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What is Health Insurance? |
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Medical expenses are sky high these days, but was never cheap ever. Even a small treatment or an appointment with a doctor might consume a lot of money. Health insurance is a must, it saves money and covers unexpected calamities. Health insurance comes in handy to meet emergencies of severe ailment or accident. Sometimes it is associated with covering disability and custodial needs. Life is unpredictable, insurance can make it safe and secure from bearing huge loss. Health insurance is affordable and carries the assurance and freedom from insecurities that threaten life now and then.
We liaise with the leading health insurance providers in India and buying through us enables analyzing costs and benefits from the pool of policies matching your requirements and of course not to forget the quality service offered by us. |
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Learn How to Save Tax with Your Health Insurance Premium
It's common knowledge that buying health insurance helps you to save tax. Under Section 80D of the Income Tax Act 1961, you can get a maximum tax benefit of Rs.15000 on health insurance premium paid. The exemption limits are as follows:
- An individual can avail an annual deduction of Rs.15000 from taxable income for health insurance premium paid for self and dependants. 'Dependents,' in this case, refers to spouse and children.
- In the case of senior citizens (aged 56 years and above), the annual deduction from taxable income goes up to Rs.20000.
But here's a tidbit that might help you save more tax than you think:
- If you are paying the premium for your parents' health insurance, you can claim an additional tax benefit up to Rs.15000 under the provisions of Section 80D.
- If your parents are senior citizens (aged 56 years and above), the benefit goes up to Rs.20000.
Put together, the two facts listed above come down to this: The health insurance premium that you pay for yourself, your dependents (spouse and children) and your parents, are all considered for tax benefit under Section 80D of the Income Tax Act 1961. Therefore, you can claim a deduction up to Rs.30000 on your taxable income, and if your parents are senior citizens, the deductible amount goes up to Rs.35000.
However, there are a few conditions:
- You cannot claim tax benefit on health insurance premium paid for your in-laws.
- Proof of payment of premium has to be furnished, in order to avail the tax benefit.
- Except cash, any mode of payment is acceptable for claiming tax benefit.
The health insurance premium must be paid from your taxable income of that year only if you want to claim a deduction. If you have paid the premium from your savings or from gifts of money received by you, then you will not be eligible to claim tax benefit under Section 80D.
Tips for choosing the right Health Insurance plan
When it comes to health insurance, there’s no one-size-fits-all plan that you can rely on. Of the numerous plans in the market, you will find that each is unique in some way, with its own benefits and limits. This makes purchasing health insurance a difficult task where painstaking research is sometimes required, before you find the right plan for you.
Before you go plan-hunting, there are some questions you need to ask yourself:
- What is my financial ceiling?
- What do I have to cover? Am I responsible only for myself? Do I have dependents? Am I planning for retirement yet? Am I already retired?
- How often do I need to visit the doctor?
- How much premium can I afford?
- Do I have any pre-existing medical conditions?
- How comprehensive a plan do I want?
- Do I need regular dental and/or vision check-ups?
- Do I use many prescription medicines?
- How much preventive care do I want?
- Am I constantly exposed to hazards such as the possibility of an accident, exposure to toxins, a weak immune system, etc.?
- Am I at risk of any hereditary diseases?
Knowing the answer to these questions will help you recognise which slot you fall into, and what your insurance needs are. It’ll narrow down your search and give you an estimate of how much you should be spending – and what benefits you ought to get for your money.
Once you know your healthcare requirements, it’s time to go shopping. Even with the field narrowed down, it’s easy to lose sight of what you need. Here are some tips you should keep in mind to ensure that you aren’t buying the wrong plan:
- Know how much the average cost of your healthcare should be. For example, it is generally accepted that a Rs.5 lakh cover is sufficient for a single adult.
- Individual covers are usually more comprehensive than family plans, and also cheaper on your wallet in the long run. Moreover, individual health plans cover most, if not all your checkups, pre- and post-hospitalisation expenses, and other domiciliary costs, which are usually somewhat limited in an umbrella cover.
- Check your policy to see if it provides cover for atypical expenses, like maternity, vision, dental, etc. If it doesn’t, find out if such covers can be added to your policy, or if they will be covered after a certain number of years have elapsed.
