How should a medical insurance policy be chosen? Find out here

Published: December 25, 2017 4:13 AM

Taking health insurance policies on individual level will be expensive when compared to a floater plan

medical insurance policy, how medical insurance policy chose, tips for choosing medical insurance policy, queries related to medical insurance policy, health insurance companyWith medical inflation at nearly 13%, one should go for higher sum insured for the amount being sufficient enough at the time of medical emergency. (Reuters)

Ashish Mehrotra

Family floater better than individual mediclaim

I have taken individual mediclaim policy for me, my wife and my son. I want to convert that into a floater plan. Will it be beneficial in the long run?
– Rajesh Kumar

Taking health insurance policies on individual level will be expensive when compared to a floater plan. For example, a Rs 5 lakh sum insured on individual level for three members would be more expensive than a Rs 5 lakh floater sum insured, in which all three members have a common sum insured. Since the chances of all members getting hospitalised in a single year is less, therefore it may make sense to have a higher floater sum insured.

How should I choose a medical insurance policy?
—Gurdeep Kahlon

With medical inflation at nearly 13%, one should go for higher sum insured for the amount being sufficient enough at the time of medical emergency. Customers must opt for comprehensive health insurance plans which provide safety net for the entire family and cover the cost of medical treatment including all day care, pre and post hospitalisation, maternity benefits, hospital cash, consultation and diagnostic tests, among various other features. Avoid policies which have cost sharing options such as co-payment, sub-limits, deductibles, etc. Other important factor is claim servicing, which is quintessential at the time of hospitalisation. The process of claim adjudication should be clear and quick for avoiding hassles. Also, in case a customer is suffering from a pre-existing disease then the waiting periods should be compared across products.

What is a super top-up and can it be taken for any health insurance company?
K S Mani

Under a super top-up policy, coverage starts only after the threshold amount is exhausted; which is known as the deductible amount. For example, in a policy of Rs 10 lakh sum insured and Rs 2 lakh annual aggregate deductible, the policy will bear the cost only after the Rs 2 lakh deductible is exhausted. The Rs 2 lakh can either be claimed from an existing policy of any insurer or can be borne by the customer himself. It should be noted that there are two different policies: top-up and super top-up. In a top-up policy, deductible is applicable on a per claim basis (on each claim this deductible is applied); whereas in a super top-up policy deductible is on an annual aggregate level.

The writer is MD & CEO, Max Bupa Health Insurance . Send your queries to
fepersonalfinance@expressindia.com

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