8 Lakh Health Insurance

8 Lakh Health Insurance: Your Supreme Health Coverage

The modern world brings modern upbringings that increase the cost of several things. Also, there is an abrupt increase in the cost of medical treatment all over the world. Healthcare costs increase due to several factors, like advancements in medical technology and an ageing population, which combinedly contribute to this cost increase. To compensate for the medical costs, which are increasing over time, it is better to choose health insurance. An individual can choose the health insurance for 8 lakh, 9 lakh, 10 lakh, etc., depending upon their needs and other criteria.

What is an 8 lakh health insurance policy?

An 8 Lakh health insurance policy is a health insurance policy that offers coverage up to Rs. 8,00,000 (8 lakh) of your incurred healthcare or medical expenses in a given policy year. This 8 lakh insurance refers to the maximum amount the insurer will have to pay out for your healthcare costs, as mentioned in the policy terms. This covers expenses such as room rent, medicine costs, doctor's fees, and other hospitalisation charges for a single insured person or a family (based upon the policy type).

Need for an 8 lakh health insurance policy

An 8 lakh health insurance plan is needed in India and is suitable for many individuals or families, especially those in Tier 2 and Tier 3 cities or with relatively lower healthcare expenses. But the suitability of an 8 lakh policy depends on several factors, such as age, lifestyle, location, and pre-existing conditions. For people in larger cities or those with pre-existing conditions, a higher sum insured (e.g., 10 lakhs or above) may be more suitable.

Benefits of an 8 Lakh Health Insurance Plan

There are several benefits of buying an 8 lakh health insurance plan. Here are the benefits of an 8 lakh health insurance plan.

• Inpatient Hospitalisation : This offers coverage for the expenses for room rent, nursing care, ICU charges, doctor's fees, medicines, and other costs related to a hospital stay of more than 24 hours.
• Pre- and Post-Hospitalisation Expenses : This health insurance plan covers medical expenses incurred before and after hospitalisation, particularly for a particular number of days (e.g., 30 days pre-hospitalisation and 60 days post-hospitalisation).
• Daycare Procedures : Several daycare procedures that do not need a full day of hospitalisation, like dialysis, cataract surgery, and chemotherapy, are usually covered.
• AYUSH Treatments : A few plans provide coverage for treatments under the Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy systems of medicine.
• Optional Benefits : Some optional benefits include the coverage for the maternity expenses, cataract treatment enhancement, and ambulance charges.
• Cumulative Bonus : Some policies offer a bonus, thus increasing the sum insured for every claim-free year.
• Room Rent Waiver : Some policies might permit a waiver of room rent restrictions.
• Cashless Hospitalisation : Several hospitals have tie-ups with health insurance companies, permitting cashless treatment.
• Organ Donor Expenses : Coverage might include expenses associated with the organ donation, like surgery, donor evaluation, and postoperative care.
• Emergency Medical Evacuation : This offers coverage for the expenses for emergency medical evacuation while you travel outside India.

How to Choose 8 Lakh Health Insurance? 

There are many things to be considered to choose the best 8 lakh health insurance. Here are the factors to consider when choosing the best 8 lakh health insurance:

• Age : Younger people usually pay out lower premiums than older people, as they are considered to have lower complications.
• Health Status : Pre-existing conditions might result in the higher premiums or the need for waiting periods before coverage starts.
• Lifestyle : Lifestyle choices such as smoking or excessive alcohol consumption can impact premiums.
• Policy Type : Individual plans provide coverage for a single person, while family floaters offer coverage for multiple family members.
• Coverage : Assess the coverage scope, like day care treatments, hospitalisation expenses, and potential add-ons.
• Waiting Period : Understand the waiting period for pre-existing conditions and other particular illnesses.
• Network Hospitals : See the availability of network hospitals in your region.
• Exclusions : Review carefully the policy's exclusions to understand what is excluded.
• Premium vs. Coverage : Balance the premium cost with the extent of coverage to identify a proper plan within your budget.
• Add-ons : Search for the optional riders, such as the critical illness coverage or maternity benefits.
• Claim Process : Understand the claim process, like if it's cashless or reimbursement-based.
• Medical History of Family Members : See for the family's medical history while you choose the health insurance coverage.
• Residential City : The city you reside in can impact medical costs and the needed coverage.
• Future Healthcare Costs : Make sure that you check the impact of medical inflation on future healthcare costs.

