Ayushman Bharat: Free Insurance for Poor with 5 Lakh Cover, Features, & more

The world’s most populous country, India, has always faced a big problem of providing quality healthcare to the poor. This is because of lack of money, these people are not able to receive proper treatment and buy health insurance.

To solve this problem, during the budget 2018, central government had announced Ayushman Bharat Yojana with an objective to provide quality healthcare treatment and insurance cover to the poor reducing the expenses incurred by them.

Ayushman Bharat – National Health Protection Mission (AB – NHPM) scheme which is the largest health care scheme in the world comprises of the following two utilities for poor Indian citizens:

  1. Health and Wellness Treatment Centres
  2. National Health Protection Scheme i.e. health insurance for poor

Details of AB-NHPM

Launch Date: 15th August 2018

Target audience: Poor and vulnerable which includes:

  • Family living in only one room with kucha walls and kucha roof
  • Family with no adult member between age 16 to 59
  • Family headed by a female member
  • Family having disabled member and no able-bodied adult member
  • SC/ST households
  • Landless households deriving major part of their income from manual casual labour
  • Destitute/ living on alms
  • Manual scavenger families
  • Primitive tribal groups
  • Legally released bonded labour
  • Rag picker
  • Beggar
  • Domestic worker
  • Street vendor/ Cobbler/hawker / Other service provider working on streets
  • Construction worker/ Plumber/ Mason/ Labour/ Painter/ Welder/ Security guard/
  • Coolie and another head-load worker
  • Sweeper/ Sanitation worker / Mali
  • Home-based worker/ Artisan/ Handicrafts worker / Tailor
  • Transport worker/ Driver/ Conductor/ Helper to drivers and conductors/ Cart
    puller/ Rickshaw puller
  • Shop worker/ Assistant/ Peon in small establishment/ Helper/Delivery assistant /
  • Attendant/ Waiter
  • Electrician/ Mechanic/ Assembler/ Repair worker
  • Washer-man/ Chowkidar

Insurance Cover: Rs. 5 Lakhs (sum assured) per family per year will be the given.

Is it a fixed or floater type of insurance?

It is a floater type of insurance policy.

Will it cover pre-existing diseases or conditions?

Yes. But with certain exclusions.

What benefits would be given as a part of this Yojana?

The coverage offered to the beneficiaries of AB-NHPM will include:

  • Hospitalization expense benefits
  • Day care treatment benefits (as applicable)
  • Follow-up care benefits
  • Pre and post hospitalization expense benefits
  • New born child/ children benefits

Where can beneficiary patient or their family member go for the treatment?

Similar to a normal medical insurance, patient can get treatment in government as well as private hospital which are part of the network. The treatment would be 100% cashless at all the network hospitals.

Who will guide patients to understand the procedure?

Every network hospital will have ‘Ayushman Mitra’ with duty of assisting patients with all the procedures involved. This will help patient and their family members to get treated without any hassles.

In which state this Yojana will be launched?

Although many of the states in India have their own healthcare schemes, Ayushman Yojana will be launched in all the Indian states.

What would be considered as a proof to validate beneficiary?

Aadhaar number would be must to take all the benefits under the scheme. However those who do not have Aadhaar card will have to furnish secondary proof such as ration card, voter ID card. More information on this would be provided by the government soon.

Who will provide insurance?

Preference would be given to government insurance companies over private insurers.

List of government owned insurance companies in India are:

  1. Life Insurance Corporation of India
  2. General Insurance Corporation of India
  3. National Insurance
  4. Oriental Insurance
  5. New India Assurance
  6. United India Insurance

However all the participating insurers should be registered with IRDAI.

Who will pay for the premium?

Premium payment will be done annually by central and state government. Premium will be splitted between the two.

Will there be any separate fees for beneficiary?

No. All benefits offered under the scheme are free of cost.

For the period during which patient is in hospital, what will be included as a part of the cover?

