Health Insurance vs Critical Illness Insurance

What is Health Insurance Policy?

A health insurance policy provides financial protection against medical expenses incurred due to illness or injury. The policyholder pays a premium to the insurance company in exchange for coverage of medical expenses. 

Health insurance policies typically cover a range of medical expenses, including hospitalization, surgery, diagnostic tests, doctor visits, and prescription drugs. Policies may also include coverage for preventive care services such as routine check-ups, vaccinations, and screenings.

How Health Insurance works

Health insurance works by paying medical expenses incurred due to illness or injury. Check out the steps involved in health insurance below:

Policy Enrollment:You can buy a health insurance policy by reviewing the coverage limits, premium amount, deductibles, co-payments, and network of healthcare provider. The premium amount depends on the required coverage, individual's age, health condition, and sum insured by the policy.

Medical Treatment: When the policyholder needs medical treatment, they visit a healthcare provider, such as a doctor or hospital. The provider may submit a cashless claim or a reimbursement claim to the insurance company for the medical services provided.

Health Insurance Claim Process: The insurance company reviews the claim and determines if the medical treatment is covered under the policy. If it is, the insurance company will pay a portion of the medical expenses, called the "benefit," to the healthcare provider. The policyholder may also be responsible for paying a portion of the expenses, such as a co-pay, deductible, or coinsurance.

Coverage Limits: Health insurance policies may have coverage limits, which mean the policyholder may be responsible for paying a portion of the medical expenses beyond a certain amount.

Waiting Period: The waiting period for pre-existing diseases and/or maternity benefits can range from 1 to 4 years from the start date. Renewal: Health insurance policies are typically renewed annually. The premium amount may change based on changes in the individual's health condition, age, or other factors.

Renewal: Health insurance policies are typically renewed annually. The premium amount may change based on changes in the individual's health condition, age, or other factors.

Why we need Health insurance policy?

Health insurance policy is important because it provides financial help for high medical expenses, ensures access to quality healthcare, promotes prevention and early detection of illnesses, and provides peace of mind.

What is Critical Illness insurance?

Critical illness insurance is a type of health insurance plan or a rider that provides a tax-free lump sum payment to the policyholder if they are diagnosed with a specified critical illness. The purpose of PNB MetLife Serious Illness Rider is to provide financial support to the policyholder during a difficult time when they are dealing with a serious illness.

The illnesses covered by a critical illness insurance policy may vary depending on the policy terms, but typically include conditions such as cancer, heart attack, stroke, organ failure, and major surgeries.

How Critical Illness Insurance works

Critical illness insurance pays out a tax-free lump sum amount to the policyholder if diagnosed with a covered critical illness. Here's how it generally works:

Policy Enrollment: The policyholders enroll and buy a health insurance policy from the insurance companyand the premium depends upon the insurance company, coverage offered, members covered, and amount of sum insured.

Diagnosis of a Covered Illness: If the policyholder is diagnosed with a covered critical illness during the policy period, they submit a claim to the insurance company. The policy will have a list of covered illnesses, which can include cancer, heart attack, stroke, and other serious conditions.

Critical Illness Claim Process: The insurance company review the claim and pay a lump sum benefit to the policyholder, which they can use to cover medical costs, living expenses, or any other financial needs.

Coverage Limits: Critical illness insurance policies may be responsible for paying a portion of the medical expenses beyond a certain amount.

Waiting Period: It usually has a waiting period of 90 days from the starting date of the policy.

Renewal: Critical illness insurance policies are typically renewed annually. The premium amount may change depending on various factors. It is important to carefully review the policy terms and exclusions before purchasing critical illness insurance to ensure that it meets your needs and provides adequate coverage.

Why do we need Critical Illness insurance?

Critical illness insurance can be an important source of financial protection for individuals and families facing a serious illness. It's important to note that critical illness insurance is not a substitute for health insurance, and it's important to have both types of insurance coverage. Critical illness insurance can complement health insurance by providing additional financial support during a serious illness.

Benefits of Health Insurance Plans

Health insurance plans provide a range of benefits that can help individuals and families access medical care and cover the costs of healthcare. Some of the benefits of health insurance plans include:

Medical Treatment:A medical insurance policy cover a wide range of medical treatments and services, including hospitalization, surgeries, doctor's visits, diagnostic tests, and prescription drugs.

Preventive Care: Many health insurance plans cover preventive care services, such as immunizations, health screenings, and wellness visits, which can help individuals, maintain their health and prevent serious illnesses.

Financial Protection: Health insurance plans can provide financial protection by covering the costs of medical treatment, which can be very expensive without insurance coverage.

Access to Healthcare: Health insurance plans can help individuals and families access healthcare services that they might not be able to afford otherwise.

However, health insurance plans do not cover all medical costs, and may not cover certain types of illnesses or conditions. In addition, while health insurance plans may cover some costs associated with a critical illness, such as hospitalization and surgery, they may not cover all of the expenses associated with a serious illness.

Benefits of Standalone critical illness insurance

Unlike health insurance plans, which provide coverage for a wide range of medical treatments and services, standalone critical illness insurance focuses specifically on providing financial protection for individuals and families facing a serious illness. Here are some benefits of standalone critical illness insurance:

What is covered by critical illness insurance?

Comprehensive Coverage: Standalone critical illness insurance policies provide comprehensive coverage for a specific list of critical illnesses. This means that policyholders can be confident that they have coverage for a wide range of medical costs, including hospitalization, surgery, and other treatments associated with their illness.

Lump-Sum Payment: Unlike health insurance plans, which may cover medical expenses as they occur, standalone critical illness insurance policies typically provide a lump-sum payment upon diagnosis of a covered illness. This can provide policyholders with financial support to cover expenses such as medical bills, living expenses, and other costs associated with their illness.

Flexibility: Standalone critical illness insurance policies are typically very flexible, allowing policyholders to choose the level of coverage that meets their needs and budget. Policyholders can choose the specific illnesses they want coverage forand can adjust the coverage amount to meet their individual needs.

No Network Restrictions: Unlike health insurance plans, which may have network restrictions or require policyholders to seek treatment from specific providers, standalone critical illness insurance policies typically have any such restrictions. Policyholders can seek treatment from any provider they choose, without worrying about whether the provider is in-network or not.

Additional Support: Some standalone critical illness insurance policies may offer additional support services, such as access to medical professionals, counseling, or wellness programs to help support the policyholder and their family during the recovery process.   

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