What is Restoration Benefit in Health Insurance?

As healthcare expenses continue to increase in India, individuals must have sufficient healthcare coverage to ensure that they are financially protected at times of a medical crisis. Normally, basic health insurance covers hospital stays but may not fully cover expensive treatments for severe medical illnesses. This is the moment when restoration benefits come in handy – they can significantly boost your coverage and provide crucial financial protection in case of a major medical emergency.

This article explores the specifics of the advantages of restoration in Indian health insurance schemes, assisting you in making informed decisions while choosing your best health insurance plan.

The Challenge of Exhausted Sum Insured

In certain situations, you can face exhaustion of the sum insured. The situations are as follows:

Severe Health Problems:

Certain extreme health conditions demand extended stays at the hospital which in turn is costly (diseases like cancer, heart problems, etc.). The original sum assured might not cover all the costs associated with the therapy.

Rising Medical Costs:

The issue of medical inflation is always a worry. Nowadays, the prices of health procedures and visits to the hospital are getting costlier. The sum insured under the insurance coverage you have opted for may not be enough to cover the pricey cost of treatments that you might need in the future.

Multiple Hospitalisations:

If you are in a situation where you have multiple health problems at once or are frequently paying a visit to the hospital, the actual sum insured amount will be inadequate and can drain quickly.

What is Restoration Benefit in Health Insurance?

The restoration benefit provides a fresh sum insured in specific circumstances, overcoming the drawbacks of conventional health insurance plans. Here is an explanation of its functioning:

An Add-on Feature:

Typically, restoration benefit is provided as an additional rider that can be bought in conjunction with your primary health insurance coverage. It is not a common inclusion in every policy.

Renewal of Sum Insured:

When you use up the original coverage amount because of a hospital stay, the restoration benefit serves as a safety cushion. It basically refreshes your coverage amount, providing you with extra financial protection for additional treatment in the current policy period.

Types of Health Insurance Restoration Benefits

Health insurance companies in India provide two primary categories of restoration benefits:

Partial Restoration:

This form of restoration coverage provides a partial refill of the original coverage amount, usually between 25% and 50%. For instance, if you use up the entire ₹10 lakh initial sum insured, a 50% restoration benefit will give you an extra ₹5 lakh for more medical expenses in the same policy year.

Full Restoration:

As implied by its name, a complete restoration benefit replenishes your total sum insured when it is depleted from hospitalisation. This offers a major financial cushion, particularly for severe illnesses needing extensive care.

Advantages of Restoration Benefits in Health Insurance

Now that you have knowledge of the concept and various types of restoration benefits, let’s delve into the primary benefits that this additional feature provides:

Enhanced Financial Protection:

The main advantage of restoration benefit is the extra financial protection it offers. If you run out of your original insurance coverage because of unexpected medical costs, the restoration benefit serves as a safety net, guaranteeing you have enough money for ongoing care in the current policy period.

Eliminates financial stress:

Having up-to-date protection against serious diseases or successive emergency hospital runs can extraordinarily reduce the mental pressure caused due to stress while confronting such challenges.

Flexibility in Treatment Options:

Lacking coverage for restoration, utilising all of your initial sum insured could restrict your choices for treatment. The increased amount of insurance coverage guarantees that you can receive optimal medical treatment without worrying about money, even if the expenses surpass the original limit.

Protection Against Rising Medical Costs:

Medical cost escalation is an undeniable fact. The restoration benefit aids in lessening the effects of increasing healthcare expenses. Although the current sum insured may appear sufficient, opting for a higher sum insured in the future can assist in covering rising treatment costs.

Security for Family Floater Plans:

Restoration benefits are especially valuable for family health insurance plans, such as family floater plans, as they provide coverage for several members through a single policy. If a family member depletes the coverage amount because of a serious illness, the restoration benefit guarantees ongoing financial protection for the rest of the family.

Conclusion

In the current healthcare environment, with the continual increase of medical expenses and the rising worry of serious illnesses, having restoration benefits in your health insurance policy can be a beneficial inclusion. It gives a financial safety buffer, providing more coverage if you use up the original insured amount because of hospitalisation. You can decide whether to add restoration benefits to your health insurance policy by knowing both its advantages and restrictions. Keep in mind that placing importance on thorough health insurance that considers future needs safeguards you and your family’s financial well-being during unforeseen medical crises.

Please feel free to reach out to our specialists for any further questions either by emailing us at support@elephant.in or giving us a call at our hotline, 1800 266 9693! For the most competitive health insurance rates, check out Elephant.in!

*Terms and conditions apply. The information provided in this article is generic in nature and for informational purposes only. It is not a substitute for specific advice in your own circumstances. You are recommended to obtain specific professional advice from before you take any/refrain from any action. Tax benefits are subject to changes in tax laws. Please contact your tax consultant for an exact calculation of your tax liabilities.| EL/BLOGS/24-25/09