Medical costs and the complexity of diseases keep increasing by the day. A minor surgery can cost you anywhere between Rs 30,000 and Rs 60,000, while a cardiac treatment can cost you Rs 5 lakh, depending on the city and hospital you choose. One way to handle this rising cost is by taking a medical insurance policy in your name. In India, there are more than 25 companies offering various medical insurance policies. However, most of these policies are complex in nature and one plan never fits all. Hence, it is very important to note that you have to understand your individual needs in order to choose the right insurance plan. Here are a few points that will help you do this.
1. Company – There are 28 general insurance companies in India that offer health insurance plans. It is very important to know the company’s background, management, network of hospitals, claim process (in-house or third party) and claim settlement ratio before choosing the right plan. It is best to choose a general insurance company for your health insurance, rather than a company that offers life and general insurance. This is because the cost for health insurance policies is higher when life insurance companies offer them.
Tip 1: For your health insurance policy, choose a company that is purely into the health insurance arena.
2. Inclusions and Exclusions – It is very important to note that pre-existing diseases are not covered during the initial years of the policy. Also, there are a few medical procedures like dental surgery, hernia, etc. which are excluded in the first few years.
Tip 2: Take a close look at the list of excluded diseases before finalizing your health insurance plan.
3. Sublimit – To tackle the rise in health care costs, insurance companies have introduced sublimit clauses. The most common sublimits are room rent, doctor’s fees and diagnostics. For example, if you are taking a plan for a sum assured of Rs 2,00,000, the insurer may cap the room rent to the extent of 1%-1.5% of the sum assured, or Rs 2,000 per day, whichever is higher. If it exceeds the specified limit, then you have to pay the balance.
Tip 3: While most companies have sublimits in their policy, do talk to your insurance advisor to find out which companies offer health insurance plans without any sublimits.
4. Co-payment – Co-payment means the fixed percentage of the total bill which you have to pay in case of a claim. This percentage is already defined in the policy document. The co-payment clause is around 10% or 20% for such policies. For some policies, it can go as high as 40%.
Tip 4: Identify those diseases that come under the co-payment clause before you opt for a health insurance policy.
5. Renewal age – Most PSU companies and certain public insurance companies provide medical insurance policies with a renewal age of up to 70 or 80 years. It is to be noted that diseases may increase with old age and so, medical costs may be higher. Hence, it is important to have medical insurance at an older age.
Tip 5: Few companies offer senior citizen policies with lifetime renewal, for which the entry age itself is 60 years. For non-senior citizens, it is advisable to look at a policy that offers lifetime renewal to you.
6. Coverage – If you are unmarried, it is better to take an individual policy. Health insurance policies offer a provision to add new family members at a later stage. If you are married with kids, then it is best to opt for a family floater policy that will cover you, your spouse and your kids. It is ideal to have a separate senior citizen policy for your parents, if they have crossed 60 years of age. This is because the cost of a family floater would be decided on the basis of the highest age of the person in the family and hence, taking such a policy with a senior citizen in it would skyrocket your cost.
If you are living in Tier-1 cities, it is ideal to have a coverage of not less than Rs 10 lakh as a family floater, while if it is Tier-2 cities, you can have a coverage of not less than Rs 5 lakh.
Tip 6: No claim bonuses will be offered by insurance companies in two different ways. Few of them will offer it to increase the sum assured every year, while few companies offer it as a discount in premium. Choose the one which increases the coverage instead of the discount in premium as the cost of medication increases on a yearly basis.
7. Cost – Ideally, the cost of the policy should be given least importance while buying medical insurance. If the policy provides you all the benefits and if the cost is a little higher, it is ideal to look at the cost benefit analysis and to take the same as it is worthwhile to pay the cost for the benefit you get.
Tip 7: Don’t compromise on service standards even if you pay extra premium for the same.
To conclude, save, invest, or do whatever you want — but remember that there can be no dispute over the need for health insurance. It offsets the impact of rising healthcare costs and gives you coverage when you most need it.
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Is there any policy that covers out patient treatment for me and my wife (ages 64 and 58)?
Dear Mr. Padmanabh Shenoy,
This is with regards to your query on out patient treatment coverage, presently no insurance company covers a senior citizen on out patient treatment. We will update you if anything comes in the future.
Thanks & Regards
Sridharan
Dear Sir,
Thanks for your compliments.
Regards
Sridharan
Sir, nice article
I have compared health insurance policies on various portals like policybazaar.com etc, i want to know which company is good , considering all these points which you have mentioned in this article, i have shortlisted ICICI LOMBARD (COMPLETE HEALTH INSURANCE ) cover and appolo munich health insurance plan . which one is better please suggest ?
I want to opt for family floater considering my requirements. without any senior citizen in my family. and want to have sum assured of 10 lack.
thanks ….
Hello Mr. Micky,
Thanks for your feedback. This is with regards to your query on the individual policy, will ask our advisor to call you and help you choosing the right policy.
Hope this will help.
Regards,
Sridharan
Dear Sridharan,
I’m covered under the Group Mediclaim Policy of my organization for 2 lac which I feel is very less. We are a family of 5 dependants [mother, father, wife & daughter]. Considering this, please suggest me a suitable plan [I live in Tier 1 city] for 10 lac SA with all the benefits as referred by you above.
Hello Mr. Sachin Kallokar,
Thanks for your mail. Addressing your query on medical insurance, we would recommend you to take a separate plan for your parents. The simple reason is that the premium will be calculated based on the top most age of the person in the family on the family floater plan. We recommend you to consider a super top up plan for yourself and your family which works out to be cheaper as you have a group medical insurance offered by your family. We recommend you to take up super top up plan from apollo minich for a sum assured of 10 Lakhs with 2 Lakhs deductable.