- Never select a policy based on premium alone. Find out what your insurer’s claim settlement history is. If they have a reputation for speedy claim resolution and better payouts, go for it. If, however, the claim settlement takes ages and too much paperwork or other hassles, search for another provider.
- Assess your risk-taking ability before you choose to opt for a floater plan. Though these are comparatively cheaper than individual plans, and provide cover for your entire family, they also mean that you have to assume a higher amount of risk in exchange for a smaller premium.
- If you are employed and your employer pays for your insurance cover, it would be wise to get a separate cover privately, as well. The main reason being – though workplace insurance covers are usually very beneficial, they may be terminated when you leave your organisation. Today, most people are mobile when it comes to changing jobs, so you might not always have a cover when you’re transitioning from one job to the next.
- Consider getting additional covers, like critical illness cover, accident cover, hospital cash, surgical cover, etc. These can be added to your existing policy as riders, for an added sum to your premium.
Keep to the above list of considerations, and you should be able to find the right cover with little trouble!
Learn How to Save Tax with Your Health Insurance Premium
It's common knowledge that buying health insurance helps you to save tax. Under Section 80D of the Income Tax Act 1961, you can get a maximum tax benefit of Rs.15000 on health insurance premium paid. The exemption limits are as follows:
- An individual can avail an annual deduction of Rs.15000 from taxable income for health insurance premium paid for self and dependants. 'Dependents,' in this case, refers to spouse and children.
- In the case of senior citizens (aged 56 years and above), the annual deduction from taxable income goes up to Rs.20000.
But here's a tidbit that might help you save more tax than you think:
- If you are paying the premium for your parents' health insurance, you can claim an additional tax benefit up to Rs.15000 under the provisions of Section 80D.
- If your parents are senior citizens (aged 56 years and above), the benefit goes up to Rs.20000.
Put together, the two facts listed above come down to this: The health insurance premium that you pay for yourself, your dependents (spouse and children) and your parents, are all considered for tax benefit under Section 80D of the Income Tax Act 1961. Therefore, you can claim a deduction up to Rs.30000 on your taxable income, and if your parents are senior citizens, the deductible amount goes up to Rs.35000.
However, there are a few conditions:
- You cannot claim tax benefit on health insurance premium paid for your in-laws.
- Proof of payment of premium has to be furnished, in order to avail the tax benefit.
- Except cash, any mode of payment is acceptable for claiming tax benefit.
- The health insurance premium must be paid from your taxable income of that year only if you want to claim a deduction. If you have paid the premium from your savings or from gifts of money received by you, then you will not be eligible to claim tax benefit under Section 80D.
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Products:
1.Health guard
Features
- You will have cashless facility at over 2300 hospitals across India.
- With Health Guard, you will have access to cashless facility at various empanelled hospitals across India as well.
- Pre and post hospitalization expenses will cover relevant medical expenses incurred for 60 days prior to and 90 days after hospitalisation.
- Covers ambulance charges in an emergency subject to a limit of Rs.1000 /-.
- No tests required for members below the age of 45, up to a sum insured of Rs.10 lakhs.*
- 10% co- payment applicable if treatment is taken in non-network hospitals.
- 20% co-payment applicable for members of age group 56 -65 years, if they are opting for this policy for the first time.
- Waiver on 10% co-payment is available on payment of additional premium.
- Pre-existing diseases will be covered after 4 years of continuous policy renewal with Bajaj Allianz.
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Benefits
- Our in-house Health Administration Team for hospitalisation claims will lower the turn around time.
- Access to over 2300 hospitals all over India for cashless facility.
- No sub-limits applicable on room rent and other expenses.
- Hassle-free claim settlement due to in-house claim administration.
- Income tax benefit on the premium paid as per section 80-D of Income Tax Act as per existing IT law.
- Health Check up for maximum amount of Rs.1000 /- at the end of 4 continuous claim-free years.
- Family discount of 10% will be applicable.
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Plan Details
Eligible Age:
- Entry age for proposer is 18 years-65 years. The policy can be renewed upto 80 yrs.
- Children aged 3 months to 5 years are eligible if both parents are insured with Bajaj Allianz.
