Health Insurance Catastrophic Plan: Key Features, Benefits and Limitations
Catastrophic health insurance plans work the best to protect yourself from adverse situations. Most people don’t take it seriously, but it deeply impacts our lives. These health insurance plans generally have low monthly premiums and very high deductibles.
These catastrophic insurance works best when you need minimal routine checkups in the present but need protection from significant medical expenses in the future. This article will discuss the key features, eligibility criteria, benefits, limitations, etc.
We will also provide in-depth knowledge about India's top catastrophic health insurance plans. So, let's discuss -
Table of Contents
Key Features of Health Insurance Catastrophic Plans
1. Cover Hospitalisation Cost
The most crucial feature of catastrophic plans is their ability to cover hospitalisation costs in emergencies or sudden illness. These plans cover all severe illness costs, such as intensive care unit (ICU) fees, room charges, surgical fees, and daycare. They also pay doctor's fees and other pre- and post-hospitalisation costs. These plans also cover diagnostics costs and annual health checkups and offer the best health care.
2. High Deductibles
These plans generally have very high deductibles. They pay a significant amount of money before the insurance coverage is covered. Lower monthly premiums balance these high-deductible plans and give you peace of mind.
3. Stand against Medical Inflation
Due to skyrocketing medical expenses, you could quickly lose thousands or lakhs of rupees. These plans help you handle the growing cost of medical bills. If you can invest in a catastrophic primary medical insurance policy at an early age, you will get benefits in the future.
4. Access to Top-notch Healthcare
A good healthcare institution often helps patients recover faster, but the best treatment is expensive. Currently, a catastrophic plan helps bear the high cost and offers the best treatment.
5. Cover Lifestyle-related Diseases:
Nowadays, many people suffer from obesity, diabetes, heart ailments, etc. Catastrophic insurance can help in these situations. They pay for all the costs of your medical care and prescription drugs to treat your illnesses.
Eligibility Criteria for Catastrophic Health Plans
Catastrophic health insurance plans have two eligibility criteria. It can differ from one to one according to their situations; let's see:
- Age: Catastrophic health insurance plans are ideal for people under 30. Young people tend to be healthy, but these plans will benefit them in old age or severe illness.
- Hardship or Affordability Exemption: These plans are eligible for people experiencing hardships such as domestic violence, homelessness, bankruptcy, or human-caused disasters.
Benefits of Choosing a Catastrophic Health Insurance Plan
There are various benefits to choosing a Catastrophic Health Insurance Plan. Let's discuss the benefits -
1. Help in Medical Emergencies
Catastrophic Health Insurance Plans help in sudden medical emergencies. These are the best ways to prepare yourself for medical emergencies. If a sudden medical emergency comes, you can start your treatment urgently with the help of these plans.
2. Offer essential health benefits
These catastrophic plans cover the same essential health benefits as other Marketplace plans.
3. Preventive Care
Many catastrophic insurance policies cover preventive services at no cost, such as vaccinations, screenings, and regular health checkups.
4. Offer annual checkups
These plans help to cover at least three primary care visits per year. These checkups are free, without deducting any amount from your insurance.
Limitations of Catastrophic Health Insurance
Catastrophic health insurance brings a lot of benefits, although there are also notable limitations:
- Limited Routine Care Coverage: These plans are not for annual routine checkups. You can get coverage yearly up to approximately three times or roughly three times until the deductible is met.
- Network Limitations: Catastrophic plans are often restricted to the network. It limits the choice of doctors and hospitals.
- Eligibility Restrictions: There are strict age and exemption requirements. Everyone can’t avail of these plans.
Top Catastrophic Health Insurance Plans in India
Mostly, catastrophic health insurance plans are common in the United States. Now, India also has similar healthcare options available. These plans provide high deductible coverage and protect you from extra medical expenses:
1. Care Supreme Plan
The Care Supreme plan by care health insurance covers daycare treatments and pre- and post-hospitalisation expenses. They also provide a cumulative bonus of up to 100%.
Coverage: Starting from ₹7 lakhs, up to ₹1 crore.
2. Bajaj Allianz Health Guard Plan
This Health Guard Plan by Bajaj Allianz Health Insurance protects an extensive network of hospitals and offers various coverage options for different age groups.
Coverage: Starting from ₹1.5 lakh to ₹1 crore.
3. Niva Bupa Health Companion
The Companion plan by Niva Bupa Health Insurance provides extensive coverage for hospitalisation, pre- and post-hospitalisation expenses, and critical illnesses. It is very beneficial to cover severe illnesses.
Coverage: ₹5 lakh - ₹1 crore
4. HDFC ERGO Optima Secure Plan
The Optima Secure plan offered by HDFC Ergo health insurance provides intense coverage for hospitalisation and emergency services. It focuses on customer satisfaction and easy claim processes.
Coverage: Starting from ₹5 lakhs to ₹2 crores.
5. Digit Health Care Plus Plan
This Health Care Plus Plan by Digit Health Insurance provides extensive coverage for hospital bills and daycare. Its user-friendly digital interface makes it easy to use.
Coverage: Up to ₹3 crores.
Various catastrophic health insurance plans are available in India that you can compare through the InsuranceDekho website. Contact an InsuranceDekho relationship manager via email at support@insurancedekho.com or on call at +91-755 1196 989 to get complete guidance about insurance according to your needs.
FAQs
Ques 1. What are catastrophic limits?
Ans. The catastrophic limits are the sum of essential benefits, according to the ACA. In 2024, they can be $9,450 for a single individual.
Ques 2. What are the factors affecting catastrophic health expenditures?
Ans. Catastrophic health expenditures include household per capita income, chronic disease, and disability. They are generally considered a factor affecting poverty.
Ques 3. How much of the total expenditure is spent on health in India?
Ans. As per the fiscal year 2022-23, health expenditures are about 26% of the total expense on social services. The government aims to increase them to 2.5% of GDP by 2025.
Ques 4. What is the limitation period for insurance claims in India?
Ans. Three Years. The general limitation period for filing a claim in civil court is three years from the date of the health insurance appeal. It begins when the insurer claims rejection.