Warm Regards
Sridharan
Thanks & Regards
Sir,
I have a ULIP policy(ICICI prudential Health saver), should i be going for another policy or should i top up this policy itself. Please help. its a family floater for 3, the coverage amount is 5 lakhs. Please comment
Hello Pavithran,
The policy that you have taken is not a pure health insurance plan. The icici pru health saver is a ULIP plan which will help you reimbursing the expenses incurred due to illness and doesn’t works the way the health insurance plan works. The annual premium will be divided in two parts one goes for covering the medical needs and one part will get invested in the market to get you a return. In the pure health insurance plan, the cash less facility is available which will help you meet your hospitalisation expenses. We recommend you to discontinue the same and take a pure health insurance policy instead of a mixed product.
Warm Regards
Sridharan
Searching for a policy for me wife and daughter. For coverage 5lakh of amount. help me to find a suitable one.
Hello Mr. Anil,
This is with regards to your query, we would recommend you to buy an apollo munich optima restore which has got multiple features and could suitable for your needs.
Thanks & Regards
Sridharan
Hi Sridharan,
Nice article!!
For a family of 2 kids, and self and spouse,need recommendation on good health insurance, as i am planning to shift jobs, and need one which would cover me in between period as well. I would also like to continue in future even when insurance is provided by new employer.
Rgds…
Dear Mr. Rajkiran,
Thanks for your appreciation. This is with regards to your query on the health insurance, we would recommend you to take optima restore plan provided by apollo munich health insurance company which offers various benefits.
Thanks & Regards,
Sridharan
i would like to know which policy is best for my family (self,spouse and 18months old baby). my spouse have pre-existing disease (have undergone open heart surgery in the age of 29 as there was a hole in her heart from birth). please suggest.
Hello Sir,
Thanks for your query. This is with regards to the health insurance policy, you may not be able to take up a health insurance policy in your spouse name as she undergone the heart surgery. However, you can apply a separate individual policy for your spouse. The Insurance company will do the due diligence and then will provide a policy with some restriction.We would suggest you to take optima restore from Apollo Munich. You can take a family floater policy to cover you and your daughter.
Hope this clarifies.
Regards,
Sridharan
Hi Sridharan,
First of all thanks for sharing such informative article with us. I have gone through you replies also based on people queries. I found that for some people you suggested Apollo Munich policy. Can you please explain a bit reason behind it. (Plz don’t take it -ve, I know you are not sailing any policy here).
The second part is , My wife is a Cancer survivor. Four year back She got diagnosed with breast Cancer. Its god grace that it was in very initial stage. We did the complete treatment in Tata Memorial (Mumbai) and now she completely cured. Last three years there is no re-occurrence of cancer and she is not going under any medication. Is any Health policy available for her . (I asked almost all insurance company, but everyone denied tough even I am fine with the waiting period)
Waiting for your earliest response
Thanks
Aditya
Hello Mr. Aditya,
Thanks for your appreciation. When we are looking at all the parameter, there are only few companies that we could recommend. One of the company is apollo munich and the second one is max bupa, however, the service standards are little fuzzy.
This is with regards to your query on the health insurance policy for your spouse, since she has undergone a cancer treatment. The insurance companies would not wanted to carry a risk knowingly and hence they reject the policy. Do let me know her age, which will help me identify the possibility.
Regards,
Sridharan
hello
sir , my father age 54 got paralytic attack 6 month ago and he was hospitalized for 22 days. After treatment he is fine and he started his normal routine work after 25 days from his discharge day.
he is in under medication till now. i would like to purchase a health plan for him.
could you suggest me any insurance company which can provide me a health insurance with such condition. i am ok with waiting period .
Hello Sir,
Sorry for the delay in reply. This is with regards to the above query. As your father has undergone a surgery recently, it is very difficult to take up a health insurance. Even if you apply now with the stated decease, the insurance companies tend to reject the policy. We would recommend you to wait for about 6 months and then you can apply.
Thanks & Regards,
Sridharan
Hello,
I am 44 Years old and my wife is 37. We have a daughter who is 11.
I already have a Health Insurance of 5 Lakhs through my employer. I plan to take a family floater policy of my own which I will continue after my retirement. I have heard that it might be difficult to get a new policy once I retire with a high coverage. My criteria are:
1. Sum Insured – 15 Lakhs
2. Co-Pay of about 3 Lakhs. Since I already have a health insurance through my employer and most likely will have it till I retire – I want to opt for co-pay to reduce premium. Once I am close to retirement – I can then buy another policy for about 5 Lakhs to cover for the co-pay amount. Is it possible to remove the co-pay clause later once I retire?
3. Recharge option if available
4. Do not need any daily cash, ambulance cost, personal accident cover (as I have a term policy) to reduce the premium.
5. Critical Illness coverage (is it necessary?)
Do you think I am thinking on the right lines. Since, we are already covered by my employer – should I buy the plan now or wait for a few more years.
Please advice. It would also help if you can suggest the right insurance plan that would meet my needs
Thanks in advance for your time.
AK
Dear Sir,
Thanks for writing to us.
This is with regards to your query, please find below my replies.
It’s essential to have an independent policy to cover the entire family though you have the employer coverage. We would recommend you to look up for a super top up plan with the coverage of 15 Lakhs with the deductible sum assured of Rs.3 lakhs as your employer coverage would cover to the tune of Rs.3 lakhs.
To know more about how super top up plan, kindly read the below article.
https://blog.fundsindia.com/blog/insurance/should-you-top-up-your-health-insurance/5931
Once you are retired, you can buy another plan for the base cover and the super topup plan can be continued as it is more efficient and cost effective.
