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Health Insurance Plans with Critical Illness Cover

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What Is A Health Insurance Policy?

A health insurance policy is an insurance product that provides financial support by covering the pre-specified healthcare expenses of the person buying the insurance policy or the person insured in case he/she needs medical attention.  

Edelweiss Tokio Life offers a health insurance plan that covers major critical illnesses. 

Types of Health Insurance Plans

Health Insurance Plans are indemnity-based or cashless. You can choose to get access to hospitalization/treatments without having to pay anything. Or you can pay for everything yourself and get everything reimbursed indemnified after its completion. 

There are various types of Health Insurance Plans to suit diverse health needs. These include:

Types of health Insurance Plans

Individual or Family Floater Health Plans

As the name suggests, these insurance plans are for individuals and small or big families. They provide holistic coverage for all family members including you, your spouse, parents, grandparents, in-laws, dependent siblings, and children. 

Critical Illness Plans

These plans provide coverage for life-threatening ailments such as cancer, kidney failure, permanent paralysis and more. 

Personal Accident Plans

These plans provide the full coverage amount in a lump-sum for death, permanent total and partial disabilities, and any other injuries or burns arising due to an accident. 

Corona Kavach and Corona Rakshak Plans

These plans provide indemnity-based coverage for COVID-19 or give a lump-sum amount on the diagnosis of COVID-19. 

Disease-specific Insurance Plans

These plans provide extensive coverage for specific diseases such as cancer, diabetes, heart ailments, and more. 

Group Health Plans

These plans provide coverage for the employees (and sometimes, their families) of a corporate group/employer/any organization. 

Individual or Family Floater Health Plans

As the name suggests, these insurance plans are for individuals and small or big families. They provide holistic coverage for all family members including you, your spouse, parents, grandparents, in-laws, dependent siblings, and children. 

What Is A Critical Illness Insurance Policy?

 Understand the features and benefits of a critical illness plan.
 
Critical illness is a serious health condition that can have a debilitating effect on your lifestyle and the cost involved in the treatment is extensively high. Few critical illnesses include Cancer, Heart Disease, Kidney disease, etc. Such serious critical illnesses will exhaust your entire life’s savings and may also lead to a loss of income. A critical illness plan provides a lumpsum amount to the policyholder on the diagnosis of a pre-listed critical illness. 

Benefits of Health Insurance Plans Health Insurance Plan

Benefits of Health Insurance Plans

Importance of Health Insurance Plans

Health insurance plans are essential if you don’t want to drain your savings paying for excessive hospitalization costs and want to protect yourself from inflation.
By taking care of all the medical expenses needed to recover from any illness, injury or accident, health insurance is the perfect tool to battle any health crisis.  

You need to buy health insurance not only for the various financial benefits it offers but also for the peace of mind it gives. With it,  you can get instant access to affordable health 
care, all-in-one protection for the entire family, and significant tax benefits.  

Why Choose A Critical Illness Plan?

 

A critical illness health insurance plan offers comprehensive protection against a host of major illness. 
Many times, we think that if we have a health insurance plan then why do we need to purchase a separate critical illness plan? Here’s the answer:  

Critical illnesses are major terminal illnesses that need utmost care and treatment. But this care and 
treatment may be extremely expensive. Now if you have a mediclaim or a health insurance plan, it may cover your medical expenses depending on the policy's term and conditions. Also, claiming this amount can be time-consuming as you may need to wait for all medical bills and records for  submission. Unlike basic health plans, critical illness plan provides a lumpsum amount on the diagnosis of a critical illness. A critical illness plan will cover critical illnesses like cancer, heart disease, kidney disease etc. 

This is because treatment of a critical illness like cancer may be as high as Rs. 20 lakhs. So if you have 
a cover of Rs.30 lakhs, you will receive the entire amount on diagnosis of the critical illness. This amount will not only act as your medical cover but also as an income replacement. During this phase,
you may not be in a position to work either temporarily or permanently so the cover amount you receive can be used for your advanced medical treatment, household expenses, repayment of EMIs
etc. In this way, a critical illness plan can complement your existing mediclaim and provide you with complete protection. 

Our Plans and Benefits

At Edelweiss Tokio Life Insurance, we offer the Edelweiss Tokio Life Criticare+ Plan: 

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With You Through Critical Illness! 

