Health Insurance for Kids

What is Health Insurance for Kids?

This refers to the health insurance that covers healthcare expenses arising from hospitalization, pre- and post-hospitalization, diagnostic tests, routine check-ups, medication, and vaccination of children. A few health insurance plans for kids might also offer financial coverage for the daycare procedures or ambulance charges. These Insurance plans may offer coverage for kids from the day of birth.

Why is Health Insurance for Kids Needed?

Medical insurance for kids is needed for many reasons. Here are the main reasons why parents should consider a child health plan:

• Handle Sudden Unexpected Medical Costs : Medical emergencies can occur anytime, even to adults and children. Buying Health insurance will help cover a small portion of hospitalization expenses, like doctor consultations, medications, diagnostic tests, and hospital stays. This financial protection ensures your kid the best possible medical care without having to worry about the cost.
• Promotes Preventive Care : Several kids' health insurance policies include coverage for preventive checkups, vaccinations, and routine screenings. These preventive measures could help identify health problems early on, permitting timely intervention and avoiding severe issues in the future.
• Provides Peace of Mind : If parents know that their child is covered by a comprehensive health insurance policy, then it offers them peace of mind. You can concentrate on their well-being without the financial panic related to unexpected medical bills.
• Offers Long-Term Benefits : Very early exposure to a healthy lifestyle with regular checkups and preventive care will improve good health habits in children. This could have a positive impact on their overall health and well-being throughout their lives.  
• Provides Several Medical Expenses : Several health insurance companies for children provide insurance coverage for hospitalization expenses, ambulatory care, daycare expenses during hospitalization, pre- and post-hospitalization costs, and even critical illness coverage.

Types of Child Health Insurances

Child health insurance plans can mainly be categorized into two types:

1. Individual Health Insurance for Kids:

An Individual Health Insurance for Kids plan offers customized coverage for a child on an individual sum insured basis. It covers only the medical expenses of the insured child, not other family members. Compared to family floater plans, this type of child health insurance plan comes at a lower premium. Includes hospitalization, paediatric consultations, vaccinations, and sometimes preventive care. It is ideal for parents who want exclusive medical coverage tailored to their child’s needs.

2. Family Floater Health Insurance:

A Family Floater Health Insurance plan provides medical coverage to a child along with other family members under a floater sum insured. Opting for a family health plan for your child is more financially feasible since it offers wider coverage at an affordable premium. It doubles up as a children health insurance policy, ensuring comprehensive protection for your child while safeguarding the entire family.

How to Choose the Best Health Insurance Policy for Kids?

Some factors help select health insurance plans for kids.  Here are the factors that help select the best health insurance for children.

1) Coverage

While you buy health insurance for family, look at the policy's coverage and benefits. Based on the insurance plan you choose, a kid's health insurance policy might cover all the major medical expenses you might incur for your child. 

2) Exclusions

The conditions that are not considered in health insurance are called exclusions. Completely check and understand the exclusions in the Insurance Plans for Kids, to make sure that you are aware of the policy terms and conditions. 

3) Network Hospitals

An emergency may occur at any age and needs quick medical assistance, which is more important for parents. Check if the plan has a good network of hospitals, particularly in your area. Get access to nearby quality hospitals.
 

4) Pre- and Post-Hospitalization Coverage

Many times, even a small stay at the hospital can incur more costs than an average person can afford. So, look for comprehensive plans that include pre- and post-hospitalization expenses, critical illness advantages, high room rent limits, and regular check-ups. 

5) Sum Insured

The sum insured refers to the maximum limit up to which the insurer will provide reimbursement or cashless for medical expenses. So, it is important to ensure the sum is insured. Sum insured is the maximum amount that can be claimed within policy period.

6) Type of Coverage

The type of insurance coverage parents select impacts the premium amount. When you select the right health insurance coverage for your children, include analysing their healthcare needs and then opt for an insurance policy that provides comprehensive advantages.

7) Co-Payments

Co-payments and deductibles are used to refer to the part of medical expenses that a policyholder must pay out of his/her pocket.  A higher co-payment lowers the total Premium but increases the claim amount.

8) Renewability

Ensure that you opt for a health insurance policy with lifetime renewability. Lifetime renewability is also an essential factor because it helps prevent the hassle of buying a new policy after a particular age. All retail indemnity health policies has life time renewability.

9) Waiting Period

The waiting period refers to a time period when particular coverage is not admissible. It is applicable to all health insurance policies and could vary between plans.  

10) Affordable Premium

Health insurance premiums are very low at an early age. The premiums for child health insurance are also low, making it affordable to get coverage for your children's medical expenses. 