As far as your query on critical illness is concerned, we would recommend you to plan a separate critical illness plans offered by the insurance company. The employer covered only medical expenses and may not cover the critical illness. If your company covers the critical illness, then it is sufficient.
Hope this clarifies.
Regards,
Sridharan
Hi Sir,
I need health Insurance for my parents. My mother has BP. I have been going through Internet and realized that there are multiple companies.
Please suggest which is the best. I have gone through Apollo Munich, Religare and Max Bupa. I need to have Rs 10 L or more policy, individually for each of them.
Also, do i need to specifically look for a plan that Includes Critical Illness or does the regular ones would cover it.
Hello Madam,
Thanks for writing to us.
This is with regards to your query, we would suggest you to go for apollo munich optima senior plan if you mother is more than 60 years old. We would recommend you to have around 3 lakhs of coverage for your parents separately. The cost per lakh would be around Rs.5000 and hence it is not advisable to have more than 3 Lakhs of coverage. If your parents are below 60 years of age, you can plan a floater policy with the sum assured of Rs.5 Lakhs in optima restore which has a restoration of sum assured in 1st and 2nd year, if there is no claim. By having this plan, the sum insured will be doubled in the 3rd year if you don’t claim anything during the first 2 years.
The critical illness plan also being provided by different various companies covering various diseases. We recommend you to consider apollo munich vital which covers almost 37 different diseases. PFB a small comparison for your reference.
Insurance company plan no. Of diseases survival Premium
Bharati Axa Smart health 20 30 days after diagnosis 1699
Religare Assure 20 0 days after diagnosis 1827
Apollo Munich Optima Vital 37 30 days after diagnosis 1853
Max Bupa Health Assured 20 30 days after diagnosis 1271
HDFC Ergo Critical Illness 8 30 days after diagnosis 1426
Hope this helps you.
Thanks & Regards,
S. Sridharan
Nice One
Hello Sir,
Thanks for your compliments.
Regards,
S. Sridharan
Hi Shridhar,
Thanks for writing this article. Before reading this article health insurance was very confusing concept for me. But I was looking for health insurance plans for my family and for my parents. Now, I got complete idea about health insurance.
I am impressed with point no 7, my opinion was its good if we’ll get discount on premium but I didn’t think about increasing policy cover. Concepts are also covered like no claim bonus, co payment, cost of policy, renewal age etc and so on. Again thank you thanks a lot!
Hello Rahul Rao,
Thanks for your compliments.
Regards,
S. Sridharan
Its my pleasure sir, You have really good knowledge about Insurance and I am glad that I read your article. Fundsindiablog is really good source where all can get excellent information. I would like to put more queries through the comments section so I can acquire more knowledge about insurance.
Dear Sir,
Thanks for this kind of Basic information regarding Helth Insurance selection.
I am also recently join One of the Helth Insurance Co. as an Advisor and I really very happy about lots of thinks I learned from this article. Thanks a lot Sir.
Regard,
Raj Jadhav
Nice One
Nice One
Nice One
Hello sir,
its very interesting that you have been given good suggestions, I have a query that I need to take senior citizen plan for my mother(60) and father(65), Recently I changed the company where they are not providing health insurance to parents.
Till my last organization it was like myself, spouse and my parents. and one more thing my mother from last one year she is having kidney problem, where 1 or 2 times dialyses been done and same been claimed with my previous health insurance and they accepted it. and right now she is not having any dialyses from last 8 months she is completely on medication but the medicines itself too costly to bear, I need your suggestion is there any plan where I can cope the medicines cost and claim.
Please suggest me some good plan for my parents.
Regards,
Kiran
Hello Mr. Kiran,
Thanks for writing to FundsIndia. As you have mentioned about your mother’s illness, I would recommend you to go-ahead with Star Health Insurance Red carpet. This is a senior citizen policy that Covers the pre-existing deceases from the first year itself except those germinated during immediate preceding 12 months. Such diseases will be covered from second year and onwards. However, for all the senior citizen policies, there is a compulsory co-payment option ranging from 20%-50% depends on the policy. In the case of red carpet, the pre-existing deceases, the co-payment of 50% is applicable and for the non-existing ailments, there is a co-payment of 30% exists. Still, it is ideal to have a policy which could at least reduce the hospitalisation cost by 70% percent.
Hope this clarifies your query.
Regards,
S. Sridharan
i am planning to take 4 lac insurance from Religare health insurance for my mother 56 yrs.
please guide me.
Hello Mr. Chitransu,
Thanks for writing to FundsIndia. This is with regards to your query on religare health insurance, this is a recommended family floater policy. It provides wide and extended coverage at reasonable rates. However, the recent news about religare exiting its insurance business would be a bit concern and hence it is advisable to avoid. Instead, you can check out with apollo munich optima restore or max bupa healthcare option which also have the similar option available.
Hope this clarifies your query.
Thanks & Regards,
S. Sridharan
Nice One
Good explanation its helpfull, it would be good if u also suggest the rating of company which provide good services
thanks for this article on Health Insurance
Thanks for this article. Going through the questions and your answers to them was like a feather in the cap. I was initially planning to go for Religare Care floater plan for my wife and self (35 years age, 10 Lac coverage). However in one of the answers you have mentioned that Religare might be exiting its insurance business and hence should be avoided. What are your views on ICICI Lombard iHealth floater plan. Is it worth? Please guide.