Medications, medical tests, doctors consultation, procedures, room stay and food will be part of the package under AB – NHPM. All this will be provided by the empanelled hospitals.

When would insurance company settle the claim?

As per the guidelines, insurer will have to settle the claim within 30 days of receiving it from the hospital.

Who will file claim?

Claim has to be submitted by the empanelled hospitals within 24 hours of patient discharge.

How much will this Yojana cost government?

Although there is no approximate calculation yet, but the Yojana is estimated to cost Rs. 12,000 Crore.

7 Health Insurance for Heart Problems: Sum Assured, Premium, Benefits

Heart disease are deadly and are on rise in India and so is the treatment cost. In fact, the cost is so high that it can wipe-off the personal savings of the individual substantially. Since the income rise of an individual is less compared to the rising healthcare cost, it is recommended to buy medical insurance cover which lets policy holder to take care of themselves while insurer takes care of the money required for the treatment.

However the traditional health insurance does not fully cover heart related ailments and in most cases related to critical illness such as heart problems, insured person has to shell out money from his/her pocket as well. Adding to the pain is individuals who already have some kind of heart problems as they face difficulty when planning to buy health insurance in India or have to shell out high premium. The reason is very simple – the risk to the insurer is very high since the treatment cost is very for heart related ailments.

For e.g. In case of heart attack, minimum treatment cost is Rs. 4, 00,000. And for bypass surgery the cost is Rs. 6, 00,000.

So to avoid losses not all insurance companies in India offer health insurance for heart conditions. However there are few insurance companies (life and health) who have launched products specifically offering coverage for treating heart related ailments but with certain terms and conditions.

Listed in the below table are details of the life/health insurance for minor and major heart conditions.

Insurance Company NameProduct NameSum InsuredPremium (Rs.)Type of Insurance
Star Health and Allied Insurance Co Ltd Star Cardiac Care Insurance Policy - Silver PlanRs. 3,00,000Rs. 16,632 - Rs. 19,128Health
Rs. 4,00,000Rs. 19,010 - Rs. 21,860Health
Star Health and Allied Insurance Co Ltd Star Cardiac Care Insurance Policy - Gold PlanRs. 3,00,000Rs. 22,172 - Rs. 25,500Health
Rs. 4,00,000Rs. 25,341 - Rs. 29,410Health
Future Generali India Life Insurance Company Ltd.Future Generali Heart and Health Insurance PlanRs. 5 Lacs - Rs. 50 LacsNALife
HDFC Life InsuranceHDFC Life Cardiac CareRs. 2 Lacs to Rs. 50 LacsRs. 357 pm - Rs. 14,43,435Life
ICICI Prudential Life InsuranceICICI Pru Heart Protect PlanRs. 25,00,000Rs. 268 pmLife
Aviva Life Insurance Company India Ltd. Aviva Heart CareRs. 20,00,000Minimum Rs. 237 pmLife
PNB MetLife India Insurance Company LimitedPNB MetLife Mera Heart and Cancer CareRs. 5 Lacs - Rs. 40 LacsMinimum Rs. 257 pmLife
Exide Life Insurance Company LimitedExide Life SanjeevaniRs. 5 Lacs - Rs. 25 LacsRs. 2,905 per yearLife

What is so unique in these cardiac plans?

The main objective of all the cardiac care plans is to give peace of mind to the family without worrying about the finances. And when taken in addition to the standard health plan, the benefits further increase.

Although each insurer offers varying features and benefits in their insurance policy, but you will find most of the following features:

  • Protects financially for various heart conditions and associated medical procedures such as angioplasty, stenting, heart transplant, cardiomyopathy and others. Money is also paid for non-medical expenses.
  • Plan can be customized with inclusion and exclusion of the procedures.
  • Lump sum amount is paid on detection.
  • Comprehensive coverage is provided in all stages.
  • Multiple claims can be made till the limit for sum insured gets exhausted.
  • Insurance plans offers tax benefit under section 80D of Income tax act.
  • Premiums can be paid monthly/quarterly/yearly so that one-time payment does not become burden.
  • Premium discount to existing customers.
  • If no claim is made then there is an increase in cover.
  • Premium is waived off when insured person gets permanently disabled.

