Questions and Answers
What is the expected growth rate of the Indian health insurance market from 2020 to 2025?
What is the sum insured range for a Family Floater Health Insurance in India?
Which type of health insurance is designed for individuals aged 60 and above?
What is the purpose of a Top-up Health Insurance policy?
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Which feature of health insurance in India covers medical expenses incurred 30-60 days before hospitalization?
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Which of the following health insurance companies is a public sector insurer?
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What is the health insurance coverage provided under the Pradhan Mantri Jan Arogya Yojana (PMJAY) program?
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What percentage of the population in India has health insurance coverage?
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What is the main challenge in health insurance in India due to the high financial burden on individuals?
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Which of the following is a national health insurance program launched in 2018 in India?
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Study Notes
Overview of Health Insurance in India
- Health insurance is a growing industry in India, with a penetration rate of around 30% in 2020.
- The Indian health insurance market is expected to grow at a CAGR of 15-20% from 2020 to 2025.
Types of Health Insurance in India
- Individual Health Insurance: Covers individual family members, with sum insured ranging from ₹50,000 to ₹50 lakh.
- Family Floater Health Insurance: Covers entire family, with sum insured ranging from ₹50,000 to ₹50 lakh.
- Group Health Insurance: Covers employees of an organization, with sum insured ranging from ₹50,000 to ₹5 lakh.
- Senior Citizen Health Insurance: Designed for individuals aged 60 and above, with sum insured ranging from ₹50,000 to ₹5 lakh.
- Critical Illness Insurance: Covers specific critical illnesses, such as cancer, heart disease, and stroke.
- Top-up Health Insurance: Additional coverage for individuals already having a basic health insurance policy.
Features of Health Insurance in India
- Pre-hospitalization: Covers medical expenses incurred 30-60 days before hospitalization.
- Post-hospitalization: Covers medical expenses incurred 60-90 days after hospitalization.
- Day Care Procedures: Covers medical expenses for procedures that do not require hospitalization.
- Domiciliary Hospitalization: Covers medical expenses for treatment at home.
- Maternity Benefits: Covers medical expenses for pregnancy and childbirth.
- Newborn Baby Cover: Covers medical expenses for newborns.
Health Insurance Providers in India
-
Public Sector Insurers:
- National Insurance Company Limited
- New India Assurance Company Limited
- Oriental Insurance Company Limited
- United India Insurance Company Limited
-
Private Sector Insurers:
- Aditya Birla Health Insurance Company Limited
- Apollo Munich Health Insurance Company Limited
- Bajaj Allianz General Insurance Company Limited
- HDFC ERGO Health Insurance Company Limited
- ICICI Lombard General Insurance Company Limited
- Max Bupa Health Insurance Company Limited
- Reliance Health Insurance Company Limited
- Star Health and Allied Insurance Company Limited
Government Initiatives for Health Insurance in India
- Ayushman Bharat Yojana: A national health insurance program launched in 2018, aiming to cover 100 million poor and vulnerable families.
- Pradhan Mantri Jan Arogya Yojana (PMJAY): A flagship program under Ayushman Bharat Yojana, providing health insurance coverage of ₹5 lakh per family per year.
Challenges in Health Insurance in India
- Low Penetration Rate: Only 30% of the population has health insurance coverage.
- High Out-of-Pocket Expenditure: 70% of healthcare expenditure is out-of-pocket, leading to financial burden on individuals.
- Lack of Awareness: Limited awareness about health insurance and its benefits.
- Rural-Urban Disparity: Limited access to health insurance in rural areas.
Overview of Health Insurance in India
- The health insurance industry in India had a penetration rate of around 30% in 2020.
- The industry is expected to grow at a CAGR of 15-20% from 2020 to 2025.
Types of Health Insurance in India
- Individual Health Insurance covers individual family members with a sum insured ranging from ₹50,000 to ₹50 lakh.
- Family Floater Health Insurance covers entire families with a sum insured ranging from ₹50,000 to ₹50 lakh.
- Group Health Insurance covers employees of an organization with a sum insured ranging from ₹50,000 to ₹5 lakh.
- Senior Citizen Health Insurance is designed for individuals aged 60 and above with a sum insured ranging from ₹50,000 to ₹5 lakh.
- Critical Illness Insurance covers specific critical illnesses such as cancer, heart disease, and stroke.
- Top-up Health Insurance provides additional coverage for individuals already having a basic health insurance policy.
Features of Health Insurance in India
- Pre-hospitalization covers medical expenses incurred 30-60 days before hospitalization.
- Post-hospitalization covers medical expenses incurred 60-90 days after hospitalization.
- Day Care Procedures covers medical expenses for procedures that do not require hospitalization.
- Domiciliary Hospitalization covers medical expenses for treatment at home.
- Maternity Benefits covers medical expenses for pregnancy and childbirth.
- Newborn Baby Cover covers medical expenses for newborns.
Health Insurance Providers in India
- Public Sector Insurers include: • National Insurance Company Limited • New India Assurance Company Limited • Oriental Insurance Company Limited • United India Insurance Company Limited
- Private Sector Insurers include: • Aditya Birla Health Insurance Company Limited • Apollo Munich Health Insurance Company Limited • Bajaj Allianz General Insurance Company Limited • HDFC ERGO Health Insurance Company Limited • ICICI Lombard General Insurance Company Limited • Max Bupa Health Insurance Company Limited • Reliance Health Insurance Company Limited • Star Health and Allied Insurance Company Limited
Government Initiatives for Health Insurance in India
- Ayushman Bharat Yojana is a national health insurance program launched in 2018 aiming to cover 100 million poor and vulnerable families.
- Pradhan Mantri Jan Arogya Yojana (PMJAY) is a flagship program under Ayushman Bharat Yojana providing health insurance coverage of ₹5 lakh per family per year.
Challenges in Health Insurance in India
- Only 30% of the population has health insurance coverage, resulting in a low penetration rate.
- 70% of healthcare expenditure is out-of-pocket, leading to a financial burden on individuals.
- Limited awareness about health insurance and its benefits exists.
- There is limited access to health insurance in rural areas, leading to a rural-urban disparity.
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Description
Overview of health insurance industry in India, including types and growth prospects. Learn about individual and family floater insurance policies.