Hello Mr. Anuj,
Apologies for late in reply. This is with regards to your query on ICICI lombard, it is always advisable to get a medical insurance from a standalone medical insurance companies like apollo munich, max bupa or star health. The primary reason is that the standalone insurance companies core business is health insurance and also they innovate new products that could cater to the needs of individuals who could not get health insurance. For example, in earlier days, the medical insurance was declined to a person who has diabetes. Where as the standalone companies have broken that history. However, once the innovator launched a new product, the other companies follow suit. In anyway, one has to buy health insurance from the standalone health insurance company will always be better.
Regards,
S. Sridharan
Thank you for sharing such great information. It is informative, can you help me in finding out more detail on ULIP , i am interested and would like to know more about this field and wanted to understand the basics of ulip insurance policy
Your comment is helpful to understand health policies benefit.
My age 36 & I want to take a health policy with two kids 12 yr & 16yr .
No major disease, Please suggest
Hello Rekha,
Thanks for the appreciation. This is with regards to your query on health policy, it would be ideal to have a look at apollo munich optima restore/max bupa health companion. Both the variants are having a similar benefits with the little difference in premium.
Hope this helps.
Regards,
S. Sridharan
Is Religare still looking to move out of the health insurance business? Their plans are nicely placed and caters to most of my family’s needs. They are also highly ranked based on MINT mediclaim ratings.
Any updates on info about Religare?
Also, as an alternate, I am considering Apollo Munich Optima Restore as an alternate option for my Mother who is 59 Years old. She has undergone knee-replacement surgery. I would advise my mother to inform the insurers about this. But, what are the possible scenarios under which her health insurance application would be accepted? Would there be a waiting period/permanent exclusion? What decides whether it is permanently excluded or not?
The premium for Apollo Munich Optima Restore (for age 59) is huge compared to their peers. But then, there is no room limit nor co-payment. This makes it attractive though.
Hello Mr. Padmanabhan,
I have replied to your earlier mail. Apologies for the delay in reply to your earlier mail. The Apollo Munich Optima Restore is a premium plan that has the advantage of a restore benefits along with life long renewal options. The other advantage is that this plan is a fully loaded plan where there is no room rent cap. However, you need to disclose the fact of undergone the knee-replacement surgery. There could be three possibilities by disclosing this
1. The insurance company issue the policy with the exclusion of knee replacement as a pre-existing decease and would not get covered for the first 3 years.
2. They issue the policy with the permanent exclusion of the knee-replacement as a pre-existing decease with which you would not be able to claim anything that arises in future pertaining to this decease.
3. The insurance company issue the policy with loading of additional premium.
You would get to know the status only after your mother undergone the medical test.
Hope this helps.
Regards,
S. Sridharan
Thank you! Appreciate the valuable feedback.
Hello Mr. Padmanabhan,
Thanks for writing to us.
This is with regards to your query, Religare is the present plans and their ratings are good. However, we could not gauge their future and hence it is advisable to avoid taking plans from aegon. There are similar plans available with other standalone health insurance companies which could be better. If you are still fine with Religare, you can pretty much go ahead with it.
Hope this clarifies.
Regards,
S. Sridharan
Hi Mr. Sridharan
Thank you very much for the immediate response.
I am referring to Religare Health Insurance ( Care Plan) but what you mentioned is Religare Aegon which is Life insurance.
Can you clarify if your opinion still remains the same for Religare Health Insurance?
Hello Mr. Padmanabhan,
Religare is associated with Aegon for life insurance business and religare is moved out of life business recently. Religare is associated with Union bank & Corporation bank for its health insurance business. Since they are slowly moving out all the business ventures, it is always advisable to wait and watch.
Regards,
S. Sridharan
sir ,,,,i had undergone medication nerve pain killers and other vitamins and all for flat foot pain for 2 months 2 years back.
so can i go for an insurance now and do i need to state the complete history to the insurance company and what if i came up with something severe in future with connection to those medications. so will those medications still be considered as pre existing disease .
nothing as such is diagnosed with me .
so what do u suggest over this which company in india will consider my proposal
or do i just need to keep my mouth shut with my history and buy the policy as im in fit n fine condition for the last 2 years
do reply quickly sir im 24 yrs old
Hello Mr. Anurag Kashyap,
Thanks for writing to us. This is with regards to your query, the pre-existing deceases would not get covered for the initial three years. You can pretty well approach the health insurance company for your health insurance needs. Also, it is very important to disclose the fact of having the flat foot pain decease that you had which will help you in claiming for the same if in case the same decease occurs in future. The other important thing is that, at times, they may also provide you an insurance coverage with out any additional charges but by permanent exclusion of the specific decease if it is so severe and occurs very frequently. It all depends on the severity of the decease and hence it is always advisable to disclose the fact to avoid the problems in the future.
Hope this clarifies.
Regards,
S. Sridharan
Hi I want to take individual plan for my sister. She was suffered from clot in brain intially but she is f9 now as it get dissolved by medicines only.
Please suggest which company is best in terms of services and claim processing
Hello Sonia,
Thanks for writing to us.Since she was suffered from brain clot,it is advisable to mention in the health insurance application form. The health insurance company, would either reject the policy or will permanently exclude this and issue the policy. You can have a look at max bupa health care or apollo munich optima restore. Both are individual health policy with the restoration of sum assured.
Thanks & Regards,
S. Sridharan
Nice blog to choose best health insurance plan. While choosing any health plan it’s important to check company policies. As, we all know we buy health insurance and whenever we are need of it companies born only 40% cost and then we realize that we have selected a wrong policy. So, you can calculate your health insurance plan cost according to your income at Big Decision Health Insurance Calculator. Even, you can refer to articles and videos which will help you to select right insurance.
Why do I need health insurance? What are the benefits and which one should I go for?