Get lump sum benefit on the diagnosis of Critical Illness.

  • Covers you against 17 critical illnesses

  • Single claim can be made on any one of the listed critical illnesses

  • Discounts⁴ when you opt for higher coverage 

  • Under MultiClaim option, you can claim up to 3 times on diagnosis of 3 critical illnesses from different groups

The prominent features of the plan include: 

  • Coverage against 17 critical illness
  • claim available from the date of diagnosis
  • 3 claims during the policy terms
  • complete waiver of premium upon diagnosis

Why should I opt for Edelweiss Tokio Life CritiCare+  

Edelweiss Tokio Life – CritiCare+ is a health insurance product, that covers a truly wide range of 17 critical illnesses. In case you are faced with the unfortunate onset of a critical
illness, you will be able to ensure that your family gets the required support to manage their day-to-day expenses as well as your health care expenses. Under the multiclaim option of this plan, you can also make claims up to 3 times during the policy term. 

Critical Illnesses that we Cover 

The Edelweiss Tokio Life Criticare+ Plan covers 17 critical illnesses

Open Chest CABG Myocardial infarction (First heart attack of specific severity) Open Heart Replacement OR Repair of Heart Valves Kidney Failure Requiring Regular Dialysis Major Organ Transplant (Heart, Kidney)
Stroke Resulting in Permanent Symptoms Arota Surgery Permanent Paralysis of Limbs Coma of Specified Severity Third Degree Burns
Blindness Aplastic Anaemia Cancer of Specified Severity Benign Brain Tumour Major Organ Transplant (Bone Marrow, Liver, Lung, Pancreas)
Motor Neuron Disease with Permanent Symptoms Multiple Sclerosis with Persisting Symptoms      

When Should You Buy Health Insurance with a Critical Illness Cover?

Having health insurance with a critical illness cover should be a priority. If you have a family history of any critical illness, a suitable time to purchase a health policy with a critical
illness plan would be as early as possible, keeping in mind the minimum entry age. It is also important to opt for a critical illness cover while you are healthy and free from any
critical illnesses, which will ensure lower premium costs. Since medical contingencies are sudden, it is advisable not to wait until you’re face-to-face with such a situation

How to Calculate Health Insurance Premium?

Having health insurance with a critical illness cover should be a priority. If you have a family history of any critical illness, a suitable time to purchase a health policy with a critical
illness plan would be as early as possible, keeping in mind the minimum entry age. It is also important to opt for a critical illness cover while you are healthy and free from any
critical illnesses, which will ensure lower premium costs. Since medical contingencies are sudden, it is advisable not to wait until you’re face-to-face with such a situation.

Factors Affecting Health Insurance Premium

Your medical history – these include your current medical conditions, genetic health risks, lifestyle habits and family illness history. 
 
  • Your gender and age – the younger you are, the lower will your premiums be. Also, you can be at risk for specific diseases based on your gender. 
  • Type of policy chosen – the sum insured, the scope of benefits, and the tenure will impact the premium price.  

What to look for in your Critical Illness Insurance Plan?

Choosing a suitable critical illness plan is essential if you need comprehensive cover to take care of medical emergencies. Out of the many critical illness plans available in the market, you can choose from the features that are best suited for you. However, here is an outline of some important features that a good critical illness plan must have –  

 
  • The coverage of the plan should be sufficient to cover the medical expenses. 
  • Most of the major critical illnesses, if not all, should be covered under the plan. 
  • The policy term should be long enough to cover you in your old age. 
  • The premiums should be constant throughout the tenure of the policy. There should be several network hospitals for cashless treatments. 
  • There should be several network hospitals for cashless treatments. 

Apart from these factors, also be sure to check the fine print for inclusions and exclusions, the minimum for the plan as well as the renewal terms, the No Claim Bonus and any additional benefits.

Who should Buy a Critical Illness Plan?

 

A medical emergency can turn up any time in our lives and taking care of medical bills can become quite expensive, given the use of modern and state-of-art equipment and specialized treatments in hospitals. As important as it is, many may not know if they need a critical illness plan. Hence, here are some points to help identify who should avail of a critical illness plan:

Who should Buy a Critical Illness Plan?

Sole earning family member

As the main or the only earning member of the family, having a critical illness plan can help your family deal with the financial burden of the costs of a medical emergency. With this cover, the family will not have to compromise on their savings fund.