Restrictions on the Value of the Sum Insured:
- Sum insured from Rs.1.5 lakh to Rs.10 lakh can be opted from the age of 3 months to 55 years.
- Sum insured from Rs.1.5 lakh to Rs.5 lakh can be opted from the age of 56 years to 65 years.
- No tests are required for a sum insured of upto Rs.10 lakh till the age of 45 years (subject to a clean proposal form).
Pre-policy Check-ups:
- No medical tests are required upto the age of 45 years, subject to a clean proposal form.
- Medical tests (pre-policy check-ups) are mandatory for members aged 46 years and above.
- The pre-policy check-up is arranged at one of our empanelled diagnostic centres.
- The cost of the pre-policy check-up is refunded in full, if the proposal is accepted and the policy is issued.
Voluntary Deductibles:
This policy has an option of voluntary deductibles where discounts are applied, as given below:
Deductible Amount |
Discount (%) |
10,000 |
10.0% |
15,000 |
15.0% |
25,000 |
17.5% |
50,000 |
20.0% |
75,000 |
22.5% |
1,00,000 |
25.0% |
1,50,000 |
27.5% |
2,00,000 |
30.0% |
2,50,000 |
32.5% |
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Coverage
- Sum insured from Rs.1 lakh to Rs.10 lakhs can be opted for a period of 3 months to 55 years.
- Sum insured from Rs.1 lakh to Rs.5 lakhs can be opted for a period of 56 months to 65 years. Policy can be renewed up to 80 years.*
- In built E-opinion cover for sum insured Rs.5 lakhs and above.
Pre and Post Hospital Expenses:
- Medicines: Mandatory to provide doctor's prescription advising medicines and the relevant chemist bill.
- Doctor's Consultation Charges: Mandatory to provide the doctor's prescription and the doctor's bill and receipt.
- Diagnostic Tests: Mandatory to provide the Doctor's prescription advising tests, the actual test reports and the bill and receipt from the diagnostic centre.
- The claims team would assess the claim for completeness of documentation and admissibility. A written communication would be sent to the insured regarding requirement of documents if any or if the claim is deemed to be inadmissible as per the policy’s terms and conditions.
- In case the claim is determined to be admissible a pay order and discharge voucher would be sent to the insured address as mentioned on the policy document.
Exclusions:
- A waiting period of 4 years will be applicable, in the case of pre-existing diseases.
- Any disease contracted during the first 30 days of commencement of the policy will be excluded from coverage.
- Diseases such as hernia, piles, cataract, sinusitis, etc. shall be covered after a waiting period of 2 years.
- Certain diseases such as joint replacement surgery, surgery for prolapsed inter vertebral disc (unless necessitated due to accident), surgery to correct deviated nasal septum and hypertrophied turbinate, congenital internal diseases or anomalies and laser treatment for correction of eye sight due to refractive error will be covered after a waiting period of 4 years.
*conditions apply |
2.Family Floater
Features
- The member has cashless facility at over 2300 hospitals across India
- With Health Guard, the member has access to cashless facility at various empanelled hospitals across India.
- Pre and post - hospitalization expenses covers relevant medical expenses incurred 60 days prior to and 90 days after hospitalization
- Covers ambulance charges in an emergency subject to limit of Rs. 1000 /-
- No tests required up to 45 years up to SI 10 lacs*
- 10% co- payment applicable if treatment taken in non-network hospitals
- 20% co-payment applicable for members of age group 56 -65 years, opting this policy for first time
- Waiver on 10% co-payment is available on payment of additional premium
- Pre-existing diseases covered after 4 years continuous renewal with Bajaj Allianz
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Benefits
- In house Health Administration Team for hospitalisation claims to lower turn around time.
- Access to over 2300 hospitals all over India for cashless facility.
- No Sub-limits applicable on room rent and other expenses.
- Hassle-free claim settlement due to In-house claim administration.
- Income tax benefit on the premium paid as per section 80-D of Income Tax Act as per existing IT law.
- Health Check up for maximum amount of Rs. 1000 /- at the end of continuous four claim free years.
- Family discount of 10% is applicable
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Coverage
- Sum insured from Rs. 1lakh to Rs.10 lakhs can be opted from 3 months to 55 yrs.