Hello Chintan Grover,
In today, the individual life style and the food habits have drastically changed. Medical costs and the complexity of diseases keep increasing by the day. A minor surgery can cost you anywhere between Rs 30,000 and Rs 60,000, while a cardiac treatment can cost you Rs 5 lakh, depending on the city and hospital you choose. One way to handle this rising cost is by taking a medical insurance policy. The benefits of taking the health insurance policy is that the entire hospital expenses can be claimed. Please look into the below link for choosing the right health insurance policy.
https://blog.fundsindia.com/blog/personal-finance/seven-secrets-to-choose-the-best-health-insurance-plan/5649
Hope this clarifies your query.
Regards,
S. Sridharan
Thank you for sharing such great information. It is informative, can you help me in finding out more detail on Ulip Insurance India,Best Ulip Insurance PlanULIP, i am interested and would like to know more about this field and wanted to understand the basics of ulip insurance policy
Hello Ritika Shah,
Thanks for your appreciation. As far as ULIP is concerned, it is a combination of Insurance and investment which may not be a right investment choice. You need to have a pure term insurance for the insurance coverage and have to choose investment products separately. Never mix up insurance and investment. The reason is that the cost of acquiring the ULIP policies are bit high compare to the other products that are available. Finally, the investment products needs to be chosen based on the risk appetite, time horizon and the objective that you have.
Hope this helps.
Regards,
S. Sridharan
There are few tips which you can follow to choose for best health insurance policy. Some of the tips are following:
You check for Insurance Company, because there are number of insurance companies available in market. It is very important to know the company background.
You need to look for Inclusions and Exclusions that what is included and what is excluded in the policy.
Coverage in Insurance policy, normally we ignore the Coverage in insurance policy because some times what we think we don’t get that at the time of maturity.
Check for limits and Sub limits of policy.
Nice information about taking right life insurance. Choosing a health insurance policy is a very important decision and will affect your health in either a positive or negative way, depending on your choice. You will want to be sure that you pick a health insurance policy that will have you covered when you need it.
Dear Sir,
Thanks for your compliments.
Regards
Sridharan
Sir, nice article
I have compared health insurance policies on various portals like policybazaar.com etc, i want to know which company is good , considering all these points which you have mentioned in this article, i have shortlisted ICICI LOMBARD (COMPLETE HEALTH INSURANCE ) cover and appolo munich health insurance plan . which one is better please suggest ?
I want to opt for family floater considering my requirements. without any senior citizen in my family. and want to have sum assured of 10 lack.
thanks ….
Hello Mr. Micky,
Thanks for your feedback. This is with regards to your query on the individual policy, will ask our advisor to call you and help you choosing the right policy.
Hope this will help.
Regards,
Sridharan
Dear Sridharan,
I’m covered under the Group Mediclaim Policy of my organization for 2 lac which I feel is very less. We are a family of 5 dependants [mother, father, wife & daughter]. Considering this, please suggest me a suitable plan [I live in Tier 1 city] for 10 lac SA with all the benefits as referred by you above.
Hello Mr. Sachin Kallokar,
Thanks for your mail. Addressing your query on medical insurance, we would recommend you to take a separate plan for your parents. The simple reason is that the premium will be calculated based on the top most age of the person in the family on the family floater plan. We recommend you to consider a super top up plan for yourself and your family which works out to be cheaper as you have a group medical insurance offered by your family. We recommend you to take up super top up plan from apollo minich for a sum assured of 10 Lakhs with 2 Lakhs deductable.
Warm Regards
Sridharan
Thanks & Regards
Is there any policy that covers out patient treatment for me and my wife (ages 64 and 58)?
Dear Mr. Padmanabh Shenoy,
This is with regards to your query on out patient treatment coverage, presently no insurance company covers a senior citizen on out patient treatment. We will update you if anything comes in the future.
Thanks & Regards
Sridharan
Sir,
I have a ULIP policy(ICICI prudential Health saver), should i be going for another policy or should i top up this policy itself. Please help. its a family floater for 3, the coverage amount is 5 lakhs. Please comment
Hello Pavithran,
The policy that you have taken is not a pure health insurance plan. The icici pru health saver is a ULIP plan which will help you reimbursing the expenses incurred due to illness and doesn’t works the way the health insurance plan works. The annual premium will be divided in two parts one goes for covering the medical needs and one part will get invested in the market to get you a return. In the pure health insurance plan, the cash less facility is available which will help you meet your hospitalisation expenses. We recommend you to discontinue the same and take a pure health insurance policy instead of a mixed product.
Warm Regards
Sridharan
Searching for a policy for me wife and daughter. For coverage 5lakh of amount. help me to find a suitable one.
Hello Mr. Anil,
This is with regards to your query, we would recommend you to buy an apollo munich optima restore which has got multiple features and could suitable for your needs.
Thanks & Regards
Sridharan
Hello,
I am 44 Years old and my wife is 37. We have a daughter who is 11.
I already have a Health Insurance of 5 Lakhs through my employer. I plan to take a family floater policy of my own which I will continue after my retirement. I have heard that it might be difficult to get a new policy once I retire with a high coverage. My criteria are:
1. Sum Insured – 15 Lakhs
2. Co-Pay of about 3 Lakhs. Since I already have a health insurance through my employer and most likely will have it till I retire – I want to opt for co-pay to reduce premium. Once I am close to retirement – I can then buy another policy for about 5 Lakhs to cover for the co-pay amount. Is it possible to remove the co-pay clause later once I retire?
3. Recharge option if available
4. Do not need any daily cash, ambulance cost, personal accident cover (as I have a term policy) to reduce the premium.
5. Critical Illness coverage (is it necessary?)
Do you think I am thinking on the right lines. Since, we are already covered by my employer – should I buy the plan now or wait for a few more years.