People with stressful jobs

Those working long hours in the office and under heavy pressure are quite prone to critical illnesses at some point in their life. That indicates the need for medical attention and treatment, which in turn calls for having a critical illness policy.

People with a medical history

Critical illnesses often run in the family. The ones like cancer and tumours have a chance of affecting a person if a family member in the previous generation has had it. Moreover, if the individual has been affected by the ailment in the past, there may be a risk, no matter how small of the ailment, returning. Therefore, having a critical illness plan is surely advisable.

Those above 40 years of age

Most individuals who cross 40 years of age tend to age progressively. Ageing makes a person’s body more vulnerable to the risk of contracting a critical illness. So that such an individual should not have to be burdened with the worry of paying hefty medical bills, it is a good solution for them to equip themselves with a critical illness plan once they are into their late 30s.

Sole earning family member

As the main or the only earning member of the family, having a critical illness plan can help your family deal with the financial burden of the costs of a medical emergency. With this cover, the family will not have to compromise on their savings fund.

Additionally, most people in their late 30s or early 40s are financially stable enough to be able to afford a good critical illness. 

Documents Required to Buy Health Insurance Plan in India

The documents needed to buy a health insurance plan in India include:
  • Age and identity proof (Aadhar card, voter ID card, PAN Card, etc.)
  • Address proof ((Aadhar card, PAN Card, electricity bills, etc.) 
  • Medical report (carried out to see if you are eligible to buy health insurance) 
  • Passport-sized photo(s) 

What is the Difference Between Health Insurance Plan, Cancer Insurance and Critical Illness Insurance?

 
Parameter Health Insurance Cancer Insurance Critical Illness Insurance
Who should buy it? Those who want all-round insurance protection for themselves or their entire family. Those who want specific coverage for all the stages of cancer. Those who want insurance coverage for multiple critical illnesses at a time.
Scope of coverage It covers the costs of hospitalization, surgical procedures, treatments, and ancillary medical needs. It covers all stages (Stage 0 to Stage 4) of cancer and the allied cots of hospitalization and treatments. It covers only the critical ailments listed under the policy and allied hospitalization and treatment costs.
Policy term 1-3 years, but it mostly requires renewal on an annual basis. Can go up to 20 years, if needed. Can go up to 20 years, if needed.
Policy type Indemnity-based (Reimbursement) or cashless mode of claim settlement A benefit-based policy that pays a lump-sum benefit amount on the diagnosis of cancer. A benefit-based policy that pays a lump-sum benefit amount on the diagnosis of any listed critical illness.
Premium payable The premium can vary and increase or decrease each year depending on personal factors like a change in the number of family members or surrounding factors like inflation. The premium remains fixed despite the long tenure of the policy. The premium remains fixed despite the long tenure of the policy.
Should I get it? Yes, as it is ideal to cover all kinds of ailments and eventualities. Yes, as it is ideal to cover all stages of cancer. Yes, as it is ideal to cover all critical ailments.

It is ideal to buy health insurance first, as you can always choose to add a critical illness or a cancer insurance policy as an add-on or get a separate insurance policy at any time.

Does Health Insurance Policy Cover Coronavirus (COVID-19) Treatment?

Edelweiss Tokio Life Insurance offers the Edelweiss Tokio Life COVID Shield+ Plan that offers comprehensive coverage against Coronavirus – hospitalization + COVID-19 term life cover. Under this plan, you get: 

  • Lump sum payout in case of COVID-19 diagnosis and admission into ICU or HDU. 
  • lan is activated once COVID-19 is diagnosed and continues even after death.
  • Life cover is paid to the nominee in case of insured’s death.
  • The policy is available online with no medical tests. 

Factors to Consider Before Buying Health Insurance Plans

  • Scope of coverage and your budget: Take a close look at the scope of coverage provided in the health policy and whether it is enough for you/ your family’s needs.  As   important it is to consider the premium price and spend as per your budget, you should not compromise on the scope of benefits just to save on a few bucks. It is  better to  pay a little extra and get a comprehensive plan to cover various needs.  

