illnesses and pay in lump-sum when claimed after the diagnosis.

5. Group Health Insurance

Group health insurance deals with the insurance needs of a group of people, such as employers working at an organization or a community of people. The employer or the community leader purchases the group insurance for all their employees or citizens. These plans provide coverage for basic health issues and are quite affordable compared to other plans.

There are two ways in which you can claim under a health insurance policy
1. Cashless basis
2. Reimbursement basis
Cashless Basis: In this case, the insurance company settles the bills directly with the hospital. However, to claim insurance in this category, you should take the treatment at the hospital that has a tie-up with your insurance company.
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Steps to claim cashless insurance
• If it is a planned treatment, inform the insurance company 3 to 4 days before joining the hospital for the procedure. You need to fill the pre-authorization form and submit it to the insurance company at least three days before taking the treatment. In emergency cases, it can be done within 24 hours of hospitalization.
2. Reimbursement claims: In this case, the insured pays the medical bill first by himself and gets reimbursed by the insurance company. You can claim reimbursement, either if you take treatment at a non-networked hospital or cannot claim the insurance in cashless mode.
Steps to claim reimbursement insurance
• Submit all the documents such as hospital admission card, medical bill, discharge certificate. You should submit these documents along with a duly filled-in claim form and the Aadhaar card.
• The insurance company then would cross-check with the hospital records and, after a thorough analysis of the disease and treatment, it would reimburse the insurer. Other documents required to make an insurance claim
1. Valid ID proof of the insured
2. Copy of the policy bond
3. Bank details of the insured
4. Canceled cheque
5. Any other documents as required by the insurance company.

Health insurance provides cover for most of the illnesses. However, certain diseases do not qualify to claim insurance.
1. Babies born with birth defects
2. Procedures that come under cosmetic and plastic surgery
3. Conditions resulting from suicide attempts
4. Psychiatric conditions
5. Conditions acquired due to alcoholism and substance abuseHow to claim health insurance?

Insurance limit: Insurance policies allow claims up to the limit the insured avails. If he incurs expenses beyond the limit, the insured himself should pay the additional amount.
At Anupama Hospitals, our expert patient financial services representatives help you sail through these procedures effortlessly and manage your financial resources efficiently in the emotionally draining times of serious illness. We can guide you navigate the maze of policies by suggesting the right plan suitable for your condition.
Meet our Insurance Consultant Mr.Chander Rao
Phone Number –9666665891
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