Please advice. It would also help if you can suggest the right insurance plan that would meet my needs
Thanks in advance for your time.
AK
Dear Sir,
Thanks for writing to us.
This is with regards to your query, please find below my replies.
It’s essential to have an independent policy to cover the entire family though you have the employer coverage. We would recommend you to look up for a super top up plan with the coverage of 15 Lakhs with the deductible sum assured of Rs.3 lakhs as your employer coverage would cover to the tune of Rs.3 lakhs.
To know more about how super top up plan, kindly read the below article.
https://blog.fundsindia.com/blog/insurance/should-you-top-up-your-health-insurance/5931
Once you are retired, you can buy another plan for the base cover and the super topup plan can be continued as it is more efficient and cost effective.
As far as your query on critical illness is concerned, we would recommend you to plan a separate critical illness plans offered by the insurance company. The employer covered only medical expenses and may not cover the critical illness. If your company covers the critical illness, then it is sufficient.
Hope this clarifies.
Regards,
Sridharan
i would like to know which policy is best for my family (self,spouse and 18months old baby). my spouse have pre-existing disease (have undergone open heart surgery in the age of 29 as there was a hole in her heart from birth). please suggest.
Hello Sir,
Thanks for your query. This is with regards to the health insurance policy, you may not be able to take up a health insurance policy in your spouse name as she undergone the heart surgery. However, you can apply a separate individual policy for your spouse. The Insurance company will do the due diligence and then will provide a policy with some restriction.We would suggest you to take optima restore from Apollo Munich. You can take a family floater policy to cover you and your daughter.
Hope this clarifies.
Regards,
Sridharan
Hi Sridharan,
Nice article!!
For a family of 2 kids, and self and spouse,need recommendation on good health insurance, as i am planning to shift jobs, and need one which would cover me in between period as well. I would also like to continue in future even when insurance is provided by new employer.
Rgds…
Dear Mr. Rajkiran,
Thanks for your appreciation. This is with regards to your query on the health insurance, we would recommend you to take optima restore plan provided by apollo munich health insurance company which offers various benefits.
Thanks & Regards,
Sridharan
Dear Sir,
Thanks for this kind of Basic information regarding Helth Insurance selection.
I am also recently join One of the Helth Insurance Co. as an Advisor and I really very happy about lots of thinks I learned from this article. Thanks a lot Sir.
Regard,
Raj Jadhav
hello
sir , my father age 54 got paralytic attack 6 month ago and he was hospitalized for 22 days. After treatment he is fine and he started his normal routine work after 25 days from his discharge day.
he is in under medication till now. i would like to purchase a health plan for him.
could you suggest me any insurance company which can provide me a health insurance with such condition. i am ok with waiting period .
Hello Sir,
Sorry for the delay in reply. This is with regards to the above query. As your father has undergone a surgery recently, it is very difficult to take up a health insurance. Even if you apply now with the stated decease, the insurance companies tend to reject the policy. We would recommend you to wait for about 6 months and then you can apply.
Thanks & Regards,
Sridharan
Hi Shridhar,
Thanks for writing this article. Before reading this article health insurance was very confusing concept for me. But I was looking for health insurance plans for my family and for my parents. Now, I got complete idea about health insurance.
I am impressed with point no 7, my opinion was its good if we’ll get discount on premium but I didn’t think about increasing policy cover. Concepts are also covered like no claim bonus, co payment, cost of policy, renewal age etc and so on. Again thank you thanks a lot!
Hello Rahul Rao,
Thanks for your compliments.
Regards,
S. Sridharan
Its my pleasure sir, You have really good knowledge about Insurance and I am glad that I read your article. Fundsindiablog is really good source where all can get excellent information. I would like to put more queries through the comments section so I can acquire more knowledge about insurance.
Hi Sridharan,
First of all thanks for sharing such informative article with us. I have gone through you replies also based on people queries. I found that for some people you suggested Apollo Munich policy. Can you please explain a bit reason behind it. (Plz don’t take it -ve, I know you are not sailing any policy here).
The second part is , My wife is a Cancer survivor. Four year back She got diagnosed with breast Cancer. Its god grace that it was in very initial stage. We did the complete treatment in Tata Memorial (Mumbai) and now she completely cured. Last three years there is no re-occurrence of cancer and she is not going under any medication. Is any Health policy available for her . (I asked almost all insurance company, but everyone denied tough even I am fine with the waiting period)
Waiting for your earliest response
Thanks
Aditya
Hello Mr. Aditya,
Thanks for your appreciation. When we are looking at all the parameter, there are only few companies that we could recommend. One of the company is apollo munich and the second one is max bupa, however, the service standards are little fuzzy.
This is with regards to your query on the health insurance policy for your spouse, since she has undergone a cancer treatment. The insurance companies would not wanted to carry a risk knowingly and hence they reject the policy. Do let me know her age, which will help me identify the possibility.
Regards,
Sridharan
Hello sir,
its very interesting that you have been given good suggestions, I have a query that I need to take senior citizen plan for my mother(60) and father(65), Recently I changed the company where they are not providing health insurance to parents.
Till my last organization it was like myself, spouse and my parents. and one more thing my mother from last one year she is having kidney problem, where 1 or 2 times dialyses been done and same been claimed with my previous health insurance and they accepted it. and right now she is not having any dialyses from last 8 months she is completely on medication but the medicines itself too costly to bear, I need your suggestion is there any plan where I can cope the medicines cost and claim.
Please suggest me some good plan for my parents.