There are many other features/benefits offered by each insurer. And it’s always recommended to do a thorough research before buying insurance for cardiac ailments.

Health Insurance: Coverage, Exclusions, NCB, Reimbursement & more

Whether you are healthy or not – we’ve been told numerous times that keeping good health is very essential. But in our quest for healthy life we also need to opt for health insurance (also known as medical insurance). This is because there is no guarantee that your body will remain always fit.

Health insurance covers medical expenses during hospitalization. Not just an individual but health insurance can cover entire family by paying a premium. This can be paid every month, quarter, or annually. And the medical insurance policy can be purchased online, app, visiting in-person at the insurer or through agents.

Health insurance comes handy during difficult situations. However it is very essential to know as many details possible in a health policy for a better claim process:

Financial support: The most important benefit of health insurance is that it safeguards you and family from financial burden which often leads to mental stress when you are ill. If there is no health insurance policy taken then the person has to use his/her hard earned income to meet various expenses.

Coverage: Most of the policies cover medical and hospitalization expenses including surgical operations, nursing care, doctor’s fees, pathology and diagnostics test, hospital accommodation and other pre and post hospitalization expenses.

Exclusions: There are however, some exclusions in health insurance like pre-existing diseases, cosmetic surgery, abortion and alternative therapies. Certain conditions have a minimum waiting period such as pregnancy, heart ailments and others. All these exclusions are detailed in the policy document. This is the reason why it is recommended to buy health cover when you are young and fit. The chances of developing diseases are low compared to when you are aging. Also the premium is high when buying at old age.

Claims during 30 days of buying the policy: Not all medical claims are accepted, if they are claimed within first month of purchase. This also includes pre-existing ailments which are covered after the expiry of a specified period.

No claim bonus: By making regular renewal payments and keeping yourself fit with no claim made, you increase the chances of better claim experience. Most importantly, insurer will reward you with reduced premium if no claim is made in previous year. This however, varies with each insurer. If you fail to renew the policy then any treatment cost incurred during the uncovered period will not be accepted by the insurer.

Policy transfer: If you are not happy with the existing insurer then you can transfer the policy to another insurance company. Other reasons leading to porting are – lack of features, job change, lesser number of network hospitals, poor claim process or settlement history and many others.

Read about 7 types of health insurance policies

Hiding medical problems: Hiding any existing condition is never recommended. This is because, if you make a claim and insurer comes to know that you did not disclose this condition intentionally while buying the policy, then claim will be rejected. This is clearly mentioned in the policy document. Remember that settling a claim is loss making for any insurer. And they will list out every reason to deny a claim. So be true when it comes to any insurance policy. If you disclose the condition before buying, then pre-existing disease will be covered after a certain period. This is known as waiting period. Typically the period is 36 or 48 months, as specified in the policy document.

Increase coverage by making higher premium: If at any point of time, you feel that existing policy is not sufficient to cover yourself or your family then you can always pay higher premium and raise the coverage.

Get claim if hospitalized for less than 24 hours: Certain procedures such as dialysis, eye surgeries and others does not need hospitalization for one full day. This is the reason many insurers settle claims in such cases. One more advantage is that many treatments that do not fall under day care or which do not require the insured to be hospitalized for one complete day, are also covered by insurers. However the list of procedures covered is very limited. And you should be aware of the same while before purchase the policy.

Not every expense is reimbursed: Remember that, buying a policy by paying high premium doesn’t mean entire bills will be reimbursed. Sub-limits are applied on various expenses. Certain medical bills are also not reimbursed if they fall under non-admissible expenses. When a insured person is ill and hospitalized, then there could be many other expenses which are not covered in the plan. And you will not get reimbursement for the same.

