Affordability is a relative term. What you consider within your means depends largely on your household income. Yet, irrespective of the economic bracket, we all would like to take maximum advantage of a deal while shelling out the least amount of money from our pocket. This is a common customer approach. Therefore, we could say that the most optimum health insurance is also the most affordable health insurance.
Just like in life insurance, there are several public sector and private sector general insurance companies that offer health insurance plans. Several plans are customised to act as umbrella covers over the entire family and offer protection from most medical adversaries. While deciding which insurance plan you would consider as affordable, do bear in mind that a low priced premium may provide a very basic cover, excluding important ailments. This means, that in a situation when you are hospitalised, the insurance company may reject your claim citing an exclusion in the policy. Thus, it is highly advisable that while selecting a plan do not base your decision on the premium alone. One must read the list of exclusions and coverages very carefully to make sure they are adequately covered. After all the purpose of buying a health insurance is lost if you are not able to use it when you need it.
Before you take up any medical insurance plan, do compare the policies offered by insurance companies. One can visit or call the insurance companies to find out details of the policy. Or one can go online and compare health insurance plans. A standard health insurance plan includes the following:
- Pre/ Post hospitalisation care – this means expenses incurred in providing care to the patient before hospitalisation and after release from the hospital is covered. This is subject to a maximum limit and not upto the full amount of sum insured.
- Room rent limit – there is a limit towards the rent of the hospital room. Incase the patient opts for a room costlier than what he is entitled to as per the policy, then the insurance company is liable to pay only as much specified in the policy wordings.
- Copay – this means that the insured and the insurer will bear the medical expenses as per a predetermined fixed ratio.
- Pre –existing diseases – Any medical expenses incurred by the insured due to illnesses present at the time of taking the policy, shall be excluded from the cover up till a specific period only, in most cases it is 48 months. The insured can get this period reduced on payment of extra premium which is also called as loading.
Following is a list of certain standard exclusions in the policy which can be included upon payment of extra premium. An insured would consider including the following in their health insurance plan:
- Ambulance charges
- Domiciliary hospitalisation – which means hospitalisation at home in case the patient is unable to go the hospital.
- Maternity cover – expenses incurred linked to pregnancy and delivery
- Eye Cover
- Dental Cover
- Alternative practice – that is cover for treatment in Ayurveda, Homeopathy, etc
- Restore benefits – The sum insured may be restored to the full limit, incase it has been used, within the policy period of one year.
And many more options.
Every company offers different products that can be tailor made to suit the insured’s needs. What to exclude in the policy, what to include in the coverages, whom to cover and the average age of the insured family are factors that affect the premium of the policy. For example for a family of four, with the oldest member being 35 years old and the youngest being 5 years old, for a family cover of five lakhs the range of premium could be from 7, 000 to 24, 000 depending on the spread of cover.
Insurance basically provides protection towards loss of income due to medical expenses. It is not a way to earn money or foster your economic value. So certain options like expenses for cosmetic correction are not covered in any medical policy. The basic health covers also do not include expenses for critical illnesses. The expenses for treatment of critical illnesses are very high therefore there are separate policies to cover those expenses. The premiums in those policies are higher too.
To compare health insurance plans, whether you take individual health insurance or family health insurance covers, the ideal way is to make sure that you compare the same plan with the same inclusions and exclusions across companies. Then it becomes easier to compare the premiums. For example, a policy offered by Iffco Tokio with a basic family floater cover of 5 lakh for a year that includes standard coverages and exclusions may cost an average family of four to around 7, 500/-. Whereas the same policy with the same set of inclusions and exclusions offered by New India Assurance may cost 7, 600/-. Since both the policies are now providing the same cover in all terms, one can select the one with the lower premium. But before selecting one must also check the insurer’s claim settlement history, time taken, claims rejected etc. This is may be vital information to the insured if they need to take a claim.
Costs of medical expenses are very high these days. By paying a small amount of premium every year, you can safeguard yourself from the stress of arranging for funds incase of a medical emergency.
Stay insured. Stay safe.