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Health Insurance क्यों जरुरी है आपके लिए ? कुछ सवाल कुछ जवाब

Health Insurance क्यों जरुरी है आपके लिए ?

Health Insurance आज की एक जरुरत बन गयी है आज के युग को देखें तो आप बीमारी के उपर कितना पैसा खर्च होगा आप इस बात का कोई भी आईडिया नहीं लगा सकते . Health Insurance यदि आप करवा लेते हैं तो आपके बीमार पढने पर सारा खर्चा Health Insurance कंपनी उठाती है आप इस तेंतिओं से दूर रहते हैं की कितना खर्च होगा और कहाँ से आयेगा . आज के समय में Health Insurance एक इसे साथी की तरह है जो आपके बीमार होने पर आपकी फाइनेंसियल हेल्प करता है और आपको उसका पैसा वापिस भी नहीं करना

हेल्थ केयर फाउंडेशन औफ इंडिया के प्रैसीडेंट डाक्टर केके अग्रवाल कहते हैं कि इस देश में बिना इंश्योरेंस के कार या कोई और गाड़ी चलाना जुर्म माना जाता है जबकि दुर्भाग्वश दुनिया के सबसे महंगे व्हीकल यानी मानव शरीर का इंश्योरेंस आवश्यक हो, इस के लिए कोई कानून नहीं है. अगर हर किसी का (Health Insurance ) हेल्थ इंश्योरेंस हो तो स्वास्थ्य सेवाएं शहर क्या गांवों तक सुचारू रूप से पहुंच सकेंगी. आज भारत की जनसंख्या लगभग 1241491960 है. अगर हर व्यक्ति रोजाना 3 रुपये से कम बतौर प्रीमियम(Premium ) के हिसाब से साल का हजार रुपए देता है तो बीमा कंपनी (Insurance Company)  के पास 124000 करोड़ की भारी धनराशि जमा होती है. जरा सोचिए इतने पैसों से देश भर में कितने हेल्थ केयर सेंटर (Health Care Centre) और अस्पताल (Hospital) खोले जा सकते हैं. और जो आदमी पैसे नहीं दे सकता उस का प्रीमियम (Premium) सरकार को देना चाहिए. आज जब दवाओं और चिकित्सा के दाम आसमान छू रहे हैं. एक समय ऐसा भी आएगा जब बिना इंश्योरेंस (Insurance) के चिकित्सा सुविधा पाना असंभव सा हो जाएगा. इसलिए हेल्थ इंश्योरेंस (Health Insurance ) सबके लिए बेहद जरूरी है. क्योंकि हेल्थ इंश्योरेंस (Health Insurance ) बीमाधारक या उस के आश्रित परिजनों को स्वास्थ्य समस्या, दुर्घटना या मृत्यु आदि की स्थिति में आर्थिक सहायता देता है.

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Health Insurance

Health Insurance/ Mediclame main कौन सा प्लान लें ?

हेल्थ इंश्योरेंस (Health Insurance ) यानी स्वास्थ्य बीमा को मेडिक्लेम (Mediclaim) भी कह सकते हैं. देश की आबादी का एक बड़ा हिस्सा खासकर ग्रामीण हिस्सा तो हेल्थ इंश्योरेंस (Health Insurance ) के मायनों से वाकिफ तक नहीं है. आसान लहजे में समझें तो हेल्थ इंश्योरेंस दो तरह का होता है. पहला इंडिविजुअल हेल्थ इंश्योरेंस (Individual Health Insurance) व्यक्तिगत स्वास्थ्य बीमा और दूसरा फैमिली फ्लोटर बीमा (Family Floter Insurance) यानी सामूहिक बीमा.

इंडिविजुअल हेल्थ इंश्योरेंस (Individual Health Insurance) के कवर क्षेत्र में सिर्फ बीमा स्वामी आता है. इस बीमा का शुल्क सामूहिक बीमा शुल्क (Group Insurance ) की तुलना में अधिक होता है. जबकि फ्लोटर प्लान (Floter Plan ) में बीमा करने वाला या प्रायोजक ही पौलिसी का स्वामी होता है और दूसरे पंजीकृत सदस्य भी पौलिसी में संलग्न होते हैं. उदाहरण के तौर पर अगर पिता ने अपने हेल्थ इंश्योरेंस (Health Insurance )के प्लान में पत्नी और बच्चों को पंजीकृत कराया है तो जरूरत पडऩे पर उन को भी कवर किया जाता है.

