4 Lakh Health Insurance

4 Lakh Health Insurance: Your Affordable Health Coverage

In the modern era, the cost of each and every thing has been increased. Likewise, the healthcare or medical costs have increased due to the combination of several factors, like chronic diseases, advancements in medical technology, an ageing population, and increasing medical drug costs. To meet the medical costs which are increasing day to day, it is better to select health insurance. One can choose the health insurance for 4 lakh, 6 lakh, 7 lakh, etc., depending upon their medical requirements and other criteria.  

What is a 4 lakh health insurance policy? 

A 4 lakh health insurance policy is a health insurance policy that offers a maximum of ₹4,00,000 (4 lakh) in coverage for medical expenses during a policy year. This means that the health insurance company will pay up to this amount for your hospitalisation, treatment, and other associated costs, but you need to pay the expenses exceeding the limit.    

Need for a 4 lakh health insurance policy 

A 4 lakh health insurance plan is required in India to overcome the medical costs and make sure that you get access to quality healthcare. A 4 lakh health insurance policy may be suitable for individuals or small families, particularly those who are healthy and live in regions with lower healthcare costs. But it's important to assess individual requirements, lifestyle, and potential health complications to check out if this coverage is enough in the long term.

Benefits of a 4 Lakh Health Insurance Plan

There are several benefits of buying a 4 lakh health insurance plan. Here are the benefits of a 4 lakh health insurance plan:

1. Hospitalisation Expenses: It covers doctor's fees, room rent, ICU charges, nursing charges, and other costs related to the inpatient care.

2. Pre- & Post-Hospitalisation Expenses: It offers coverage for the medical expenses incurred before and after hospitalisation, such as the medications, doctor consultations, and diagnostic tests.

3. Day Care Procedures: This health insurance provides coverage for the treatments that do need a full day of hospitalisation, like cataract surgery or dialysis.

4. Ambulance Charges: It might include coverage for ambulance transportation to and from the hospital.

5. Diagnostic Tests and Imaging: It offers coverage for the expenses for tests such as X-rays, CT scans, MRIs, and blood tests used for diagnosis.

6. Surgeon and Doctor Fees: This plan provides coverage for the cost of medical consultations and treatments from doctors and surgeons.

7. Organ Donor Expenses: A few policies provide coverage for expenses associated with the organ donation, like medical and hospitalisation costs for the donor.

8. Cumulative Bonus: A bonus (usually a percentage of the sum insured) is included in the policy's coverage for every claim-free year.  

9. Health Check-up: It covers the cost of a health check-up after some number of claim-free years or as a standard advantage.

10. Newborn Baby Cover: It offers coverage for the medical expenses of a newborn baby from birth.

11. Alternative Treatments: A few policies provide coverage for treatments such as yoga, Ayurveda, and naturopathy.

12. Maternity Benefits: A few plans provide maternity coverage, like prenatal and postnatal care and newborn baby expenses.

13. Cashless Facility: This health insurance permits policyholders to get treatment at network hospitals without upfront payment.

How to Choose 4 Lakh Health Insurance?

There are many things to be considered to choose the best 4 lakh health insurance. Here are the factors to consider when choosing the best 4 lakh health insurance: 

1. Coverage: Make sure that the health insurance policy covers your particular healthcare needs, like hospitalisation, day care procedures, pre- and post-hospitalisation expenses, and critical illnesses.

2. Network Hospitals: Check whether the health insurance provider has enough network hospitals in your region, particularly if you choose cashless hospitalisation.

3. Sum Insured: A 4 lakh sum insured may be enough for basic needs, but check your age, medical history, and potential future health needs when you identify if it is enough.  

4. Policy Terms and Conditions: Review waiting periods, exclusions, and any co-payment clauses carefully.

5. Premiums and Deductibles: You can compare premiums and deductibles across different plans to know the balance between cost and coverage.

6. Lifestyle: Consider your lifestyle choices and potential health risks associated with them.

7. Age and Medical History: Senior citizens or people with pre-existing conditions may need higher coverage and potentially various health insurance policy types.

8. Family Floater Options: If you have a family, search for the family floater plans that offer coverage for multiple family members below a single policy.

9. Policy Renewal: Make sure that the health insurance policy provides lifelong renewability and consider top-up plans for enhanced insurance coverage.

10. Extra Benefits: See the features such as the cumulative bonus, no-claim bonuses, and wellness programmes.

Inclusions in 4 Lakh Health Insurance

There are many things included in the 4 lakh health insurance. Let's see what is included in 4 lakh health insurance in general:

1. In-patient Hospitalisation: 4 Lakh Health Insurance offers coverage for the expenses associated with the surgeon's fees, room rent, nursing care, doctor's consultation, medicines, diagnostic tests, and other hospital charges at the time of a stay of 24 hours or more.

