What Are The Two Main Types Of Health Insurance?

In recent times, the main things we do in our lives revolve around our and our family’s well being and overall health. Thus it leads to more development of the health insurance industry. Health insurance is the insurance company that provides coverage to the policyholder to meet their future unpredictable medical expenses. Naman has never bought any health insurance before because he has so many complex views every time he asks his family, friends, or colleagues which make it difficult for him to grasp what is health insurance and how to go about it. Also, there is so much information available online that has confused him about which policy he should buy and what is best for him. Today, various health insurance companies offer their customers multiple plans that include higher medical coverage of almost fifty plus illnesses, cashless treatment at their network hospitals, free medical check-up, and much more. Many were investing for tax saving purposes under section 80D of the income tax act, 1961, and ignored the fact that there are different health insurance plans. There are many health insurance types, but the policyholder’s most common questions are — what are the two main types of health insurance? Or  what are the two major types of health insurance? Well, let us understand about it in the article below.

What are the two main types of health insurance?

There are two main types of health insurance — Indemnity Policy Plan and Defined Benefit Policy Plan.

1. Indemnity Policy Plan

An indemnity plan is a basic medical insurance policy plan that protects the policyholder from an unforeseen medical expense to the sum insured; the insurance company reimburses the hospitalization charges. The sum insured amount is pre-decided by the insurance company.

The plans under indemnity health insurance are:

- Medical Insurance

Also known as the Mediclaim policy, the insurer compensates the policyholder for the hospitalization expense incurred due to accident or illness. The cost includes medicine charges, oxygen, surgery expenses, etc.

- Individual Health Insurance Policy

This insurance policy is meant for an individual, and the policyholder can claim up to the necessary sum insured only. For example, if a policyholder has an individual health insurance policy of INR 2 lakhs and the spouse is covered, then both can claim INR 2 lakhs individually.

- Family Floater Plan

This policy is meant to cover the whole family. The sum insured will be distributed equally among the family members, and in case of a medical emergency, one family member can also use the entire amount. The premium of a family floater plan is lesser than an individual plan.

- Senior Citizen Plan

This policy is designed for any individual above 60 years. It generally covers a higher sum assured with the benefits of pre-existing disease cover, other critical disease covers, cashless hospitalization, ambulance charges, hospitalization charges, daycare expenses, etc.

Clauses of Indemnity Plan include deductibles

— the policyholder needs to pay the pre-fixed sum amount to the health insurance policy company before they reimburse the amount in the event of a medical emergency in the form of claims. And co-payment clause — where a certain percentage of the claim amount will be paid by the insurer and the rest amount the policyholder needs to pay at the event’s time. Senior citizen’s health insurance policies usually attract this clause.  

2. Defined Benefit Policy Plan

A defined benefit health policy pays a specified sum on a covered event. Hospital cash policy, critical illness policy, major surgeries, etc., are defined benefit health plans. A vital health policy is the most generally defined benefit plan. The insurance company pays the coverage or sum assured on diagnosis of an insured critical illness, irrespective of the hospital expense.

What are the two major types of health insurance?

Medical Insurance and Critical Illness are the two major health insurance types offered in India and the basic health insurance plan. In India, when it comes to health insurance, Bajaj Allianz leads with a wide-range of cost-effective health insurance plans with maximum coverage customized for each customer to save money in hospital bills and save tax well.

Below are some frequently asked questions asked by a policyholder about health insurance:

1. What is Group Health Insurance?

Group health insurance is intended for a group of employees working together in the same company, and the employer of the company provides it to their employees.

2. What are the three main tips to check before buying the health insurance policy?

• Choose a health insurance policy plan with a minimum waiting period.
• Maximum network hospital for cashless claims.
• Plan which includes maximum age renewal.

Final Thoughts

Medical insurance can vary from one person to another and majorly depend on their age, medical condition, and lifestyle. Both the Indemnity plan and Defined Benefit plan have their benefits; doubling both policies gives a comprehensive cover towards any unforeseen medical emergency. Balancing between both the policy ensures to cover any expenses towards pre and post-hospitalization.