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Frequently asked questions on Health Insurance - I

Health insurance​ was launched in India in 1986 and went by the name of Mediclaim Insurance. After its launch it has grown significantly over the years. As per government estimates by the year 2010, 25 per cent of Indian population had access to one or other form of health insurance.

Given to understand the growing health insurance phenomenon among the general population, it is very important to shed some light on what is health insurance and what are the benefits available to the general public. Present below are some of the frequently asked questions pertaining to Health Insurance sector in India. The topic being vast so will cover the questions and answers in two parts.

What is actually Health Insurance?

Health insurance is type of insurance that covers medical expenses incurred by the individual. It is an agreement between the insurer and individual or group of people in which the insurer agrees to provide sufficient health coverage at a premium to the individual or group of people.  

Why is it important?

With the cost of medical expenses and hospitalisation skyrocketing , it is very important to get oneself covered with health insurance. It helps in meeting the sudden expenses of emergency hospitalisation of oneself or any member of the family. It protects from sudden , unexpected costs of hospitalization or other covered health events like critical illnesses, which otherwise may dent the household savings  even leading to indebtedness.

Medical emergency can strike anyone without prior warnings  and healthcare becoming increasingly expensive, it is very important to opt for medical coverage and buy policies which covers the entire family too. Sometimes high treatment expenses may be beyond the reach of many, so opting for medical insurance is the best thing to do at this point of time.

What are the different forms of Health Insurance available in India?

​The basic health insurance is available for hospitalisation in India. But due to liberalisation and the insurance sector opened for private players, and with increase in competition in health insurance sector, a variety of products have been launched which offers range of services for individuals, families, group of people and senior 


The health insurance works in two ways in India, one is cashless facility, wherein the entire bill is taken care of by the provider at the time of hospitalisation and the other way is where the entire money is reimbursed to the policy holder after he takes care of the hospital expenses himself. 

What is cashless facility?

This facility is only available at the network hospitals of the Insurance provider. 
The insurance companies ties up with hospitals in different parts of the country and forms a network of such hospitals which offer cashless hospitalisation benefits to the policy holder. So in case of emergency hospitalisation or planned hospitalisation, the policy holder has to approach one of the network hospitals of the insurance providers.

At the time of hospitalisation, the policy holder has to fill up preauthorization form for availing this facility and this form has to be submitted to Third Party Administrator (TPA) as appointed by the Insurance provider. Once the TPA approves the form, the patient becomes eligible for availing this facility. 

Cashless facilities​ cannot be availed at other hospitals which are not part of the network hospitals.