Multiple claims: You can take as many claims possible in a year. However the maximum amount is limited to the sum insured. This amount is as per the chosen plan.

 

7 Health Insurance Types: Individual, Floater, Top-up, Critical Illness & more

Every individual’s health is different and needs vary accordingly. However one thing every individual should buy is a health insurance. This is because medical inflation is at rise coupled with lifestyle related diseases. With multiple health insurance insurance plans available in the market, it is confusing especially for a first time buyer to choose a desired plan and most importantly the insurer.

Here are the common health plans available in the already flooded Indian insurance market:

Individual health plan: It is a very basic healthcare plan typically covering treatments undertaken when hospitalized. The cover extends to pre- and post- hospitalization expenses on medication and diagnostics, subject to limits and conditions in the policy.

Family floater plans: This is an extended version of individual health plan. It covers a family by spreading the risk across the members. For instance, a Rs. 2, 00, 000 cover is spread across four members; two adults and two children. This plan is most recommended to those who cannot afford individual plans for every member of the family. Although different families have different healthcare needs, a family floater policy with a sum insured of minimum 10-15 Lakh is highly recommended for families living in metro cities like New Delhi, Mumbai, Chennai, and others. The reason for higher sum insured plan is because in such cities the cost of medical treatment is very high compared to smaller cities like Nagpur, Ahmedabad, Surat, and others.

Read more on family vs. individual plans.

Senior citizen health plans: As they name indicates, these are the plans for individuals who’ve crossed 60 years of age. Such plans come with a lower value of cover, due to the predictable risks associated. If you are a senior person with no health insurance in the kitty, then you should buy a basic health cover to reduce the financial burden on you or your dependents, in case of any hospitalization. But remember that, not many companies in India offer plans for senior as probability of health risks go up as you grow older. And if they do, exclusions create hindrance. This is the reason why medical insurance should be bought at an early age as premium is low as risks are minimal.

Check out what to look for in a senior citizen plan.

Group health cover: Provided by employer to their employees with additional benefits that individual plan do not offer. The most important benefit is that the pregnancy is covered in most of the plans, which typically is not covered in an individual or family floater. And if covered, waiting period is applied.

Hospital cash: Such plan pays a fixed sum for each day spent in the hospital. This sum excludes room rent and medical treatment undergone during the stay at the hospital. It acts as a buffer as it prevents income loss due to hospitalization.

Critical illness plan: Long term critical illness health lists wide range of cost, low incidence critical health conditions such as cancer, stroke, or kidney failure that it covers for 20 years period. Most recommended to individuals having family history of critical ailment or the ones leading a lifestyle which typically leads to such illnesses. It also helps to cover medical bills and other related expenses and acts as a supplement to health insurance plan.

Top-up and super-top up plans: This cover goes beyond the threshold limit or the maximum limit of the existing health insurance policies. For instance, if an individual has an individual cover of Rs. 3, 00,000 and also a top-up cover for 10, 00,000; the threshold limit of 3 lakh will work the best.

If you are not happy with your health plan, then transfer option is also available.

Choosing a right insurer after going through terms and conditions in detail is also a key factor to be considered in addition to the type of plan. It’s your duty to know as much as possible about your policy and its features/benefits.

Health Insurance for Dengue: Low Premium, Coverage, Benefits, How to Buy

Dengue also called as bone breaking fever, has become an epidemic disease in India and every year over thousands of people succumb to dengue. It is spread through the bite of mosquito and is more prevalent during monsoon and runs uptill November. The symptoms are so severe that there is no alternative to hospitalization. There were 1, 00,000+ reported cases of dengue in the year 2015, and the number is expected to rise in 2016.

Those who successfully get treated for dengue actually have to shell out no less than Rs. 50,000 from his/her pocket on hospitalization. The overall treatment cost mainly includes hospitalization, medical tests, medicines etc. Medical tests are not covered by insurer offering dengue cover.