Inclusions in 8 Lakh Health Insurance 

There are many things that are included in the 8 lakh health insurance. Let's see what is included in 8 lakh health insurance in general :

1. Inpatient Hospitalization : This offers coverage for the expenses incurred during a hospital stay, like room rent, nursing charges, doctor's fees, ICU costs, and surgery expenses.
2. Pre- and Post-Hospitalisation : This provides coverage for the medical expenses incurred before and after a hospitalisation, like diagnostic tests, doctor consultations, and medications.
3. Day Care Procedures : Several health insurance policies offer coverage for the expenses for day care treatments that don't need a full overnight stay in the hospital.
4. Ambulance Charges  : Many plans include coverage for ambulance expenses, either a fixed amount or a percentage of the sum insured.
5. AYUSH Treatment : Several plans offer coverage for treatments under the Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homoeopathy systems of medicine.
6. Preventive Health Check-ups : Several policies provide coverage for annual health check-ups.
7. Other Inclusions : A few policies cover expenses associated with the organ donor costs, domiciliary hospitalisation (treatment at home under specific conditions), and some vaccinations.
8. Maternity Coverage: This offers coverage for the expenses associated with the childbirth, like delivery, prenatal care, and postnatal care.
9. Critical Illness Cover: This coverage involving a lump-sum payment upon diagnosis of a specific critical illness (e.g., cancer, heart attack) is optional only.
10. Room Rent Waiver : This waives the limit on room rent charges, permitting you to select a higher-category room. 
11. OPD Coverage : This offers coverage for the expenses for outpatient consultations and treatments, even without hospitalisation.
12. Home Care Treatment : This offers coverage for the medical expenses for treatment at home, according to the policy's terms and conditions.
13. Consumables Coverage : This offers coverage for the expenses for items such as syringes, gloves, and other consumables used at the time of the treatment.
14. Restore Benefit Coverage : This feature will help restore the sum insured once it's been exhausted at the time of a policy year, permitting continued coverage.

Exclusions in 8 Lakh Health Insurance

There are several things that are not included in the 8 Lakh Health Insurance. Let's see what is excluded in 8 Lakh Health Insurance in general: 

• Pre-existing Conditions : Many health insurance plans have a waiting period for pre-existing illnesses. This means that if you have a condition before buying the policy, it will not be covered till after the waiting period, which can range from a few months to a few years.
• Maternity Expenses  : Many policies exclude coverage for childbirth, prenatal care, and postnatal care. However, some policies offer maternity benefits after a waiting period.
• Outpatient Department (OPD) Treatments : Check-ups, routine doctor visits, and other outpatient treatments are usually not covered. These are not included to maintain the premiums lower.
• Cosmetic and Plastic Surgery  : Procedures such as cosmetic surgery for aesthetic reasons are not covered. However, reconstructive surgery after an accident or injury may be covered.
• Dental and Eye Treatments  : Routine dental work and vision correction procedures are usually not covered. But accidents that need dental or eye treatment might be covered.
• Self-Inflicted Injuries and Substance Abuse  : Injuries due to suicide attempts, self-harm, or illnesses associated with the drug or alcohol abuse are excluded.
• Congenital Conditions : Congenital diseases or genetic disorders might be excluded from health insurance coverage.
• Specific Diseases : Some diseases, such as HIV/AIDS and sexually transmitted infections, might not be covered.
• Experimental Treatments : Treatments that are not yet proven effective or considered experimental are not covered.
• War and Related Complications : Expenses associated with the war, invasion, or other similar events are not included.
• Particular Exclusions in Annexures : Certain policies might have particular exclusions listed in annexures or extra clauses, like non-medical expenses or artificial life maintenance.