by
icicilombard 002
| Dec 06, 2023
Today, the benefits of health insurance are well acknowledged by all, but what is often asked is, "How much health insurance should I avail?"
One needs to factor in many variables while deciding on the right health insurance cover. Lifestyle, one's medical history, family's medical history and annual income are the main parameters on which an adequate health cover should be selected.
If your family has a history with a particular disease then you are more likely to suffer from it. One needs to look at the nature of major and minor diseases that may probably affect you and your family, along with the approximate costs of dealing with those health issues to ascertain your ideal health cover.
Group Health Policy
People often consider the group health policy offered by their employer as a primary health policy. Yes, it acts as a cushion but it is not adequate to be considered as a primary healthcare policy. Irrespective of whether one's employer provides a group healthcare policy, the need for a personal healthcare policy is paramount.
Your employer may opt to back out of the policy by discontinuing with it. Many group health policies do not consider one's parents in the health cover. Moreover, it is not available from a sustainable point of view. What if you leave your present job and your new employer does not provide a group health insurance policy?
Even if you plan to continue with your existing company for a major part of your life, the group insurance policy may not support you after you retire.
Health Insurance Plan
On an average, Indian’s prefer to avail health insurance cover amounting to 50% of their annual salary.
Insurance provided by your employer is an added advantage and that is what it should be. It should be in addition to your primary individual health care plan.Health insurance has proved to be a lifeline to innumerable people during crisis. A sound health insurance policy safeguards you by preventing a health crisis to transpire in to a financial crisis.
Tips for Purchasing Adequate Health Cover
Insurance companies go all out to promote their respective insurance policies. Every company has policies that are similar to others and they differ with minor changes. After all, different people have different needs. While choosing an adequate cover, you must ensure that you are availing the policy, which you need, and not what the insurance company is providing. Go through the following tips to ascertain an adequate health cover.
- Tip 1- One must understand and differentiate between necessity and frills. Additional covers to the policy should not be opted for if you do really do not require them.
- Tip 2- Many a times people decide the cover depending upon the premium they will have to pay. Rather than concentrating on the premium, one must focus on the finer aspects of the policy like benefits and terms.<
- Tip 3 - Noting the renewal age is one of the important factors while deciding your insurance cover. The need for insurance is more profound when one has crossed the age of retirement and the regular source of income is not available any longer.
- Tip 4 - The sum insured is not a guarantee for the claim. There are certain limits, which overrule the sum insured. One must consider limits if any, in the policy and then weigh those with the extent of the coverage. Example, there are limits on the insured amount in case of heart related diseases, cataract etc.
- Tip 5- Long term policies overpower plans restricted by days. Think of the sum insured as a long-term investment to safeguard your health. While choosing the sum insured also consider the inflation rate.
- Tip 6- Insurance premiums undergo a drastic change when the person in question crosses the age of 45. Hence, premiums have to be weighed accordingly and an insurance plan must be bought at the earliest.
What does Complete Health Insurance - iHealth Plan Cover?
- Cashless Hospitalisation:The plan offers to provide a cashless facility for covering expenses incurred during hospitalisation such as room and boarding, fees of surgeon, anaesthetist, nurses, specialists, the cost of diagnostic tests, medicines, blood, oxygen, appliances like pacemaker, artificial limbs and organs, etc, among other in-patient hospitalization expenses.
- Day Care Treatment and Surgeries: Expenses for day care treatment or small surgeries that do not warrant hospitalization are also reimbursed under the plan.
- Pre Hospitalisation Expenses:As the name suggests, it covers all the expenses that have been incurred 30 days prior to being hospitalised. The expenses include medical and diagnostic tests, visit to the doctor, cost of prescribed medicines etc.
- Post Hospitalisation Expenses:The plan also provides for expenses incurred within 60 days after being discharged from the hospital. These include follow up visits to the doctor, further medical checkups, cost of medication etc.
- Ambulance Cover: The plan provides you with the benefit of reimbursing emergency ambulance services up to Rs. 1,500 per hospitalization.
- Value Added Services: Free health coupons, discount coupons, online chat with doctors/ dieticians, and e-consultations are few of the value added services provided by the iHealth Plan.
Add-on Options of iHealth Plan
By opting for these add-ons you can design a plan to suit your specific needs. The basic cover of iHealth plan can be enhanced by choosing either or both of these options:
Option 1
Hospital Daily Cash: Subject to the extent of the sum insured and deductibles, you can opt for daily hospital allowance to meet
Convalescence Benefit: You may incur a host of other expenses besides medical expenses while recovering from your illness in the post hospitalization period. Complete Health Insurance - iHealth Plan provides a convalescence benefit of Rs. 10, 000, once during the insurance policy period.
Option 2
Critical Illness Cover: Critical illness plan covers certain life threatening diseases and offers you 100% sum assured as lump sum payment on the first diagnosis or treatment.
Donor Expenses: Complete Health Insurance - iHealth Plan aims to provide financial relief in organ transplant surgeries to your donor. A maximum sum of Rs. 50,000 can be reimbursed to the donor towards medical expenses incurred for donating an organ to you.
Beneficial Features of iHealth Plan
Lifetime Renewability: The Policy provides for lifelong renewability and offers financial security to you at the age when it is most required. Note: Any applicant above 18 years of age can apply for iHealth Plan as there is NO Maximum Entry Age Limit. However, it is advisable to opt for this health plan before you turn 46 to avoid the hassle of getting medical tests done.
Pre Existing Condition Waiting Period: Pre existing diseases are covered after two years for policies with a sum insured of 3 Lakhs and above and after four years for policies with a sum insured of 2 Lakhs. This clause is valid only if you renew the policy every consecutive year.
Tax Exemption: The premium paid for this plan is deductible under Section 80D of the Income Tax Act.
No Claim Incentives: Policy periods without any claims make you eligible for incentives like discount in premium amount or enhanced sum assured during renewal.
Floater Benefit: All the dependent members of your family can be covered under a single iHealth - Floater Plan. Children above three months of age are eligible for a floater cover along with one adult.
Other Essentials to Lookout For
Peruse through the policy document to lookout for the treatments and diseases not covered under the iHealth Plan to avoid unpleasant surprises at the time of a claim. Some of the major exclusions include:
- Any illness contracted within 30 days from the commencement of the policy
- Cosmetic surgery
- Non allopathic treatments
- Treatment taken outside the country
- Therapies like acupressure or acupuncture
Complete Medicare Insurance - iHealth Plan covers various healthcare expenditures to ensure your well-being. Opt for it to enjoy a secured life!
Claims Settlement
With the advent of technology, the claims process has become streamlined. The claims are sorted through dedicated portals of insurance companies. For example, ICICI Lombard's Health ID card facilitates cashless services. All one needs to do is display the card at an affiliated hospital.
Health Care Plus
Health Care Plus is designed to provide an adequate and enhanced sum insured. Such type of a policy is extremely beneficial when one is unable to meet the towering medical expenses. Health Care Plus helps when the coverage limit is crossed and the expenses are beyond an individual's affordability limit. It is advisable to enhance your health cover with Health Care Plus to protect your finances and overcome unexpected health issues. It provides individual cover for each member of the family with a flexible sum insured and flexible deductibles. This long-term cover is applicable for two years for people falling in the age group of 5 - 65 years. There are no sub limits on room rent, hospitalization expenses, diagnostic tests and doctor's fees. Free health checkup is also provided on policy renewal. One can also avail income tax benefits using this cover.