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17 Myths About Health Insurance Busted

Team AckoJan 20, 2025

India stands as the most populated country in the world. Despite the increasing population and the importance of public health for national growth, India has one of the lowest rates of health insurance coverage as compared to other countries.

Several key factors contribute to this, including affordability issues and restricted access to suitable coverage options for different population groups. Notably, a lack of awareness about health insurance policies and related concepts is the primary reason why most Indians fail to recognize the significance.

However, adequate health insurance coverage has become necessary in light of escalating healthcare expenses and lifestyle changes that increase health risks. Despite the COVID-19 pandemic highlighting the importance of health insurance, there is still a lack of understanding about how it functions in India.

Common myths and misconceptions persist, hindering customers from fully comprehending the benefits and protections of health insurance policies. Disposing these misconceptions is crucial to safeguard your health and financial security.

Take a look at this article to know what they are and how you can avoid them.

Myths

Contents

Health Insurance Myths busted
- Frequently Asked Questions
Protect Your Future with Life Insurance

Health Insurance Myths busted

1. Young people don’t need health insurance: A common myth is that you don’t need a health plan if you are young and fit. Well, there is no assurance on when an illness or accident can strike. So, it is wise for everyone, irrespective of their age and health condition, to get a good health insurance cover. Also, when you are young, the coverage is available at a lower cost. Take advantage of this and buy a plan right away.

2. You get coverage as soon as you buy the plan: Not always. Some medical insurance plans have a waiting period. Certain illnesses are covered only after the waiting period lapses. So, when you buy the plan, make sure you read the policy wordings carefully to understand how soon you can make a claim.

3. The cheapest plan is the best option: This is perhaps the biggest medical insurance myth out there. You cannot get a coverage by just looking at the plan’s price tag! You need to see what the features are. Health needs are people specific, so you need a plan that suits your requirements. Your ideal plan should be affordable, but not always the cheapest option.

4. Employer provided group insurance is enough: Most employers offer group health insurance plans to their employees. While these are good, the coverage is limited. You therefore need to back it up with a plan of your own.

5. Pregnancy is never included in health insurance: This is another massive myth that prevents good quality maternity care from reaching many women. Maternity is widely included in most family floater health insurance plans. You can also buy special maternity health insurance plans. There are waiting periods associated with such plans, so do keep an eye for that.

6. Hospitalization is a must: You don’t always need to be admitted to a hospital to make a claim on your health plan. You get claims for daycare procedures, OPD expenses, diagnostics tests, etc. too.

7. Online plans are fraudulent: It is sad to see people believing in this myth in the present-day digital age. Online health insurance is very safe and is actually much sought after. You get some of the best and the most economical deals when you purchase an online health insurance plan.

8. Pre-existing illnesses will never be covered: A vast number of pre-existing health conditions are covered in medical insurance, albeit after a pre-decided waiting period.

9. Customizations are seldom possible: You can customize your health insurance plan with the help of riders. Riders are Add-on covers that are available at an added cost.

10. The best health insurance policy covers a lot of daycare procedures: When selecting health insurance, people often pay a lot of attention to the daycare procedures covered. You might think that it’s good if the insurer offers a wide range of daycare treatments. But be aware that there may also be numerous restrictions on claiming reimbursement for these treatments.

11. People who smoke and drink are not eligible for health insurance: Contrary to popular belief, health insurance is available to individuals who smoke and consume alcohol. Despite their increased health risks, insurance companies offer them policies. However, to account for the higher risk, smokers and alcohol consumers generally pay higher premiums and are required to undergo extensive pre-policy check-ups to obtain an insurance policy.

12. Hiding pre-existing illnesses can help get insurance: Many individuals conceal their illnesses from insurance providers believing that doing so will ensure coverage. However, insurance companies expect individuals to disclose pre-existing conditions while purchasing a policy. The insurance company may deny coverage if an undisclosed pre-existing condition is later discovered during a claim.

13. Network hospitals can only be found in big cities: Contrary to popular belief, the hospital networks offered by health insurance companies are not limited to major cities. Most insurance providers have extensive networks that reach into smaller cities and towns throughout the country. You can take advantage of cashless treatments at hospitals within the network. Non-network hospitals can still receive reimbursement for covered services.