आमतौर पर फैमिली फ्लोटर प्लान (Family Floter Insurance)को लोग तरजीह देते हैं. भारत में आजकई बीमा कंपनियां हैं जो अच्छी और सुलभ हेल्थ इंश्योरेंस पौलिसी (Health Insurance Policy) मुहैया कराती हैं. हाल ही पंजाब नेशनल बैंक ने इस क्षेत्र में बढ़ती आर्थिक संभावनाओं के चलते मेट लाइफ (MetLife)के साथ करार किया है. इसी तरह आईसीआईसीआई बैंक(ICICI Bank)  ने भी लोम्बार्ड (Lombard) कंपनी के साथ हेल्थ इंश्योरेंस (Health Insurnce) के क्षेत्र में करार किया है. यों तो सभी बीमा कंपनी बेहतर सुविधाओं और क्लेम का दावा करती हैं और देती भी हैं पर बीमा के मामले में सबसे जरूरी बात यही होती है कि हम उससे जुड़े सभी नियमों, शर्तों को भलीभांति समझ लें. कुछ गंभीर रोगों के लिए बीमा कंपनिया कवर नहीं देती इसलिए यह अवश्य पता कर लेना चाहिये कि किन बीमारियों का बीमा होता है और किनका नहीं.

Health Insurance company और उनके Health Insurance प्लान

बाजार में कई तरह की हेल्थ इंश्योरेंस पौलिसी (Health Insurance Policy) मौजूद हैं. सब कंपनियां प्रतिस्पर्धा के चलते कम राशि और बेहतरीन सुविधाओं से लैस आकर्र्षक प्लान दे रहीं हैं. उम्र और बीमारियों के आधार पर सबके लिए अलग अलग पौलिसी मुफीद हो सकती है. बाजार में मौजूदा कुछ हेल्थ प्लान की बात करें तो आईसीआईसीआई लोंबार्ड जनरल की कंप्लीट हेल्थ इंश्योरेंस(Complete Health Insurance) , हेल्थ केयर प्लस (Health Care Plus) , हेल्थ एडवांटेज प्लस(Health Advantages Plus) , पर्सनल प्रोटेक्ट(Personal Protect) , क्रिटिकल केयर पौलिसी (Critical Care Policy) के अलावा अवीवा (Aiviva)  का अवीवा हेल्थ सिक्योर (Aviva Health Secure) और आई लाइफ, बजाज अलायंज (Bajaj Allianz) की इंडीविजुअल हेल्थ गार्ड(Individual Health Guard) , फैमिली फ्लोटर हेल्थ गार्ड (Family Floter Health Guard) व एक्स्ट्रा केयर (Extra Care) , एगौन रेलीगेर (Egon Religare) का आई हेल्थ प्लान, कौम्प्रिहेंसिव हेल्थ प्लान आदि प्रमुख हैं.

इन ढेरों प्लान के तहत हर बीमा कंपनी की अलग अलग क्लेम राशि, प्रीमियम, सेवाएं, सुविधाएं और प्रोसेसिंग हैं. उदाहरण के तौर पर आईसीआईसीआई लोंबार्ड जनरल की कंपनलीट हेल्थ पौलिसी में 10 लाख तक का कवर मिलता है. इसके अंतर्गत 46 साल से कम उम्र वाले बीमा ग्राहक को मेडिकल टेस्ट की कोई जरूरत नहीं होती. अगर बात उम्र की करें तो इसे कोई भी ले सकता है. फिर भी कागजी तौर पर फैमिली फ्लोटर पौलिसी के लिए 3 महीने और इंडीविजुअल प्लान के लिए 6 साल है. इसके अलावा प्लान में पौलिसी लागू होने के 30 दिनों के अंदर किसी बीमारी पर क्लेम की सुविधा नहीं हैं सिवाए एक्सीडेंट की घटना के. इसी तरह क्लेम को लेकर और भी कई नियम होते हैं जो बीमा एजेंट पौलिसी देने से पहले ग्राहकों को बताते हैं.