- Sum insured from Rs. 1lakh to Rs.5 lakhs can be opted from 56 months to 65 yrs Policy can be renewed up to 80 years*
- In built E-opinion cover for SI 5 lacs & above.
Pre and Post Hospital Expenses:
- Medicines: Mandatory to provide doctor's prescription advising medicines and the relevant chemist bill.
- Doctor's Consultation Charges: Mandatory to provide the doctor's prescription and the doctor's bill and receipt.
- Diagnostic Tests: Mandatory to provide the Doctor's prescription advising tests, the actual test reports and the bill and receipt from the diagnostic centre.
- The claims team would assess the claim for completeness of documentation and admissibility. A written communication would be sent to the insured regarding requirement of documents if any or if the claim is deemed to be inadmissible as per the policy’s terms and conditions.
- In case the claim is determined to be admissible a pay order and discharge voucher would be sent to the insured address as mentioned on the policy document.
Exclusions:
- A waiting period of 4 years will be applicable in the case of pre-existing diseases.
- Any disease contracted during the first 30 days of commencement of the policy will be excluded from coverage.
- Certain diseases such as hernia, piles, cataract (liability restricted upto 10% of SI, max. upto Rs. 35,000) and sinusitis shall be covered after a waiting period of 2 years.
- Treatments consisting of non-allopathic medicine will not be covered.
- Congenital diseases are also excluded from coverage, as are all expenses arising from AIDS and other related diseases.
- Cosmetic, aesthetic or related treatments will not be covered.
- Treatment will not be covered for use of intoxicating and/or addictive substances like alcohol, drugs, etc.
- Joint replacement surgery (other than due to accidents) shall have a waiting period of 4 years before it is covered.
*conditions apply |
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Plan Details
Eligible Age:
- Entry age for proposer is 18-65 years. The policy can be renewed upto 80 years.*
- Children from 3 months to 25 years are eligible if both the parents are insured with Bajaj Allianz.
*conditions apply
Restrictions on the Value of the Sum Insured:
- Sum insured from Rs.2 lakh to Rs.10 lakh can be opted from 3 months to 55 years.
- Sum insured from Rs.2 lakh to RS.5 lakh can be opted from 56 years to 65 years.
- No tests are required for a sum insured of upto Rs.10 lakh till the age of 45 yrs (subject to a clean proposal form).
Pre-policy Check-ups:
- No medical tests are required upto the age of 45 years, subject to a clean proposal form.
- Medical tests (pre-policy check-ups) are mandatory for members aged 46 years and above.
- The pre-policy check-up is arranged at one of our empanelled diagnostic centres.
- The cost of the pre-policy check-up is refunded in full, if the proposal is accepted and the policy is issued.
Voluntary Deductibles:
This policy has an option of voluntary deductibles where discounts are applied, as given below:
Deductible Amount |
Discount (%) |
10,000 |
10.0% |
15,000 |
15.0% |
25,000 |
17.5% |
50,000 |
20.0% |
75,000 |
22.5% |
1,00,000 |
25.0% |
1,50,000 |
27.5% |
2,00,000 |
30.0% |
2,50,000 |
32.5% |
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3.Silver Health
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As the age of an individual increases, health care costs increase & become a burden on the individual. Senior citizens have to pay out their hard earned savings to meet the expenses. Bajaj Allianz' Silver Health is an insurance policy designed exclusively for senior citizens that covers medical expenses incurred during hospitalization. |
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Features |
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- Pre-existing diseases covered upto 50% from the second year of the policy
- A flat benefit of 3% on admissible hospitalization expenses are paid towards pre & post hospitalization expenses
- Cashless facility: With Silver Health plan, the member has access to cashless facility at wide network of 2400 hospitals across India (subject to exclusions and conditions)
- Incase of admission in non-network hospitals, the expenses incurred would be reimbursed within 14 days from the submission of all documents
- 20% of co-payment of the admissible claim to be paid by the member if treatment is taken in a hospital other than a network hospital
- Waiver of co-payment is available on payment of additional premium
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Advantages |
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- Cumulative bonus of 5 % added to your sum assured for every claim free year
- Health Check up at the end of continuous four claim-free years
- Family discount of 5 % is applicable
- Income tax benefit on the premium paid as per section 80-D of the Income Tax Act as per existing IT law
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Coverage |
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- Policy can be taken form 46-70yrs *
- Renewal up to 75 yrs*
- SI can be opted from 50,000 - 5, 00,000.