14. Insurance companies cover all expenses in the event of hospitalisation: Having health insurance doesn't guarantee that every hospital expense will be covered. Policies may have exclusions, where certain conditions or treatments aren't covered, and you must pay out-of-pocket. Additionally, some policies have co-payments, where you pay a portion of the hospital bill while the insurance company covers the rest. If you have a pre-existing condition, there may be a waiting period before the insurance company covers expenses related to that condition. If your health insurance policy has a limit for room rent and you spend more than the daily cap, you'll have to cover the excess expenses yourself. Carefully review the policy details to understand these terms and fully avoid unexpected costs.

15. Health insurance in India is too expensive: Many people believe that health insurance in India is too costly, so they skip it to avoid additional financial strain. However, health insurance can be affordable. Some insurance companies offer plans at low prices with financing options like those used to purchase electronics. Additionally, most people don't know that health insurance premiums are tax-deductible, further reducing the cost.

16. Failing to renew health insurance on time will mean the loss of all benefits: Even after the health insurance plan expires, policyholders have 15-30 days to renew it without being penalised. This allows them to continue receiving benefits like coverage for pre-existing conditions and avoid waiting periods. However, it's important to note that any medical treatments received during the gap between the policy's expiration date and its renewal date will not be covered under the renewed policy.

17. You can destroy health insurance documents at the end of the policy term: When multiple TPAs handle claims, it can result in missing or incomplete medical history data. This is because the new TPA may need help determining the duration of continuous coverage, which is crucial for approving claims, especially those with waiting periods. TPAs might request copies of insurance policies from the past three to four years to ensure seamless claim approvals. To facilitate hassle-free claim settlements, it is advisable to retain all insurance policies for the previous three to four years in addition to the current one. You can also store your health records online with an ABHA card.

The final word

Stay away of these baseless and outdated health insurance myths. You need a good medical insurance policy to take care of yourself and your loved ones. Go ahead and find a good plan and live a happy, healthy and stress-free life.

Also, read: Health Insurance for Women

Frequently Asked Questions

Here is some Frequently Asked Questions for Myths About Health Insurance

Is it smart to buy health insurance?

Given today's lifestyles, diseases like diabetes and heart problems are common in people of all ages. Moreover, the rising costs of medical care (medical inflation) are an ongoing concern. Health insurance looks after your well-being and promotes financial stability. Therefore, it is extremely crucial for everyone to buy health insurance in India.

Does employer health insurance offer adequate coverage?

Employer health insurance offers a lot of benefits. But, they often offer limited coverage and might not pay for the medical expenses of your dependent family members. Moreover, employer-sponsored policies usually end with your employment. Therefore, it is often wise to buy family health insurance even if you have employer health insurance.

What is the right age to buy health insurance?

People often put off buying health insurance until they turn old. However, buying a health insurance plan at a young age can be more cost-effective. Your premiums will be much lower since you will be at a lower risk of health issues at a young age. So, purchasing health insurance as soon as you turn 18 is recommended.

Is there an upper age limit for health insurance in India?

There is no upper limit for buying health insurance in India as per the latest guidelines of the insurance regulator.

What is the best health insurance coverage amount?

The best health insurance coverage amount will differ for every individual. You must consider your medical history, number of dependents, lifestyle, and other factors while deciding the coverage amount. The health insurance policy you choose should be able to offer adequate coverage during medical emergencies.

Disclaimer: This content is for informational purposes only and is based on industry experience and secondary sources. It is not a substitute for professional advice. Please consult a qualified expert for health or insurance-related decisions. Content is subject to change. Refer to current policy wordings for specific ACKO details.

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Protect Your Future with Life Insurance

Investing in health insurance safeguards your well-being with benefits like restoration coverage during medical crises. Similarly, Term insurance can enhance your long-term financial safety.

For example, choosing the best term insurance plan for 1 crore protects your loved ones in case of unforeseen events. This coverage ensures that your family remains financially secure, even in the face of the unexpected. When actively looking for a plan that suits you and your family's requirements, you can easily identify a cost-effective plan that provides significant coverage using a term insurance calculator.

Life insurance plans provide long-term security and investment. They are perfect for creating wealth and providing a financial cushion for loved ones.