इसी कंपनी का एक और प्लान हेल्थ एडवांटेज प्लस ओपीडी (Health Advantage plus OPD) के खर्च भी कवर करता है जबकि अन्य कई कंपनियां ऐसा नहीं करती. प्लान में 40 हजार से ज्यादा अस्पतालों का भारत भर में नेटवर्क हैं. आप अपने सुविधा से नजदीकी अस्पताल चुन सकते हैं. कुछ हेल्थ इंश्योरेंस कंपनियां गंभीर बीमारियों जैसे कैंसर या हृदय संबंधी रोग से पीडि़त होने पर एक बार लाभ देते हैं. इसे एड औन हेल्थ कवर कहते हैं. आईसीआईसीआई लोंबार्ड के अलावा इंडस इंड बैंक भी हेल्थ इंष्योंरेस देता है. यह अपनी विभिन्न हेल्थ पौलिसी के तहत भारत के 2200 से भी अधिक अस्पतालों में बिना नकदी दिए भर्ती रहने की सुविधा प्रदान करता है. यह भर्ती होने से पहले और अस्पताल से घर जाने के बाद के उपचार के दौरान हुए खर्च को भी भरता है. इनका दावा है कि चिकित्सा व्ययों का अस्पताल से निवृत्ति के 90 दिन तक भुगतान भी बीमा के तहत होता है.

भारत की कोई भी अन्य हेल्थ इंश्योरेंस पौलिसी (Health Insurance Policy) इस सुविधा की बराबरी नहीं करती. ऐसी कई कंपनी हैं जो अलगअलग राशि के हेल्थ इंश्यारेंस पर कई लुभावनी सुविधाएं देती है. स्वास्थ्य बीमा कंपनी के सभी नियम व शर्तों का विवरिण यहां संभव नहीं. इसलिए जब भी स्वास्थ्य बीमा लें अपने बीमा फार्म को तसल्ली से पढें़ और एजेंट से सभी शंकाओं का समाधान कराएं.

Health Insurance में यदि कीमत की बात करें तो इसके लिए कोई तय रकम नहीं है. हां, अपनी आय, स्वास्थ्य समस्याओं और जिम्मेदारियों के आधार पर बीमा तय करना फायदेमंद होता है. 21 से 25 साल की उम्र में आप 2 से 3 लाख रुपये का स्वास्थ्य कवर ले सकते हैं. बाद में इस कवर की राशि बढ़ाई भी जा सकती है. वहीं अगर फैबिली मेंबर की आयु 28 से 35 के बीच है तो 3 से 5 लाख का फैमिली फ्लोटर प्लान लेकर बाद में आवश्यकताओं के अनुरूप राशि में इजाफा किया जा सकता है. हालांकि एक्पर्ट मानते हैं कि हेल्थ इंश्योरेंस जितना जल्दी लिया जाए उतना ही फायदेमंद होता है. क्योंकि बाद में उम्र ज्यादा होने या किसी बीमारी का पता चलने पर या कई बीमा कंपनियां बीमा करने से इंकार कर देती हैं. और जो करती भी हैं उनका प्रीमियम बहुत ज्यादा होता है.

आमतौर पर 45 साल से कम उम्र के हैं तो पॉलिसी लेने से पहले किसी मेडिकल चेकअप की जरूरत नहीं होती. कुछ कंपनियों में यह उम्र 60 साल भी है. सामान्यत रक्तचाप(BP) , डाबिटीज (Diabetes) , एसजीपीटी(SGBT) , कौलेस्ट्रोल (Cholestrol) , यूरीन रुटीन(Urine Routine) , ईसीजी(ECG) , चेस्ट का एक्सरे(Chest X-ray) , मोतियाबिंद और ग्लूकोमा आदि का मैडिकल टेस्ट करवाना पड़ता है. कुछ बीमारियां  मसलन एचआईवी, मनोरोग आदि कभी कवर नहीं होते. कुछ में प्लान ऐम्बुलेंस खर्च, हौस्पिटल का रोजाना का खर्च आदि भी कवर होते हैं. हालांकि मैटरनिटी का खर्च आमतौर पर कवर नहीं होता, लेकिन मैक्स बूपा और अपोलो म्यूनिख जैसी कुछ कंपनियां कुछ सीमा और शर्तों के साथ यह कवर दे देती हैं. हालांकि डाक्टर अग्रवाल का मनाना है कि ओपीडी भी इंश्योरेंस के दायरे में आना चाहिए. इसके अलावा इंश्योरेंस के लिए उम्र की कोई सीमा नहीं होनी चाहिए और स्वास्थ्य बीमा जीवनपर्यंत चलना चाहिए.

गौरतलब है कि अब हेल्थ इंश्योरेंस सेक्टर में पोर्टेबिलिटी लागू हो चुकी है. इसलिए जब बीमा कंपनी पौलिसी के रिन्यूअल के दौरान प्रीमियम बढ़ाए तो आप कंपनी बदल सकते हैं. हेल्थ इंश्योरेंस पर टैक्स में भी छूट मिलती है. इसके अलावा समय और धन की बचत के लिए औनलाइन हैल्थ पौलिसी खरीदना उचित रहता है.