Regards,
Kiran
Hello Mr. Kiran,
Thanks for writing to FundsIndia. As you have mentioned about your mother’s illness, I would recommend you to go-ahead with Star Health Insurance Red carpet. This is a senior citizen policy that Covers the pre-existing deceases from the first year itself except those germinated during immediate preceding 12 months. Such diseases will be covered from second year and onwards. However, for all the senior citizen policies, there is a compulsory co-payment option ranging from 20%-50% depends on the policy. In the case of red carpet, the pre-existing deceases, the co-payment of 50% is applicable and for the non-existing ailments, there is a co-payment of 30% exists. Still, it is ideal to have a policy which could at least reduce the hospitalisation cost by 70% percent.
Hope this clarifies your query.
Regards,
S. Sridharan
Nice One
Hello Sir,
Thanks for your compliments.
Regards,
S. Sridharan
Nice One
Thanks for this article. Going through the questions and your answers to them was like a feather in the cap. I was initially planning to go for Religare Care floater plan for my wife and self (35 years age, 10 Lac coverage). However in one of the answers you have mentioned that Religare might be exiting its insurance business and hence should be avoided. What are your views on ICICI Lombard iHealth floater plan. Is it worth? Please guide.
Hello Mr. Anuj,
Apologies for late in reply. This is with regards to your query on ICICI lombard, it is always advisable to get a medical insurance from a standalone medical insurance companies like apollo munich, max bupa or star health. The primary reason is that the standalone insurance companies core business is health insurance and also they innovate new products that could cater to the needs of individuals who could not get health insurance. For example, in earlier days, the medical insurance was declined to a person who has diabetes. Where as the standalone companies have broken that history. However, once the innovator launched a new product, the other companies follow suit. In anyway, one has to buy health insurance from the standalone health insurance company will always be better.
Regards,
S. Sridharan
Good explanation its helpfull, it would be good if u also suggest the rating of company which provide good services
Hi Sir,
I need health Insurance for my parents. My mother has BP. I have been going through Internet and realized that there are multiple companies.
Please suggest which is the best. I have gone through Apollo Munich, Religare and Max Bupa. I need to have Rs 10 L or more policy, individually for each of them.
Also, do i need to specifically look for a plan that Includes Critical Illness or does the regular ones would cover it.
Hello Madam,
Thanks for writing to us.
This is with regards to your query, we would suggest you to go for apollo munich optima senior plan if you mother is more than 60 years old. We would recommend you to have around 3 lakhs of coverage for your parents separately. The cost per lakh would be around Rs.5000 and hence it is not advisable to have more than 3 Lakhs of coverage. If your parents are below 60 years of age, you can plan a floater policy with the sum assured of Rs.5 Lakhs in optima restore which has a restoration of sum assured in 1st and 2nd year, if there is no claim. By having this plan, the sum insured will be doubled in the 3rd year if you don’t claim anything during the first 2 years.
The critical illness plan also being provided by different various companies covering various diseases. We recommend you to consider apollo munich vital which covers almost 37 different diseases. PFB a small comparison for your reference.
Insurance company plan no. Of diseases survival Premium
Bharati Axa Smart health 20 30 days after diagnosis 1699
Religare Assure 20 0 days after diagnosis 1827
Apollo Munich Optima Vital 37 30 days after diagnosis 1853
Max Bupa Health Assured 20 30 days after diagnosis 1271
HDFC Ergo Critical Illness 8 30 days after diagnosis 1426
Hope this helps you.
Thanks & Regards,
S. Sridharan
Nice One
i am planning to take 4 lac insurance from Religare health insurance for my mother 56 yrs.
please guide me.
Hello Mr. Chitransu,
Thanks for writing to FundsIndia. This is with regards to your query on religare health insurance, this is a recommended family floater policy. It provides wide and extended coverage at reasonable rates. However, the recent news about religare exiting its insurance business would be a bit concern and hence it is advisable to avoid. Instead, you can check out with apollo munich optima restore or max bupa healthcare option which also have the similar option available.
Hope this clarifies your query.
Thanks & Regards,
S. Sridharan
sir ,,,,i had undergone medication nerve pain killers and other vitamins and all for flat foot pain for 2 months 2 years back.
so can i go for an insurance now and do i need to state the complete history to the insurance company and what if i came up with something severe in future with connection to those medications. so will those medications still be considered as pre existing disease .
nothing as such is diagnosed with me .
so what do u suggest over this which company in india will consider my proposal
or do i just need to keep my mouth shut with my history and buy the policy as im in fit n fine condition for the last 2 years
do reply quickly sir im 24 yrs old
Hello Mr. Anurag Kashyap,
Thanks for writing to us. This is with regards to your query, the pre-existing deceases would not get covered for the initial three years. You can pretty well approach the health insurance company for your health insurance needs. Also, it is very important to disclose the fact of having the flat foot pain decease that you had which will help you in claiming for the same if in case the same decease occurs in future. The other important thing is that, at times, they may also provide you an insurance coverage with out any additional charges but by permanent exclusion of the specific decease if it is so severe and occurs very frequently. It all depends on the severity of the decease and hence it is always advisable to disclose the fact to avoid the problems in the future.
Hope this clarifies.
Regards,
S. Sridharan
Your comment is helpful to understand health policies benefit.
My age 36 & I want to take a health policy with two kids 12 yr & 16yr .
No major disease, Please suggest
Hello Rekha,
Thanks for the appreciation. This is with regards to your query on health policy, it would be ideal to have a look at apollo munich optima restore/max bupa health companion. Both the variants are having a similar benefits with the little difference in premium.
Hope this helps.
