Mediclaim / Health Insurance

Health insurance, like other forms of insurance, is a form of collectivism by means of which people collectively pool their risk, in this case the risk of incurring medical expenses. The collective is usually publicly owned or else is organized on a non-profit basis for the members of the pool, though in some countries health insurance pools may also be managed by for-profit companies. It is sometimes used more broadly to include insurance covering disability or long-term nursing or custodial careneeds. It may be provided through a government-sponsored social insurance program, or from private insurance companies. It may be purchased on a group basis (e.g., by a firm to cover its employees) or purchased by an individual. In each case, the covered groups or individuals pay premiums or taxes to help protect themselves from unexpected healthcare expenses. Similar benefits paying for medical expenses may also be provided through social welfare programs funded by the government.

By estimating the overall risk of healthcare expenses, a routine finance structure (such as a monthly premium or annual tax) can be developed, ensuring that money is available to pay for the healthcare benefits specified in the insurance agreement. The benefit is administered by a central organization such as a government agency, private business, or not-for-profit entity.

 

The concept of health insurance was proposed in 1694 by Hugh the Elder Chamberlen from the Peter Chamberlenfamily. In the late 19th century, “accident insurance” began to be available, which operated much like modern disability insurance. This payment model continued until the start of the 20th century in some jurisdictions (like California), where all laws regulating health insurance actually referred to disability insurance.

   

Accident insurance was first offered in the United States by the Franklin Health Assurance Company of Massachusetts. This firm, founded in 1850, offered insurance against injuries arising from railroad and steamboat accidents. Sixty organizations were offering accident insurance in the U.S. by 1866, but the industry consolidated rapidly soon thereafter. While there were earlier experiments, the origins of sickness coverage in the U.S. effectively date from 1890. The first employer-sponsored group disability policy was issued in 1911.

                                                                                  

Before the development of medical expense insurance, patients were expected to pay all other health care costs out of their own pockets, under what is known as the fee-for-service business model. During the middle to late 20th century, traditional disability insurance evolved into modern health insurance programs. Today, most comprehensive private health insurance programs cover the cost of routine, preventive, and emergency health care procedures, and most prescription drugs, but this is not always the case.

Hospital and medical expense policies were introduced during the first half of the 20th century. During the 1920s, individual hospitals began offering services to individuals on a pre-paid basis, eventually leading to the development of Blue Crossorganizations. The predecessors of today’s Health Maintenance Organizations (HMOs) originated beginning in 1929, through the 1930s and on during World War II.

 

BENEFITS IN HEALTH INSURANCE:-

1. Accident Cover.

2. Death Cover.

3. Hospitalization Expenses.

4. Doctor Fees.

5. Medical Expenses.

6. Deceases Cover.

If you are planning to buy a health insurance policy and are not sure how much is enough, here is a quick guide to help you out.

HEALTH INSURANCE:-

There is no thumb rule to guide you about the amount of health insurance you need. We say that keeping in mind the average cost of major surgeries these days, a cover of Rs. 4 lakhs is good enough. Also, if you are covered by your employer for say Rs. 2 lakhs, you can go in for an individual health policy of another Rs. 2 lakhs, provided that you work at a reputable company and don’t change jobs frequently.

If you have a family, you can top up your individual policy with a family floater. Keep in mind that even though a family floater policy covers all the members of the family, even if you make a claim for one member of the family, the amount that was claimed will reduce the sum insured by that much. For instance, if your family floater policy offers a sum insured amount of Rs. 3 lakhs and one member makes a claim of Rs. 1 lakh, the sum insured for the rest of the year would be reduced to Rs. 2 lakhs.

The above mentioned figures do not take into account your specific individual situation.

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