All You Need to Know About Child Health Insurance

Shailesh Kumar

3 years ago

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A child is the most precious person in a parent’s life. The parents make a lot of effort to provide the best for their children. The arrival of a new born baby is an extremely precious moment for them. When a child is born and brought up, there are several concerns that come to the mind of the parents. They are concerned about child’s health, education, safety, etc.

Out of all concerns, health is the most important one. Newborns or even a toddler have weaker immunity and frequently fall sick due to increasing pollution, obesity, and diseases such as malaria, pneumonia, diarrhea, etc.

These health issues not only increase our emotional stress but also our financial stress. To reduce such mental and financial stress, child health insurance comes to the rescue.

All You Need to Know About Child Health Insurance

What is Child Health Insurance?

A child health insurance policy is a type of health insurance that is designed for kids to cover their hospital medical expenses, vaccinations as well as clinical check-ups. A child health insurance policy can be taken for any age of the child. It covers children right from newborns to teenagers.

4 Reasons to Buy Child Health Insurance

Weaker Immunity
The immunity system of children is very weak. Kids frequently catch infections. This can lead to frequent hospital visits and result in an increase in financial burden. Health insurance for kids will shift the burden of the child’s treatment from the parents to the insurance company.
High Risk to Fall Sick
Kids eat anything and everything that they believe to be a food item. Be it dust, chalk, toys, etc. Even if they are eating edible food, they tend to avoid washing their hands and fall sick.
Lifestyle
These days parents give their kids smartphones to play games and watch videos. The children have ditched playing outdoor activities. Not only physical activities have stopped, but their eating habits have also deteriorated their health. Now kids prefer junk food over healthy and home-cooked food. This lifestyle has impacted their health as obesity can be found in children.
Prone to Injuries
Kids don’t care about themselves. Especially infants, they can easily get hurt while they are learning how to walk and run. They can fall from the bed or from the stairs.

Medical treatment costs for all such issues can be taken care of by a child health insurance policy. Parents won’t need to exhaust their savings.

Types of Child Health Insurance Plans

A child can be covered under a health insurance plan in two ways:

Individual Child Health Insurance Plan: It is a separate customized health insurance plan designed to cover children only. Here the sum assured will be dedicated to the child only. The plan covers hospitalization expenses, ambulance expenses, lab tests, etc. The premium of this plan is comparatively lower than family floater health insurance.
Family Floater Health Insurance: It is a joint health insurance plan designed to cover a child along with his family members. The plan works on a floater sum assured basis. So, if one family member gets hospitalized and claims the entire sum insured, the other members cannot benefit from the policy.

What is Covered in Child Health Insurance?

The following expenses are covered under health insurance for children:

In-patient hospitalization Expenses:
• Room rent
• Nursing
• Boarding expenses
• Medicines
• ICU/ICCU expenses,
• Diagnostic services, etc
Day Care Treatments
Ambulance Expenses
Domiciliary Hospitalization Expenses in case of unavailability of beds or on doctor’s advice.
Pre- hospitalization Expenses (usually 30-90 days)
Post-hospitalization Expenses (usually 60-180 days)
Newborn cover:
• Medical expenses for neonatal care of the newborn baby
• Vaccination of newborn baby in the first year.

What is Not Covered in Child Health Insurance?

Pre-existing diseases during the waiting period (except in the case of newborns)
Injuries due to war or nuclear perils
Injuries due to participation in adventurous sports
Congenital disabilities
Personality disorder treatment
Cosmetic surgery

Read the policy document carefully as there can be more exclusions under different child health insurance plans.

Go ahead and buy a child health insurance plan.

If in the future, you face any issue related to the claim, you can contact Insurance Samadhan.*

Read How Insurance Samadhan Helped a Parent to Get a Child Health Insurance Claim

Nidhi bought a health insurance policy for her 1-year-old child, Sneha. Later Sneha suffered Pneumonia and was hospitalized for a week. Nidhi notified the insurance company about the hospitalization and submitted the cashless claim form along with the documents. Her cashless claim was rejected. Nidhi paid for the hospital bills out of her pocket.

Then she applied for reimbursement. But the insurance company rejected her claim. Nidhi received a claim rejection letter but was unable to comprehend the letter. She lost hope to get the reimbursement amount.

Later she came to know about Insurance Samadhan. She contacted us with her daughter’s case. We investigated her case and came to the conclusion that it was a genuine case but was rejected on the grounds of unnecessary hospitalization. We helped her to reapply for the claim. We guided her with documents to be submitted to the company which will prove that the hospitalization was necessary. Her case was resolved within a month.

If your genuine claim gets rejected, then you can reapply for the claim. If you need help, you can contact Insurance Samadhan.

If you also have an insurance complaint, you can contact Insurance Samdhan.

We have resolved 14,500+ insurance-related complaints. These insurance complaints include claim rejection, delay in claim settlement, mis-selling and fraud in insurance.

*Insurance Samadhan is a private organization and has no association with IRDA or any Government body.