  • Cap and sub-limits: Health insurance policies do not give unlimited coverage. There are caps and sub-limits on every benefit, treatment, or illness under the insurance policy. Always read the policy wordings in their entirety before you make a purchase. 
  • Exclusions and waiting periods: Under every surgical procedure, treatment, or illness listed under the health insurance policy, there is a mandatory waiting period before you can make a claim. Moreover, there is a clear list of exclusions given that health insurance does not cover. 
  • Insurer credentials: Buying a health insurance policy from a reliable insurer is of utmost importance and will decide whether you have your claim settled within time. Before you zone in on a policy, it is vital to check the insurer’s credibility and performance metrics. These include the CSR, the cashless/ reimbursement claim    settlement time, the company reputation, customer testimonials, and more.
  • Additional benefits: Different health insurance policies offer different benefits. However, some additional benefits are an absolute must in health insurance. Factors like  automatic restoration of the SI, easy portability, convenient top-up enhancements, lifetime renewability, and the network hospitals associated can impact your health insurance policy and claim a lot.  

 Some Myths About Health Insurance

Here are a few common myths people have before buying health insurance: 

  • I am fit and healthy, so I don’t need health insurance.  
    Fact: You will need health insurance at some point.  

  • I am covered under my corporate health insurance policy, so I don’t need a separate health policy.  
    Fact: Corporate health insurance is not enough to cover your needs.  

  • I will receive coverage for all types of illnesses, treatments, and costs with health insurance. 
    Fact: Health insurance comes with exclusions, sub-limits, and caps.  

  • Since I am a smoker or drinker, I will not get health insurance.  
    Fact: You will get health insurance but will have to pay higher premiums.  

How can a multi-claim option help you? 

Critical illness cover is generally not very expensive. It provides the entire sum assured to the policyholder on the diagnosis of a critical illness and then the policy is terminated.         This means if a policyholder is diagnosed with cancer, he receives the claim amount and will not receive any future claims. Few critical illness plans cover multiple critical illnesses
like cancer, heart disease. In this case, one is protected against not just one but multiple critical illnesses.

Now the policyholder can also choose if he wants to protect himself against a reoccurrence of critical illnesses by adding a minuscule amount and choosing a multi claim option. Under multi claim option, you can claim thrice on the diagnosis of other critical illnesses. So, if the insured is diagnosed with another critical illness, he can claim the sum assured.
In this case, the policy doesn’t discontinue after the first claim. 

Choosing a multi claim option will be a wise because critical illnesses hamper the other parts/organs of the body too and may give rise to a second critical illness. If you have a
multi claim option, you are financially prepared against any uncertainty a critical illness can bring along. 

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Do I Need To Be Hospitalized To Get The Critical Illness Cover?

No, the entire critical illness cover is paid on diagnosis. The full payout is made irrespective of undergoing hospitalization or medical costs due to the illness. This amount can be utilized to meet the costs of medical care, manage regular expenses, repay any loans that you may have or for any other expense. 

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A pre-policy medical check-up and test are mandatory before you can get health insurance coverage. It is to determine the amount of risk attached to your health and the value of premiums payable.  

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CritiCare+ provides cover against 17 critical illnesses like cancer, heart disease, chronic kidney disease, etc. It provides the claim amount on the diagnosis of the pre-listed critical illness. Unlike regular health plans, you don’t have to submit hospital bills to get the claim amount. Since a critical illness plan covers major critical illnesses, the premium for critical illness plan is comparatively low for a high sum assured. 

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Smoking increases the insurance premium because it increases health complications such as heart disease, lung disease, cancer, hypertension, etc. This, in turn, increases the insurer’s liability. 

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There are two claim options. In a single claim option, the pay-out is done on the diagnosis of the critical illness to the policyholder and the policy discontinues. In a multi claim option, the policyholder can claim thrice on being diagnosed with three different critical illnesses. The policy continues even after the first claim. But the good part is that after the first claim the future premiums are waived off. 

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Yes, you can cancel your health insurance policy after purchasing it. However, you can do so within the 15-day or 30-day free look period. If you cancel your policy after this period, you will be liable to pay cancellation fees and might not get a refund of any premiums paid. 

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For queries, write to onlinesales@edelweisstokio.in

3 - As per provisions of Income Tax Act, 1961. Tax benefits are subject to changes in tax laws.

** - Claim statistics are for Financial Year 2019-20 and is computed basis individual claims settled over total individual claims for the financial year. For details, refer to Public Disclosures in our Website.

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