Most commonly asked question by people today is – whether any specialized health insurance for dengue is available in India to avoid financial impact on one’s pocket. The answer is YES.

There are three ways you can get dengue cover in India:

  1. Standard health insurance: When you already have insurance policy and the insured person or family members covered in the family are diagnosed with dengue and hospitalized, then your insurer will cover the treatment cost. But this policy only covers medical expenses incurred during inpatient treatment and not the outpatient treatment cost. So insured person will lose out on no claim bonus when you claim for dengue.
  2. Standalone medical insurance for dengue: For those who do not have any health insurance plan, buying a specialized health plan for dengue is highly recommended. And especially for individuals staying in areas where the disease is widely spread, it is worth buying insurance plan for dengue. Ofcourse, it is must even for people with standard indemnity policy. The benefits of this plan is mentioned below.
  3. Group cover: If you have insurance from your employer then you can make use of it. This way you can continue to get no claim bonus on standalone health plan.

Benefits or features of specialized medical insurance for dengue:

  • In-patient and out-patient treatment costs are covered
  • 100% sum insured is paid provided the claim is legit and meets terms and conditions of the insurer.
  • No pre-medical tests are required
  • Premium is fixed for all ages
  • Waiting period is minimum but varies with each company
  • Pre and post hospitalization costs are covered
  • There is no sub-limit and co-insurance (i.e. co-pay clause)

Exclusions:

  • Unlike standard policy requiring medical tests for specialized cases, specialized policy for dengue does not mandate medical tests. And they can be bought online or offline from various insurance companies as mentioned below:
  • You should not be suffering from dengue

Which companies in India offer specialized health insurance plans for dengue?

Listed in the below table is the list of insurers offering specialized health insurance policy, name of the product, along with the premium and insured amount. Standard health insurance policies will also cover against dengue.

Insurance CompanyPlan NameAnnual PremiumSum Insured
Apollo MunichDengue CareRs. 665 (including taxes)Rs. 50,000 & 1,00,000
DHFL PramericaDengue ShieldRs. 365/annum. You can even pay single premium for 5 years and save 21% on premium.Rs. 25,000, 40,000 & 50,000

Claim process:

Is very simple & straight forward compared to claims made for others. You need to submit following common documents apart from the ones specifically asked by the insurer:

  • Proof of dengue
  • Hospitalization proof
  • Hospital bills
  • Outpatient bills, if covered under the policy

Note: Before buying a policy, please check with the insurer on above mentioned benefits and/or additional terms & conditions. This general rule applies to any type of policy you buy.

What to do if you plan to buy a regular health insurance policy after hospitalization?

It’s always recommended to have a medical cover. If you were hospitalized for dengue/any other treatment and later on decide to buy health policy, then you should inform insurer about your hospitalization. Informing is recommended so that medical underwriter will undergo details about the treatment and accordingly your premium would be priced. This will also help in avoiding a situation where a future claim would be withheld by an insurer on count of not disclosing facts about pre-existing disease or hospitalization due to dengue or any other medical problem. Hiding any fact will result in claim getting rejected. And this rule is used by every insurer. Check out reasons for buying personal health plan and not rely on group policy.

How to treat at home, is it possible?

Dengue is a self limit and treatable at home.  But it is highly recommended to consult medical practitioner before using any self medications. Watch out this video by Baba Ramdev on treating dengue at home:

General preventive measures:

  • Keep surroundings clean
  • Remove water saturated in coolers, pots etc. It helps in reducing mosquito habitat
  • Make use of and apply natural mosquito repellent oils such as lemon eucalyptus, lavender, neem, and cinnamon oil.
  • Use mosquito net
  • Plant mosquito repellent plants such as feverfew, lavender, catnip in your house. They are less space consuming.

Comparison of Cancer Insurance Providers in India

Do you know what is common in following people?

