Best Health Insurance & Mediclaim Policy in 2022
Hi, My Name is M U Sunny, and welcome to How71Tech.
Guys, we talk about different types of investments on this Website Like Stocks,
Mutual Funds, Real Estate Gold, etc. But we never discussed that where should
be our first investment. Its answer is there in another question that What is
the biggest asset for us?
For me, the most important asset is myself
Because my earning potential is unlimited and that's why it is very important
to take care of our self. There is a famous saying 'If you have life, you have
the world'. If we'll take care of our self then only we can realize our earning
potential.
That's
why it is very important to invest in your body and health and that's why The
first investment we should do is to get Health insurance. But when we go to buy
health insurance, many questions come to our mind Do I need health insurance
according to my career stage or age?
Or how much total cover should I take?
Sometimes some companies provide health insurance to their employees so they
think that they're done But is that cover sufficient? If you buy any health
insurance policy then what is included and what is excluded On what you should
focus more on? And if we're buying any policy then should we buy the cheapest
one? Sometimes, even if you buy the policy, the claim gets rejected Some
pre-existing diseases are not covered in that What are restoration benefits,
top-up cover, and super top-up cover?
We'll cover this Article in 4 parts. Firstly,
we'll see the benefits of health insurance. Secondly, we'll talk about
inclusions and exclusions that means about the features what all things are
included and excluded in a standard policy and what all things to keep in mind.
On third, we'll talk about how much total cover we should take Either as an
individual or as a family And finally,
we'll
watch a live demo on how to buy health insurance and what all things to keep in
mind. Let's discuss the benefits. The first benefit of health insurance is that
your savings remain untouched at times of emergency Let's say any medical
problem occurs in your family And as we know medical costs are very high
nowadays Surgery or treatment cost for any critical illness is very high like
5-15 lakhs So in this case,
your
savings will not be affected much and you'll get total cover from health
insurance. 2nd huge benefit is Cashless treatment and we don't have to pay
anything from your pocket. Most of the standard policies have a network of
hospitals where you can get cashless treatment. 3rd benefit is, there are
Corporate Plans Top-up. Many companies provide 1.5-3 lakhs insurance cover. But
it's not sufficient in most cases so you can Top-up that also.
4th big benefit is, if you buy insurance at a young age, then your premium is less and most of your diseases are covered. Because there are fewer chances of diseases at young age But over a period of time, the chances of diseases or any illness increases Most of the policies have a waiting period for pre-existing diseases of around 3-4 years If that will be covered then any other disease will be covered in future 5th benefit is, you get cover for all the lifestyle diseases Nowadays most of the jobs are desktop jobs because in this COVID time,
most
of the people are working from home So it becomes more important in these times
And 6th benefit is, you get many other benefits other than hospitalization like
Maternity benefit or daycare facilities. Many surgeries or treatments do not
require hospitalization That is also covered in many policies. Many viral
diseases are covered and there are special policies for COVID these days. 7th
benefit is, Tax benefits Under Section 80D, you get a tax deduction of Rs.
25,000 if you choose the old slab. However, it's not a big thing but it may be
a big advantage for some people.
Now let's talk about Inclusions and
Exclusions. The first feature you have to check in any policy is In your nearby
hospitals, check which policy is providing cashless treatment. Secondly, check
that whether pre and post hospitalization charges are covered or not Pre and
post hospitalization charges are the charges which include during treatment
charges And along with that, 30-60 days of pre-hospitalization period which
includes consultation of a doctor,
diagnostic
test, any physiotherapy, etc. And post-hospitalization may also include
physiotherapy, diagnostic consultation. So many policies cover 30-60 days of
pre hospitalization expenses And covers 60-180 days post-hospitalization
expenses. So keep this in mind as well. You should also check Day Care
Facilities because Nowadays, many surgeries last just for 1 day That means you
don't need night admission in hospitals Many policies do not cover Day care
facilities So keep this in mind as well. Along with this, many policies cover
Ambulance charges as well.
You
have to check the coverage and there should not be any cap on different
diseases or treatments. For example, your policy may have a limit of Rs. 50,000
on maternity benefits And maybe your expenses come out Rs. 75,000-1,00,000. So
keep this in mind. Besides this, some policies also contain a Co-pay option
That means you also have to give some money So if treatment costs Rs. 1 lakh
and 10 % is Co-pay clause Then you have to pay Rs. 10,000 so it's better not to
have a Co-pay option.
One
more thing to keep in mind is how much Room Rent is available All these charges
are linked to your room rent and let's say room rent is high under your policy
So you have to Co-pay accordingly That's why it's important to see the room you
would prefer according to your lifestyle. One more benefit which is available
in some policies is the Restoration benefit. Let's say all your cover is
exhausted in one year.
Let's
say Rs. 3,00,000 cover exhausted for a family member So that cover will be
restored for another member. Hence, restoration benefits are also there. And in
some policies, These restoration benefits are available during hospitalization.
Similarly, there's one more benefit which is the Top-up benefit. If there is a
company insurance going on and if someone wants to take Top-up insurance then
that is a very good option Let's say you have a cover of Rs. 3 lakhs and you
want it to be Rs. 6 lakhs Then you can buy an additional cover of Rs. 3 lakhs
which is called Top-up cover.
Top-up
cover means if your Rs. 3 lakhs cover is exhausted then additional Rs. 3 lakhs
cover will be available. And there is one more beneficial plan which is Super
Top-up cover In which your multiple claims are also covered. And multiple
claims means Let's say a family member fallen sick and it cost Rs. 1 lakh for
the treatment Then the remaining Rs. 2 lakhs got spent on another family member
and the total cover exhausted.
