Health Insurance

Eligibility for Health Insurance

The premium that the policy holder pays for health insurance depends on various factors one of which is the health condition of the insured. While buying a health insurance policy the insurer asks the policy holder to undergo a medical test to be submitted to the insurance company as one of the most important documents. This helps the underwriters to determine the premium for the prospective policy holder. Usually this practice is followed for individuals above 45 years of age opting to buy a health insurance policy. The amount you pay for the premium varies with the age of the individual and certain pre-existing medical conditions. Declaring the age is important to avoid any claim rejection and is a compliance issue for the company.

It is unlikely that an application for health insurance is rejected. The grounds on which you will be eligible for a health insurance plan or rather not being rejected with an application for a health insurance plan can be the following:

  1. If you are suffering from a serious health ailment and your health condition is already bad. Since one cannot predict the future and specifically the future health, it is better to apply while you are still at good health.
  2. If you are suffering from a chronic illness which is not permanent in nature, the health insurance company may reject your application and ask you to reapply once you have cured yourself. However, since the ailment was chronic in nature, the chances if recurring is high which ultimately increases your risk profile and hence higher premiums.
  3. There could be situations where in your initial application might be accepted but post a medical test, the insurer might feel their risk appetite is low to have you as a policy holder and may reject your application. There could be another insurer who might reject your application based on the rejection history from the previous one. However, certain insurers can on-board you with a higher premium.
  4. The eligibility also depends on the results of your medical tests. The tests involve urine and blood sample tests which is a clear indicator of any sort of kidney issues, diabetes or smoking and drinking habits. Depending on the risk appetite of the insurer, your application may be accepted or rejected.

Eligible Age for Buying Health Insurance

Speaking of numbers, the entry age for having a health insurance plan for adults to be a policy holder is 18 with an upper age limit of 65. In certain cases, 70 years depending on the plan and the insurer. The age at which children can avail health insurance benefits is from 90 days to 18 years.

It is recommended to buy the health insurance plan at an early age. The benefits are many:

  1. Avail the benefits at a lower premium.
  2. Since at an early age, the chances of undergoing a major surgery or being diabetic is less, the coverage amount is much lower compared to a policy bought at later age with pre-existing medical conditions.
  3. The earlier the policy is bought, the longer you enjoy the benefits.
  4. The premium amount can be locked in and further amendments to the premium is made keeping the existing premium amount as the base price.
  5. Cumulative bonuses and no claim bonuses can be availed during renewal. This is possible when you buy at an early age and have made no claims and in good health during renewal.

ULIP in Health Insurance?

For people who feel putting money in buying a health insurance plan is preventing them from building a corpus and saving some amount to gain financial freedom, ULIP is the best option. A ULIP in health insurance is a combination plan which comprises of two plans- a regular health insurance plan which you can keep yourself and your family covered and claim as and when need arises and an investment plan which is market based and can be used to invest in equity and debt markets depending on the risk appetite of the policy holder.

This is particularly helpful for the following reasons:

  1. Instances where you are hospitalised for a pre-existing disease, the health insurance plan will not cover the claims. The corpus built from a ULIP can be immensely beneficial.
  2. It is up to the policy holder to determine the amount to be set aside for health coverage. The balance amount is directed to the savings pool.
  3. You get the maturity amount at the end of the term and the amount is equal to the fund accumulated. If the policy holder passes away before that, the nominee receives the money.

Getting health insurance is not tough, but declaring the right information and having some basic knowledge is essential for claim processing.