  • Manisha Koirala
  • Yuvraj Singh
  • Lisa Ray
  • Anurag Basu

Apart from being famous celebrities, they had one more thing in common, they all were treated for cancer. Treating this deadly health condition, is very expensive and not affordable by common man. Typically the treatment costs no less than Rs. 5,00,000. It really drains off the whole life savings and creates financial instability for the whole family. So never in the wildest dream someone would think of having a cancer.

This is because of following reasons:

  • It is life threatening
  • Diagnosis and complete cure is difficult
  • Treatment cost is very high. Check out hospitals offering cheapest treatment for cancer in India.

How to manage money when you suffer from cancer?

When cancer is detected and suggested treatments are recommended, the patient has to either rely on following for arranging money:

  • Own’s savings
  • Existing health insurance provider
  • Take personal loan
  • Borrow money from friends/relatives

Now the question arises who offers cancer insurance in India?

There are many insurance companies covering cancer under their critical illness policies. Few of the companies are:

  • Bharti Axa
  • Bajaj Allianz

Although these companies provide coverage for cancer, there are various terms and conditions involved. So best solution is to buy cancer insurance plan specially designed for the ailment offered by following companies/entities:

  • Indian Cancer Society in collaboration with New India Assurance
  • Cancer Patients Aid Association in collaboration with New India Assurance
  • HDFC Life Cancer Plus Plan
  • ICICI Prudential Cancer Care Plus

Here is the chart showing the comparison of important features. Also mentioned is the direct contact number:

Features ComparisonIndian Cancer Society (ICS) + New India Assurance CompanyCancer Patients Aid Association (CPAA) + New India Assurance CompanyHDFC Life Cancer Plus PlanICICI Prudential Cancer Care Plus
Annual Premium1) Rs. 496 for sum assured of Rs. 50, 000
2) Rs. 1157 for sum assured of Rs. 2,00, 000
One time lump sum payment of:

1) Rs. 2400 for sum insured of 30,000
2) Rs. 3000 for sum insured of 50,000
3) Rs. 4700 for sum insured of 1,00,000
4) Rs. 6300 for sum insured of 1,50,000
5) Rs. 8000 for sum insured of 2,00,000
Depends on 4 factors:

1) Plan type viz: Silver, Gold, Platinum
2) Age
3) Policy Term
4) Gender (Male or Female)
E.g.
Silver plan: Rs. 1,333 for 35 years age male and policy term of 10 years
1) Between Rs. 4,604 to 8,945 for 10 Lakh Cover (For Male)
2) Between Rs. 8,602 to 14,845 for 10 Lakh Cover (For Female)
Sum AssuredRs. 50, 000 or Rs. 2,00, 000Rs. 30,000 or 50,000 or 1,00,000 or 1,50,000 or 2,00,000Rs. 10,00, 000 or Rs. 40,00,000Rs 5,00,000 – 25,00,000
Pre-Medical Test Required?
NoYesNoYes
Pre-existing cancer covered?NoNoNoNo
Waiting PeriodYesYesYesYes
Can you buy policy online?NoNoYesYes
Contact Details - Phone No.+91-22-2413 9445 / 51+91 22 24924000 / +91 22 24921856 / +91 22 249287751800-266-9777 (toll free)1800-22-2020 (toll free)

About Cancer:

  • After heart disease, cancer is the second most common cause of death in India.
  • There are various signs of cancer such as – unexplained weight loss, difficulty in swallowing food, sore doesn’t heal etc.
  • Causes of cancer vary. This includes genetic changes, chewing tobacco/alcohol etc.
  • Heredity also increases risk of developing cancer.
  • Every year in India, over 7 lakh new cases of of cancer are detected and nearly 3.5 lakh succumb to death.
  • Tobacco is the major cause of cancer death in India contributing above 30%.

