15 Things To Know Before Buying Health Insurance: Best Health Insurance.
Another question that comes to your mind is whether I need to buy health insurance. Let us clarify this question with a simple example. Does Bill Gates, Elon Musk, Mark Zuckerberg, Mukesh Ambani, or any other billionaire need health insurance? no! Those who are already rich do not worry about what to do when medical bills of 5–8 lakhs are incurred because they have surplus cash in their accounts. So the point is, if you budget the money considering the future health of you and your family without affecting your current savings or future goals, then you may not need health insurance.
However, this depends on many factors, such as your lifestyle, the type of work you do, or the average cost of heart surgery in your city. After weighing all these factors, a coverage amount of 3 lakh for fit children and 5 lakh for adults is sufficient.
It is a combo pack where you have the whole family insured together and you only have to pay one premium for it, it has some advantages and disadvantages. The advantage is that you have to pay less or only one premium to insure your whole family. However, the disadvantage is that if you take a sum insured of 4 lakh for husband, wife, and 2 children, for example, it does not mean that the total coverage is 4×4= 16, but the total coverage is only 4 lakh. In a year, all four family members together can claim only 4 lakh medical claims. If one of your members is hospitalized and a bill of 2 lakh comes in the same year the remaining 3 members or one of them is hospitalized, then he/she is entitled only to 2 lakh medical claims.
In some plans restoration benefit is also available which means if you left 1.5 lakh coverage then after adding 2.5 lakh it will restore 4 lakh coverage in the same year but of course, if this feature is extra then the premium will also have to pay a little extra and the other drawback is that if there are elders in the family and they have any disease so because of their premium the family will be high.
This health insurance works on the opposite concept of floater health insurance. The name itself suggests that individual health insurance is a premium that is only paid for one person. If you buy an individual health insurance policy for 5 lakhs, your medical coverage will be 5 lakhs per year and you can use it individually. The advantage of individual medical insurance is that the sum insured is only for you, according to your premium. The disadvantage of this plan is that the premium is very high compared to a floater plan.
A multi-individual health insurance policy covers two people on a single policy. For example, if you purchase a multi-individual policy with a sum insured of 10 lakhs, the coverage will be 10 lakhs for each person. The benefits of this policy are that the company gives you some sort of discount and the premium is about halfway between the floater and individual health insurance plan.
So we conclude that an individual plan is better for a person living alone, a floater plan is better for a family, and a multi-individual plan is best for couples. For elderly people in your family, you can choose individual plans because they need more coverage than anyone else in the family. Eventually, choose a policy based on your needs and required coverage rather than the premium.
1) Room Rent- The room rent is set at 1% of the sum insured. If we assume a sum insured of 6 lakhs, then the room rent allowed is 1% of that 6 lakhs, which is Rs 6000. Let us say you have been admitted to a room that costs Rs 12,000. And you think that you have to pay just 50% (Rs 6000) of the room rent, This is not so, because other costs are also associated with the room rent, if the bill for the surgery is 3 lakh comes, which means that the company pays only 50% of it means only 1.5 rupees, and you have to pay the rest yourself. So the first point is a cap on room rent. You have to find a policy where there is no cap on room rent, or if there is a cap, then there are no fees associated with room rent.
2) Sub-Limit- The next point to consider is sub-limits. You may have a cover of 6 lakh, but the maximum cover for heart surgery is only 3 lakh, or the maximum cover for another disease is only 3 lakh, so we must avoid any policy that has a cap imposed on according diseases.
7) Pre & Post-Hospitalization- We don’t need to admit today. For example, if I have a planned surgery one month from now and the doctor instructs me to take therapy and medicines daily, will my health insurance reimburse the cost of therapy and medicines? You must check that, and on today’s date, most policies cover your expenses. Most companies cover pre-hospitalization expenses for 60 days and post-hospitalization expenses for 180 days, so these are important factors to consider.
* HDFC Ergo Optima Restore
* MaxBupa Health Companion
* Carehealth Care Advantage
Choose any health insurance plan wisely, before buying the plan read all the instructions or terms and conditions very carefully, because at that point many people get trapped. The above factor will definitely make it an easy process to select the best plan according to your needs. Kept every medical bill and expense carefully so that when going to claim for insurance there will be no trouble in reimbursement.
Originally published at https://www.therichgorilla.in on December 4, 2022.