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Journalism of Courage
While the average age of an Indian might have increased over the years the quality of health has certainly gone down. With ever increasing stress levels due to deadlines,long office hours,and improper food cycle cardiac,orthopedic,blood sugar etc are on the rise among most of the working class. The problem arises when you suddenly need to get hospitalized for some disease which you may have never heard of and the hospital dishes out a bill which drains all your savings over the years. The only way out is a health insurance. Even if you pay an annual premium of Rs 5,000 for next 10 years you end up paying only Rs 50,000,but probability of your getting hospitalised in these 10 years is much higher and even a 3 day stay in a good hospital will at least cost you upwards of a lakh depending upon the nature of the treatment. Also you must take into account the tax benefit of up to Rs 15,000 Rs 20,000 for senior citizens you get on the annual premium amount on the health insurance policy.
Let us discuss some important points which will help you decide the best policy for you and your family.
Which policy is best for you?
There are various health plans available in the market that can confuse you. Broadly you have 2 choices-family floater or individual policy. A family floater covers your entire family while individual policy as the name indicates covers an individual. Although family floater is the cheaper option than individual policy experts advise going for an individual policy rather than a family floater.
Though the cost of individual policies is certainly higher than a family floater policy an option where each of the family members holds individual coverage equal to what you would have taken as a family floater plan works best in all situations. Though the family floater plans are sold as a flexible option which can be used by the entire family a situation where whole family needs to get hospitalised will cause a drain on your finances as your family would be covered only to the extent of the coverage you get in the family floater. According to the insurance experts it is better to buy a Rs 2 lakh individual policy for each family member than buying a Rs 3 lakh family floater policy. Harsh Roongta,CEO,Apnapaisa.com says,Since continuous coverage and claim history is critical in a health policy and the cost of taking individual policies is only marginally higher,it makes no sense at all to buy a family floater policy for an so called reduction in cost when the family is younger. It makes even less sense to include your parents in the family floater as they are likely to have claims as they age and clearly require their own individual policies.
You Have Insurance From Your Employer
If you are covered by the organisation you are working with,chances are that you would not buy an additional health insurance policy. However,insurance experts advise buying a separate health insurance policy for several reasons. If your company withdraws the mediclaim policy due to some reason then you will be left un-insured. It may also be that the new company you decide to join may not offer you a cover under mediclaim. When you get retired or you decide to take an early retirement you will be left without health insurance. At that age there are chances of some health complications and there may be a situation that no health insurance company is ready to give you health insurance and if they do give the premiums would be much higher. Remember,that is the age when you need the health cover most.
Cashless Health Insurance
Almost all health insurers now provide cashless cover along with the re-imbursement facility. Cashless cover means that you do not have to shell out even a single rupee under your cover,and even if you do it would be re-imbursed at a later date depending upon the approval from your insurer. Cashless policy is much faster and involves much lesser hassle. You must carefully go through the list of hospitals that are empanelled with the health insurer to provide cashless facility. It is important to have at least one hospital in that list which is near to your house and provides cashless facility.
Questions You Must Ask The Agent
In this age of cut-throat competition among health insurance companies and ever increasing health insurance agents there are chances that some agent may try to fool you by making false promises on the policy he is trying to sell you. Here are the questions you must ask an agent before buying a health policy:
Are there any restrictions on the amount of reimbursements on the claim amount
With my increasing age how would the premiums change
What are the sub-limits for the doctor fees,room rent or the medicines
Does it cover the pre-existing diseases? Ask for the list of diseases that are covered
Will my premium increase if I make claim in certain year
What are the list of hospitals on the list that provides cashless facility
Is Cheapest Necessarily the Best Option
You are paying a premium to insure yourself against some unforeseen event which may cause a huge financial drain on your pocket. There might be a situation where while the insurance company does give a cheap option they might not have a proper infrastructure to service their clients at a later date. A smart way would be to do an online search for the complaints against the company you decide to buy health insurance from. PV Subramanyam,a Mumbai based financial expert suggests rather than going for the cheapest plan,compare features and pay extra to get additional benefits. It will all get more than compensated in a single hospitalization given rising healthcare costs
Pre-existing Diseases amp; Exclusions
According to the Insurance Regulatory and Development Authority IRDA,A pre-existing disease is any condition,ailment,injury or related condition for which one had signs or symptoms,were diagnosed,or received medical advice or treatment within 48 months prior to the purchase of the policy. Almost all health insurance companies have a defined waiting period before you start getting cover for the pre-existing diseases. It is very important for you to know what are the exclusions or limitations mentioned in the health policy which will not cover some specific pre-existing diseases. Buying health insurance policy as early as possible will limit the risk if you fall ill during the waiting period. Most of the health policies will not provide cashless service/re imbursements if you undergo any treatment within one month of taking the policy.
Regarding the exclusions in a policy,Dr Pradyot Kumar,a neuro-surgeon with AIIMS,Delhi,has a piece of advice for you,Carefully go through the brochure of the health insurance policy and refer the exclusion mentioned in it. You may also refer the companys website for the same
Imagine the hassle and mental tension you will have to undergo if you are not able to get yourself or your wife best treatment possible just because you did the mistake of not insuring your health. As far as the costs are concerned it is a necessary evil. Your health is not cheaper than your car for which you pay more than Rs 8,000-10,000 per annum as motor insurance.
It is better to pay a cost for insuring your health and feel safer than being sorry at a later date!