Now
you will get a Top-up of Rs. 3 lakhs again which is called super Top-up. And if
you buy Top-up Or Super Top-up cover then your existing conditions are
continued as it is That means the waiting period is continued as it is. This is
the benefit of Top-up or Super Top-up. Now let's understand what is
Pre-Existing Disease and Waiting Period Because most of the claims used to get
rejected because of this earlier and today as well. So to tackle this,
IRDA defined the Pre-existing diseases
properly. So the disease diagnosed 48 months prior to the date of policy buying
is called Pre-existing disease. And this is considered basically for your
claim. So for example, if someone is suffering from diabetes and let's say he
took the policy in July 2020 and he was already suffering from diabetes Hence,
it is a Pre-existing disease. So he can claim the cost of its treatment from
the 5th year onwards which means from July 2024. But definitely, if you have
any existing conditions or illnesses, then your premium increases.
And this waiting period can be different for
different diseases It is generally 2-4 years of duration. Along with this,
remember that you don't have to hide your existing condition. If you smoke,
you're diabetic, or have any other type of heart condition then clearly mention
it Because if you will not tell and later on it got detected, then your policy
may get terminated. Besides this, you can check the No Claim Bonus in your
policy. Because of that,
conditions of decrease in premium maybe there
or you get extra cover. So let's say you took policy for the current year
without doing any claim and you were paying the premium regularly And let's say
you continued that policy, then you may get 10% extra cover or a rebate of 10%.
So No claim bonus may go up to 50-100% So check how much No Claim Bonus is
available.
Along
with it, if you have No Claim for any year, then you get Preventive Health
Check-up in many policies In which you can do your health check-up in a
hospital and you get its refund. Let's say you didn't claimed for 2 years then
you may get Rs. 2500 to Rs. 5000 So it depends on how much is your total cover.
Now let's come on our 3rd segment How much Health Insurance Cover should you
take? It depends on many factors like your age, medical history of the family,
existing
conditions, nature of your job, is there any danger involved in that, income
level, lifestyle, etc? But still, we'll talk about some thumb rules. If you're
buying a policy as an individual, then you should take a minimum cover of Rs. 3
lakhs because there are fewer chances of existing diseases at young age And as
your age increases, you can increase your cover with that. Now let's talk about
the Family cover.
If we talk about a standard family with 2
adults and 2 kids then You should take Rs. 5-10 lakhs standard cover And there
are some thumb rules here as well You can choose one among the 2 thumb rules
Like 50% of annual salary or you can choose what's the cost of heart surgery in
your city. If the cost of heart surgery in your city is 4 lakhs then you can
choose the cover of Rs. 4 lakhs But if you are in a Tier 1 city, it may go
around Rs. 7-8 lakhs so you can take cover according to that. But it also
depends on your income and lifestyle.
So a minimum cover for a family should be Rs.
5-10 lakhs. Besides this, if your parents are above the age of 50-60 years, You
can keep them in a separate policy Otherwise, your premium will be very much
high because the premium is decided according to the highest age. So let's come
on to our final segment that, How should we buy health insurance? So firstly,
understand that the cheapest is not the best. We saw in our last Article that
the brand value of a company is also very important when we buy insurance
Because we are actually buying a promise So it becomes important that whether
that company will pass our claim or not.
So
for this, we can check Incurred Claim Ratio and Claim Settlement Ratio. We'll
talk about these in detail that what exactly these are and how to check them.
But before that, let's talk about 1-2 more points. Many times an agent or a
bank approaches us for the policy There we have this disadvantage that we
cannot compare the insurance And maybe that person had his vested interest And
maybe he's selling you that policy in which he has more commission That's why
the best way is to purchase online insurance For example,
Policy Bazaar is a good website from where you
can purchase your insurance. I also purchased insurance many times from this
website. So let me give you a quick demo. We're on the website of Policy Bazaar
and this is the Health Insurance section Different types of health insurance
are available here Normal health insurance, family, senior citizen insurance.
And there is also special health insurance for Corona Virus. Now let's get into
the Normal Health Insurance plan and fill in the details.
After that, go to view plans and let me select
an individual plan And the age I selected is 25 years. Click on continue Select
the city. Do you take any daily medication or not? I am selecting No here and
let's see what all plans we're getting. So the plans are starting from Rs. 206
per month and you're getting cover of Rs. 5 lakhs by Edelweiss.
So
we can compare all the plans here. After this, we'll go to features. So you can
check all the features about which we discussed Here are all the highlights and
features. Hospital room eligibility. So we can check all these in details. What
is the claim process and which are the cashless hospitals. You can also compare
plans by yourself. I will give the link in the description and comment. Along
with this, there are some more benefits of using these online platforms.
Like executers will help you if you are not
able to understand If you're facing a problem in claim settlement then the
claim settlement team will help you. And nowadays, claim settlement teams are
there in hospitals and they will help you. Besides this, because of this Covid situation, Medical test is usually Telemedical or Article medical.
So
we saw how to do the online comparison of health insurance. Along with this, we
should also check the conditions of the company also We can check that by
mainly 2 ratios 1. Claim settlement ratio. This means the ratio of how many
claims did company passed out of the total claims in a year. If this ratio is
greater than 85% then we can say that it is a healthy ratio and you can
consider that policy. 2. Incurred claim ratio. That means how much money
company pays for paying the claims out of the total premium they received.
So if this Incurred claim ratio is too much,
then that is also not good. Let's say if it's more than 90% then maybe the
company cannot pay the claims due to lack of money. And if it's less than 50,
then maybe the company is charging more premiums and they are more focused on
profitability. So a healthy ratio is ideally between 70-90 but you can consider
55-60 on a lower side. And the flexibility of these ratios depends on the brand
value of the company. I hope I solved most of your doubts related to health
insurance.