Health Insurance Related Question Answer

सवालः क्या फैमिली पॉलिसी को इंडीविजुएल पॉलिसी (Individual Policy) में बदल सकते हैं? क्या आगे जाकर सम एश्योर्ड (Sum Assured) बढ़ाया जा सकता है?

जवाब :- अगर आपने हर साल क्लेम नहीं किया है तो आपके नो क्लेम बोनस (No Claim Bonus) मिलता है। ये दो तरीकों से मिलता है-एक आपका सम एश्योर्ड बढ़ाकर (Increase Sum Assured) और दूसरा आपका प्रीमियम घटाकर9Less Premium)। लेकिन ये जरूरी नहीं कि हर कंपनी आपका सम एश्योर्ड बढ़ा दे।

सम एश्योर्ड की रकम बढ़ाना बीमा कंपनी पर निर्भर करता है इसलिए अगर आप सम एश्योर्ड बढ़ाना चाहते हैं तो आपको नई पॉलिसी लेनी होगी। आप फैमिली हैल्थ पॉलिसी (Family Health Policy) को इंडीविजुएल पॉलिसी (Individual Policy) में बदलना चाहते हैं तो बदल सकते हैं। ग्रुप हैल्थ पॉलिसी (Group Health Policy) को उसी बीमा कंपनी से इंडीविजुएल पॉलिसी (Individual Policy) में तब्दील कराएं। ग्रुप हैल्थ पॉलिसी (Group Health Policy) के खत्म होने के 6 महीने के अंदर पॉलिसी बदलने की जानकारी दें।

सवालः हेल्थ इंश्योरेंस पॉलिसी (Health Insurance Policy) में हेल्थ उपकरणों को कवर किया जाता है?

जवाब :-ज्यादातर हेल्थ बीमा पॉलिसी हेल्थ से जुड़े उपकरणों को कवर नहीं करती हैं। बीमा कंपनियां आपके इलाज से जुड़े खर्चों, अस्पताल का खर्च, डॉक्टर की फीस आदि कवर करती हैं।

सवालः हेल्थ इंश्योरेंस (Health Insurance) लेना है, पहले फैमिली फ्लोटर (Family Floter) लूं या इंडिविजुएल पॉलिसी (Individual Policy) लूं?

जवाब :- आप अपने लिए और अपने परिवार के लिए फैमिली फ्लोटर पॉलिसी (Family Floter Policy)  ले सकते हैं। आप अपोलो म्यूनिख ऑप्टिमा रीस्टोर पॉलिसी, या टाटा एआईजी की हेल्थ इंश्योरेंस पॉलिसी या ओरिएंटल इंश्योरेंस मेडिक्लेम ले सकते हैं। मैक्स बूपा हार्टबीट, स्टार हेल्थ मेडिक्लासिक पॉलिसी भी ले सकते हैं। 3 लाख रुपये के कवर वाला हेल्थ इंश्योरेंस प्लान खरीद सकते हैं।

सवालः क्या टर्म प्लान के साथ क्रिटिकल इलनेस पॉलिसी (Critical Illness Policy)लेनी चाहिए?

जवाब :-आप टर्म प्लान (जिसमें कोई राइडर ना हो) के साथ क्रिटिकल इलनेस पॉलिसी (Critical Illness Policy)ले सकते हैं। क्रिटिकल इलनेस पॉलिसी के प्रीमियम काफी कम होते हैं। इन पॉलिसी में आखिर तक प्रीमियम भरने होते हैं। इन पॉलिसी को हर साल रिन्यू करना होता है।

Health Insurance के बारे में आप समझ ही चुके होंगे की आज के समय में इसकी इतनी आवश्यकता क्यों है आप चाहें तो किसी बैंक में या किसी भी Health Insurance कंपनी के ऑफिस पर जा कर इसके बारे में पता कर सकते है. वैसे आजकल हर बैंक भी Health Insurance Plan करता है और ज्यादा Checkup  की भी कोई दिक्कत नहीं आती और क्लेम भी आसानी से मिल जाता है और लगभग हर जिला में Health Insurance कंपनी के tieup लोकल डॉक्टर और हॉस्पिटल के साथ जरुर होता है.

Source :- http://www.allrights.co.in/

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