2. Day care Procedures: This includes expenses for treatments or surgeries that do not need a 24-hour stay in the hospital, like cataract surgery or chemotherapy.

3. Pre- and Post-Hospitalisation Expenses: This offers coverage for the medical expenses incurred before hospitalisation (e.g., tests, doctor's visits) and after discharge (e.g., medication, follow-up consultations).

4. AYUSH Treatment: A few policies offer coverage for the treatments below of the Indian systems of medicine, such as Ayurveda, yoga, Unani, Siddha, naturopathy, and homoeopathy.

5. Ambulance Charges: 4 lakh Health insurance provides coverage for the cost of ambulance service for transportation to the hospital at the time of emergencies.

6. Other Inclusions: A few policies might also offer coverage for the organ donor expenses, consultation charges, and even particular modern treatments, based upon the policy terms.

Exclusions in 4 Lakh Health Insurance

There are many things that are not included in the 4 lakh health insurance. Let's see what is excluded in 4 lakh health insurance in general:

1. Pre-existing Conditions: Several health insurance plans have a waiting period for pre-existing conditions, which means they will not cover expenses associated with the illnesses diagnosed or treated prior to the policy's start date for some duration.

2. Waiting Period: Other than the pre-existing conditions, a few policies might have a general waiting period (e.g., 30 days) before covering any illnesses, except those that are caused by accidents.

3. Cosmetic Treatments: Procedures such as cosmetic surgery or treatments which target to improve appearance are usually not covered.

4. Self-Inflicted Injuries: Injuries that are caused by the suicide attempts or other self-harm are generally excluded from coverage.

5. Substance Abuse and Mental Illness: The cost for the treatment for substance abuse, alcoholism, and a few mental health conditions might not be included.

6. Alternative Treatments: As mentioned above, only a few plans may cover alternative treatments. In general, the expenses for alternative therapies such as acupuncture might not be covered.

7. Specific Illnesses: A few plans might have specific exclusions for some illnesses, such as certain types of cancers or chronic conditions, particularly during the initial policy period.

8. Maternity and Newborn Care: Maternity expenses, like childbirth and newborn care, are generally excluded from general health insurance policies or might have a separate waiting period.

9. War and Terrorism: Injuries or illnesses as a result of acts of war, terrorism, or nuclear activity are not included.

10. Adventure Sports: Medical expenses as a result of participation in adventure sports or hazardous activities might also not be included.

11. Outpatient Treatment: Outpatient department (OPD) treatments, in which the patient is not admitted to the hospital, are not included in insurance coverage.

12. Non-Medical Expenses: A few non-medical expenses, like those associated with the diagnostics, might also not be included.

How to apply for 4 lakh health insurance?

In order to apply for a 4 lakh health insurance plan, you must select a health insurance plan, fill out an application, and provide required documentation such as identity proof and medical history. You can apply online through the insurer's official website or offline by visiting a proper agent.

1. Explore and Choose a Plan

• Just compare plans of different health insurance providers, then consider factors such as the coverage amount (4 lakhs in your case), premium costs, and network hospitals.
• Carefully review the policy documents, such as the inclusions, exclusions, waiting periods, and any co-payment clauses.
• Make sure that you consider your individual or family's health requirements and select a plan that best suits those needs.
   

2. Gather the needed documents

• You must gather the necessary documents. 
• Proof of Identity, such as an Aadhaar card, voter ID, passport, or PAN card.
• Proof of Address, like an Aadhaar card, passport, or utility bill.
• Medical History that helps in finding out any pre-existing conditions to make sure of the accurate coverage.
   

3. Apply Online or Offline

•  If you apply online, you can visit the insurer's website, select the desired plan, and fill out the online application form.
• If you apply offline, then you can contact a local agent or visit the insurer's branch to apply in person.

4. Pay the Premium

• Once your health insurance application gets approval, then you need to pay the premium amount to do the health insurance policy's activation.

5. Get Policy Documents

• After the payment gets successful, you need to get your health insurance policy documents.

What is a health insurance claim process?

A health insurance claim is the request submitted to your health insurance provider to receive the reimbursement or payment for covered health expenses. The health insurance claim process will involve informing the insurer, collecting required documents, and submitting them for further review.

When you get admitted to a non-network hospital where cashless facilities are unavailable, you must settle the bills directly with the hospital. Then, submit the full set of original documents to us for reimbursement as per the policy terms and conditions. We provide you many options for submitting the claim documents.

You can provide them over at the nearest Star Health office directly or through your advisor.

You can make use of our Customer Portal or Customer App for the document upload and then send the complete set of original documents through postal mail or courier to our address.