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Silver Health: Annual Premium Rate |
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Age/
Sum Insured |
46-50 |
51-55 |
56-60 |
61-65 |
66-70 |
50000 |
1995 |
2495 |
3824 |
4780 |
7170 |
100000 |
2993 |
3742 |
5736 |
7170 |
10755 |
150000 |
3741 |
4677 |
7170 |
8963 |
13444 |
200000 |
4676 |
5846 |
8963 |
11203 |
16805 |
300000 |
5845 |
7308 |
11203 |
14004 |
21006 |
400000 |
8767 |
10962 |
16805 |
18905 |
24199 |
500000 |
10959 |
13155 |
21006 |
23632 |
29039 |
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* Premium excludes Service Tax |
Claim Procedure |
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1. The illness / claim should be reported to Bajaj Allianz General Insurance Company Ltd with an immediate notice by telephone or in Writing (email / letter).
2. On receipt of claim intimation, Bajaj Allianz General Insurance Company Ltd will forward a claim form and check list for the documents to be submitted by the claimant.
3. After receiving the claim form the claimant should submit the completed claim form mentioning the following mandatory details:-
- Insured details (Name / Address / Age / Sex / Contact NO).
- ID card number and the current policy number
- Hospitalization details (Date and time of admission and discharge).
- Details of the other mediclaim policies in force.
- Signature of the claimant.
4.The other relevant documents to be submitted along with the claim form are as follows:-
- A photocopy of your previous policy details prior to taking your Silver Health policy from Bajaj Allianz (if applicable)
- A photocopy of your present policy document with Bajaj Allianz
- First Prescription from the Doctor.
- The Claim Form duly signed by the claimant or family member.
- The Hospital Discharge Card
- The Hospital Bill giving detailed break up of all expense heads mentioned in the bill. E.g. if Rs.1,000/- has been charged towards medicines in the bill, the names of the medicines, the unit price and the quantity used should be mentioned. Similarly e.g. if Rs.2,000/- has been charged towards Laboratory Investigations, then the names of the investigations, the number of times each investigation has been performed and the rate should mentioned. In this way clear break ups have to be mentioned for OT Charges, Doctor's Consultation and Visit Charges, OT Consumables, Transfusions, Room Rent, etc.
- The Money Receipt duly signed with a Revenue Stamp.
- All Original Laboratory & Diagnostic Test Reports. E.g. X-Ray, E.C.G, USG,MRI Scan, Haemogram etc.(Please note that it is not mandatory to enclose the films or plates, a printed report for each investigation is sufficient)
- If the medicines have been purchased in cash and if this has not been reflected in the hospital bill, a prescription from the doctor and the supporting medicine bill from the Chemist have to be enclosed.
- If the insured has paid in cash for Diagnostic or Radiology tests and it has not been reflected in the hospital bill, it is mandatory to enclose a prescription from the doctor advising the tests, the actual test reports and the bill from the diagnostic centre for the tests.
- In case of a Cataract Operation, please enclose the IOL Sticker
PLEASE NOTE THAT ONLY ORIGINAL DOCUMENTS SHOULD BE ENCLOSED (EXCEPT FOR POLICY COPY), DUPLICATES OR PHOTOCOPIES WILL NOT BE ENTERTAINED
Pre & Post Hospital Expenses:-
- Medicines: Mandatory to provide doctor's prescription advising medicines and the relevant chemist bill.
- Doctor's Consultation Charges: Mandatory to provide the Doctor's prescription and the doctor's bill and receipt.
- Diagnostic Tests: Mandatory to provide the Doctor's prescription advising tests, the actual test reports and the bill and receipt from the diagnostic centre.
- The claims team would assess the claim for completeness of documentation and admissibility. A written communication would be sent to the insured regarding requirement of documents if any or if the claim is deemed to be inadmissible as per Policy terms and conditions.
- In case the claim is determined to be admissible a pay order and discharge voucher would be sent to the insured address as mentioned on the policy document.
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*conditions apply. |
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