11) Cashless Claims

See if the health insurance plan provides cashless hospitalization. Under cashless claims, you don't have to pay the admissible medical bills from your pocket.

13) Check the Waiting Period Clause

Look for plans with shorter PED waiting periods or those that offer coverage for pre-existing diseases after a specified waiting period to ensure timely access. The PED waiting period is the time period after which you can raise claims for pre-existing diseases.

14) Health Insurance Coverage

Clearly understand the health insurance policy you're planning to buy. Health insurance providers might provide insurance coverage for various aspects of treatment for various conditions, like critical illnesses and daycare.

15) No Claim Bonus

A few insurance policies provide a no-claim bonus, raising your insured sum for each claim-free year. If your kid has their own policy, they will enjoy a No-Claim Bonus (NCB) for many years.

16) Tax Benefits

You can enjoy tax deductions when you pay the Premium for a health insurance policy that covers you, your spouse, your children, and senior citizens in your family. According to Section 80D of the Income Tax Act, people of ages below or above 60 years of age can avail of different tax deductions.

17) Additional Benefits

See the extra advantages, such as the wellness programs, health check-ups, or discounts on medicines. Additional coverage, such as critical illness, may need a higher sum insured.

18) Calculate Premium

Premium refers to the amount you need to pay the insurer for health insurance coverage. Parents must calculate the premium amount or the cost they must pay to the insurer before buying the policy. Compare premium costs across different child health plans. Affordable options are available, but balance cost with coverage.

19) Check Age Criteria

Eligibility criteria for child health insurance plans usually include the child's age. The premiums vary according to the individual’s age.

20) Compare Multiple Health Policies

You must choose a cost-effective plan that provides coverage for the maximum hospitalization and treatment costs. Check the time period of the insurance policy to see if it's a one-year plan or a longer-term policy, as it can affect premiums.  

21) Go Through the Brochure and Prospectus

It is easily available on insurance company website to access all details of policy terms and conditions.

22) Financial Security

Financial Security that the insurance plan offers helps cover the rising cost of medical treatments.

23) High Claim Settlement Ratios

High claim settlement ratios denote the insurer's reliability and effectiveness in settling claims. Choose a plan with High claim settlement ratios.

24) Policy Duration

See the policy duration, whether it's a one-year plan or a longer-term policy, and whether it can affect premiums. Also, check the insurance plan's renewal process and whether it's easy to renew.  

By considering these factors, parents can confidently select the best child health insurance plan in India.

What is Covered Under Kids Health Insurance Plans?

Generally, the below listed are covered under Kids Health Insurance Plans. This includes,

• In-patient Hospitalization Expenses: Insurance plans typically cover hospitalization expenses such as room rent, nursing charges, ICU costs, and medical tests during your stay. This ensures financial protection for patients requiring extended treatment.
• Pre- and Post-Hospitalization Expenses: Health insurance also covers pre-hospitalization and post-hospitalization costs, including consultations, diagnostic tests, and medications. These benefits usually extend for 30 to 60 days before admission and after discharge, ensuring complete care beyond the hospital stay.
• Day Care Treatments: Many health insurance policies include daycare treatments, medical procedures or minor surgeries that do not require 24-hour admission. This makes it easier to access modern treatments without worrying about long hospital stays.
• Vaccination Coverage: Certain health insurance plans provide coverage for routine immunizations for children, helping parents manage the cost of essential vaccines. This benefit ensures timely protection against common diseases and supports overall child health and wellness.
• Ambulance Charges Coverage: Health insurance plans often cover ambulance service expenses, ensuring the insured child can be safely transported to the nearest hospital during a medical emergency.
• Domiciliary Hospitalization Coverage: Some policies include domiciliary hospitalization, which pays for medical treatment provided at home when advised by a qualified doctor. This coverage supports families when hospital admission is not possible but professional care is required.

What is Not Covered under Kids Health Insurance Plans?

The following will not be covered under the Insurance plans for kids.

• Pre-Existing Diseases: Treatment for pre-existing medical conditions in children is not covered until the completion of the specified waiting period mentioned in the policy.
• Congenital Disabilities: Expenses related to the treatment of congenital disabilities (conditions present at birth) are generally excluded from child health insurance coverage.
• War or Nuclear Hazard: Any injuries or illnesses caused by war, nuclear risks, or related perils are excluded from coverage under child health insurance policies.
• Personality or Behavioural Disorders: Insurance plans typically do not cover treatment for personality disorders, behavioural issues, or psychological conditions in children.
• Adventure Sports Injuries: Most child health insurance policies exclude coverage for injuries sustained during participation in adventure sports such as trekking, paragliding, or scuba diving.