75 Lakh Health Insurance

Benefits of Opting for 75 Lakh Health Insurance in India

Health insurance is an essential investment for any Indian family, as the increasing medical costs can be a considerable pressure to bear. A 75 lakh health insurance plan covers the broad gamut of disease, surgery, or even hospitalisation, which will protect a person's finances against any illness. This article introduces the reader to the particulars of such policies, including eligibility criteria, benefits, features, ineligibilities, claim procedures, and digitalisation in the health insurance sector.

Health insurance has become a necessity in India due to rising medical inflation. A 75 lakh health insurance plan caters to individuals and families who seek comprehensive medical coverage for critical illnesses, hospitalisation, and emergency treatments. With the advent of digital platforms and increasing awareness, more people are considering high-coverage plans for financial security.

Understanding 75 Lakh Health Insurance

A 75 lakh health insurance policy is a high-value indemnity plan providing comprehensive financial protection against significant healthcare expenses. It suits families, senior citizens, and individuals who want to secure their medical future against unforeseen health crises.

Types of 75 Lakh Health Insurance Plans

Individual Health Insurance -  Covers a single person.
Family Floater Plan – A single policy covering multiple family members.
Senior Citizen Health Insurance – Especially for senior citizens.
Top-Up/Super Top-Up Plans – Adds to the existing health insurance.

Eligibility Criteria

The eligibility criteria differ from one insurer to another, but some general conditions are as follows:

• Age Limit: 18 to 65 years (for individual and senior citizen plans).
• Pre-existing disease Waiting Period: 2 to 4 years.
• Medical Tests: For people above 45 years old.

Income Criteria: Some insurers may have income-based eligibility.

Key Benefits of 75 Lakh Health Insurance

A high-value health insurance policy comes with several unique features:

Coverage Benefits

A health insurance cover of 75 lac may have the following inclusions:

hospitalisation Coverage

hospitalisation expenses for surgeries and medical treatment in the form of ICUs.Room rent, along with physician consultation charges.

Critical Illness Coverage

Diseases such as cancer, failure of kidneys, heart disease, etc. are covered.
Lump sum payout in case of detection.

Maternity and Newborn Coverage
Delivery and other post-delivery expenses. Cover for the newborn baby's medical expenses.

Domiciliary Treatment

Treatments taken at home due to medical conditions.

AYUSH and Alternative Therapies

Inclusions of treatments that are not allopathic.

Exclusions in the Policy

Though the coverage is broad, there are a few conditions that are not covered:

Pre-Existing Conditions: Unless covered after the waiting period.
Cosmetic Procedures: Plastic surgery that is not medical.
Self-Inflicted Injuries: Suicide or self-harm.
Drug or Alcohol Abuse: Treatments because of substance abuse.
War and Terrorist Activities: Injuries due to war-related activities.

Benefits of a High-Coverage Plan

1. Medical Inflation Protection

Reduces hospitalisation expenses without creating financial burdens.

2. Large Hospital Network

Cashless treatments at thousands of hospitals.

3. Tax Deductions Under Section 80D

Tax relief on premium payments.

4. Family Members' Peace of Mind

Guarantees protection against sudden medical emergencies.

5. NCB Benefit

Increases coverage for claim-free years.
6. Expensive Treatments Covered

Includes robotic surgery, organ transplants, and specialized care.

7. Financial Security During Emergencies

Reduces out-of-pocket expenses in medical crises.

Cost Analysis and Premium Considerations

Factors Affecting Premium

• Age and Health Condition
• Family Floater vs. Individual Plan
• Add-on benefits like OPD Cover

Insurer's Underwriting Policy

Age Group Approximate Annual Premium ()

20-30 years 12,000 - 18,000
30-40 years 18,000 - 25,000
40-50 years 25,000 - 40,000
50+ years 40,000 - 70,000

Claim Process and Settlement

Steps in the Claim Process

• Inform the Insurer – Notify within 24-48 hours of hospitalisation.
• Submit Required Documents – Bills, prescriptions, and medical reports.
• Claim Intimation Verification-Insurer goes through documents and sanctions
• Settlement -Pay directly to the hospital (cashless) or the policyholder for reimbursement.

Effect of Digitalisation on Health Insurance

• E-Issue of Policy – Immediate online policy purchase and renewal
• AI Processing of Claim -Claims cleared speedily.
• Telemedicine –Doctor consultation virtually is included.
• Health Tracking Application -Wellness programs integrated to health tracking of the policyholders

Disadvantages or Limitations

Though with lots of merits, high-value health insurance has several demerits:

High Premiums: These are more expensive than the low coverage plans.
Rejection of Claims:  Pre-existing conditions and exclusions in policies may lead to rejection.
Complicated Terms: The policy terms are challenging to understand.
OPD and Dental Care Coverage: Not covered by all the policies. 12.

Conclusion

Health insurance for 75 lakh provides a robust financial safety cushion against medical shocks. As healthcare costs continue to increase, a full-fledged policy will ensure that all medical requirements are met without pressure.

At the same time, the buyer must compare plans, know the exclusions, and select the insurance provider correctly so he is not bothered while reaping the benefits.