Regards,
S. Sridharan
Thank you for sharing such great information. It is informative, can you help me in finding out more detail on Ulip Insurance India,Best Ulip Insurance PlanULIP, i am interested and would like to know more about this field and wanted to understand the basics of ulip insurance policy
Hello Ritika Shah,
Thanks for your appreciation. As far as ULIP is concerned, it is a combination of Insurance and investment which may not be a right investment choice. You need to have a pure term insurance for the insurance coverage and have to choose investment products separately. Never mix up insurance and investment. The reason is that the cost of acquiring the ULIP policies are bit high compare to the other products that are available. Finally, the investment products needs to be chosen based on the risk appetite, time horizon and the objective that you have.
Hope this helps.
Regards,
S. Sridharan
There are few tips which you can follow to choose for best health insurance policy. Some of the tips are following:
You check for Insurance Company, because there are number of insurance companies available in market. It is very important to know the company background.
You need to look for Inclusions and Exclusions that what is included and what is excluded in the policy.
Coverage in Insurance policy, normally we ignore the Coverage in insurance policy because some times what we think we don’t get that at the time of maturity.
Check for limits and Sub limits of policy.
Hi I want to take individual plan for my sister. She was suffered from clot in brain intially but she is f9 now as it get dissolved by medicines only.
Please suggest which company is best in terms of services and claim processing
Hello Sonia,
Thanks for writing to us.Since she was suffered from brain clot,it is advisable to mention in the health insurance application form. The health insurance company, would either reject the policy or will permanently exclude this and issue the policy. You can have a look at max bupa health care or apollo munich optima restore. Both are individual health policy with the restoration of sum assured.
Thanks & Regards,
S. Sridharan
thanks for this article on Health Insurance
Nice information about taking right life insurance. Choosing a health insurance policy is a very important decision and will affect your health in either a positive or negative way, depending on your choice. You will want to be sure that you pick a health insurance policy that will have you covered when you need it.
Thank you for sharing such great information. It is informative, can you help me in finding out more detail on ULIP , i am interested and would like to know more about this field and wanted to understand the basics of ulip insurance policy
Is Religare still looking to move out of the health insurance business? Their plans are nicely placed and caters to most of my family’s needs. They are also highly ranked based on MINT mediclaim ratings.
Any updates on info about Religare?
Also, as an alternate, I am considering Apollo Munich Optima Restore as an alternate option for my Mother who is 59 Years old. She has undergone knee-replacement surgery. I would advise my mother to inform the insurers about this. But, what are the possible scenarios under which her health insurance application would be accepted? Would there be a waiting period/permanent exclusion? What decides whether it is permanently excluded or not?
The premium for Apollo Munich Optima Restore (for age 59) is huge compared to their peers. But then, there is no room limit nor co-payment. This makes it attractive though.
Hello Mr. Padmanabhan,
I have replied to your earlier mail. Apologies for the delay in reply to your earlier mail. The Apollo Munich Optima Restore is a premium plan that has the advantage of a restore benefits along with life long renewal options. The other advantage is that this plan is a fully loaded plan where there is no room rent cap. However, you need to disclose the fact of undergone the knee-replacement surgery. There could be three possibilities by disclosing this
1. The insurance company issue the policy with the exclusion of knee replacement as a pre-existing decease and would not get covered for the first 3 years.
2. They issue the policy with the permanent exclusion of the knee-replacement as a pre-existing decease with which you would not be able to claim anything that arises in future pertaining to this decease.
3. The insurance company issue the policy with loading of additional premium.
You would get to know the status only after your mother undergone the medical test.
Hope this helps.
Regards,
S. Sridharan
Thank you! Appreciate the valuable feedback.
Hello Mr. Padmanabhan,
Thanks for writing to us.
This is with regards to your query, Religare is the present plans and their ratings are good. However, we could not gauge their future and hence it is advisable to avoid taking plans from aegon. There are similar plans available with other standalone health insurance companies which could be better. If you are still fine with Religare, you can pretty much go ahead with it.
Hope this clarifies.
Regards,
S. Sridharan
Hi Mr. Sridharan
Thank you very much for the immediate response.
I am referring to Religare Health Insurance ( Care Plan) but what you mentioned is Religare Aegon which is Life insurance.
Can you clarify if your opinion still remains the same for Religare Health Insurance?
Hello Mr. Padmanabhan,
Religare is associated with Aegon for life insurance business and religare is moved out of life business recently. Religare is associated with Union bank & Corporation bank for its health insurance business. Since they are slowly moving out all the business ventures, it is always advisable to wait and watch.
Regards,
S. Sridharan
Why do I need health insurance? What are the benefits and which one should I go for?
Hello Chintan Grover,
In today, the individual life style and the food habits have drastically changed. Medical costs and the complexity of diseases keep increasing by the day. A minor surgery can cost you anywhere between Rs 30,000 and Rs 60,000, while a cardiac treatment can cost you Rs 5 lakh, depending on the city and hospital you choose. One way to handle this rising cost is by taking a medical insurance policy. The benefits of taking the health insurance policy is that the entire hospital expenses can be claimed. Please look into the below link for choosing the right health insurance policy.
https://blog.fundsindia.com/blog/personal-finance/seven-secrets-to-choose-the-best-health-insurance-plan/5649
Hope this clarifies your query.
Regards,
S. Sridharan
Nice blog to choose best health insurance plan. While choosing any health plan it’s important to check company policies. As, we all know we buy health insurance and whenever we are need of it companies born only 40% cost and then we realize that we have selected a wrong policy. So, you can calculate your health insurance plan cost according to your income at Big Decision Health Insurance Calculator. Even, you can refer to articles and videos which will help you to select right insurance.