Such scenarios in which a medical illness requires continuous or expensive treatment, the ailing person will always feel he is being a burden to his family. Some families lose their savings, others lose their assets, and some even take heavy loans to cover the rising medical treatment in our country. This brings health insurance into the picture and highlights how essential it is for us to have a good, comprehensive policy that will serve us in our times of need. A health insurance policy provides a cover for you and your family against sudden medical contingency or bodily injury. The two options in getting a health insurance are a general health insurance, a life insurance company’s health plan or even both.
A comparison “In an ordinary health plan/Mediclaim, the cover is reviewed every year. The premium amount and cover amount might fluctuate, depending upon the experience of the insurer with the customer. There are times when the cover may be denied too. In a health plan through a life insurance company, the plan is usually long-term (around 15-25 years). The premium amount is fixed for a specific period (say 5 years) and then reviewed. The purchaser has the assurance that his cover is in existence for a specific period,” as told by Vikram Memi, president and CEO, of Birla Sunlife Insurance.
This is the rough differentiation between the two broad options one has on entering the insurance market.
Santosh Balan, corporate communications director, Bajaj Allianz further clarifies the two schemes and tells us his rationale behind making a choice. An ordinary health plan or mediclaim is covered under the general insurance purview, as it deals with all forms of insurance other than life, and is valid for one year at a time only.
General health insurance schemes usually include hospital reimbursements for medical expenses, with up to 30 days pre and 60 days post hospitalisation expenses fully covered. There is no cap on coverage with an ordinary health insurance plan, and these cover all medical expenses except those that occur for already existing illnesses.
On the other hand, life insurance companies have a cap on coverage, and it is not the actual expenses but only a certain percent of the sum spent that would be insured. However, they provide you with long-term coverage without you having to re-validate your insurance policy every year. The above explanation from Santosh Balan, provides us with a fair insight on the two, and in conclusion he tells us, “Look at coverage of a policy and only then make a need-based decision. General insurance health plans seem to have more benefits.”
Breaking it down, life insurance health plans basically pay you cash to cover certain life threatening, critical illnesses.
They cover only certified diseases and these usually include cancer, heart attacks, and kidney failure.
However, these modern health plans seem to give people the benefits in health as well as savings, and now in some newer ones even help you make money. An example being, the recently launched Reliance Health + Wealth plan.
Since these plans pro vide you with cover against only a few diseases, industry experts’ advice people to use these plans as a top-up to your mediclaim plan.
The mediclaim or general health insurance plans usually cover a person for all illnesses and hospitalisation charges as well, for a yearly premium. Each scheme will have its own nuances and reading the fine print of your policy is of utmost importance. These policies cover almost all diseases, except pre-existing ones, at least until a certain time frame has passed. After the given time period, all diseases pre-existing and those specified uncovered diseases, get covered too. Therefore, understanding which diseases are covered when, should be your first priority.
Other pointers that one must look for are: ? Check on the type of rooms for which room expenses of the hospital are cov ered. Then based on ones lifestyle choose your policy that best suits your needs.
? Some procedures, for which expenses are said to be reimbursed, will have a mention in fine print that only a specific amount is covered. Like a cataract oper ation, hernia, tonsillitis, etc will each have their individual limited coverage amounts.
? Whenever you come across the word “Exclusion”, stop and carefully read what they are talking about. Make sure all such points are clearly understood, as this is an area, which causes many people regrets later on.
? Never accept anything that an agent gives you verbal confirmation of that is not present in the policy. Make sure everything is clearly written down, as these few minutes you spend today, might be worth your while tomorrow.
Identify your needs “Insurance needs may vary. So a person may take a life cum health insurance from one company but for his retirement or children’s education and similar needs, he will have to take a policy addressing those areas,” says Vikram Memi on the idea of there being one comprehensive policy. .
Every industry expert swears by one thing within this vast, hugely growing industry. Identify your needs before you even begin to look, advice given by everyone within this industry, is something that one must do. There are over 75 different plans and polices within the insurance sector, and comparing them all is a fruit less, pointless exercise. However, identifying what you want to get out of a policy will help you narrow down your choices, search, and even finally make a decision.
To sum it all up, after you have understood the basics of the insurance world, look at the terms and conditions of your policy, look at the extent of coverage in each instance and then make a need-based decision.
Both, general and life insurance companies will have policies that will suit your needs, and as there is no compulsion to only have one policy, the ideal way to go about this seems to be to primarily have a mediclaim and in addition to that a health plan.
URL: http://epaper.financialexpress.com/Default.aspx?selpg=1405&selDt=04/13/2008&BMode=100