Health Insurance for Seniors: Buying Tips, T&C

Health problems are part of life and nothing is certain as it can strike anyone at anytime. However as person ages, possibilities of health problems also increase. And with rising medical treatment cost, it has become very essential for an individual to buy health insurance for the whole family especially when parents or seniors are part of it. However, when an individual wants to purchase a policy for his/her parents then lot of terms and conditions come into play. This is because, profit margins of insurers takes a hit when it comes to claim settlement. And since senior citizens are more likely to get health problem due to age and for insurance companies this is loss making. On the other hand, it is difficult to bear the cost if senior person has no income source, so dependency increases.

Considering this, companies have come up with specialized insurance plans for parents with age greater than 60, which of course are expensive due to the above mentioned reason. Check out cheapest heart surgery in world offered in India.

So what are the various terms and conditions set by insurance companies for elderly people?

  • Coverage of pre-existing diseases is after certain years only. This means that, if someone suffering from any disease buys a policy today and gets hospitalized next month then insurance company will not reimburse.
  • Pre-existing diseases are covered minimum 1 year after.
  • Pre-medical tests are mandatory to uncover pre-existing disease.
  • Certain pre-existing ailments are covered only after paying additional premium.
  • Cover is provided upto a certain age only. i.e. somone with an age of 80+ years will not get claim even if they’ve got cover.
  • Annual premium is high. Read where you can get low cost medicines in India.

Things to keep in mind before buying medical insurance for senior citizens:

  • Never hide health problems while giving details during buying of policy. In case of any fault, your policy will be cancelled moreover the premiums you have paid over years is also gone.
  • Verify till what age, cover will be provided. And even if there is a maximum age limit, opt for a plan which guarantees renewal.
  • Check out the list of exclusions. This is the most important point.
  • Don’t rely on group insurance even if they cover parents. This is because, if you lose your job then the group policy gets terminated. And buying a policy will result in higher premiums.
  • Amongst all the illnesses critical problems related to heart, kidney, liver and others are most expensive to treat. So while buying check all the terms with regards to critical illnesses.
  • Check whether health check-up is arranged or not.
  • Daily hospitalization cost is covered or not.
  • Check for claim settlement history of the insurer. This will give fair idea on reputation of the company.
  • Check how fast claims are settled and also on ambulance charges.
  • Check whether doctors, surgeons, anesthetists are covered or not.
  • There are many medical tests/procedures are carried out after hospitalization which costs high depending on the hospital. If your provider covers these charges, then it’s an added benefit.

Which insurance companies offer health insurance especially for seniors?

Here is a list of companies offering insurance for seniors along with the name of the plan:

  1. Apollo Munich – Optima Senior
  2. Apollo Munich – Easy Health Plan
  3. Religare – Senior Citizen Insurance
  4. New India Assurance – Senior Citizen Mediclaim Policy
  5. Bajaj Allianz – Silver Health Plan for Senior Citizens
  6. National Insurance Company – Varishtha Mediclaim for Senior Citizens
  7. ICICI Lombard – iHealth Plan
  8. Star Health – Senior Citizen’s Red Carpet
  9. Max Bupa – Heart Beat Silver
  10. United India – Senior Citizen Insurance

Buying health insurance for seniors is very essential in order to avoid financial trouble and choosing the best plan too needs special consideration.

When to Increase Health Insurance Cover, Benefits, Tips

Until now, buying a health insurance with a cover of Rs. 5, 00,000 was considered sufficient for a family of 3-4 persons. However with rising healthcare treatment cost coupled with inflation, this amount is very small especially when you are suffering from critical illnesses which have high treatment costs along with other medical expenses. So it has become very essential for a policy holder to relook into the policy and make a decision on increasing the cover. Many companies have started offering high value health insurance plan i.e. cover amount is high. But at the same, policy holder has to pay high premiums.

However benefits offered in return of high premiums are justifiable which includes:

  • Increase in the list of health tests such as dental treatments, physiotherapy cost and others. Get this checked with your provider
  • Post discharge treatments are covered
  • Higher maternity cover
  • Network hospital list is large
  • International treatment is covered along with air ambulance
  • Annual free health check-up. Although this is offered in normal health insurance plans as well but still higher numbers of medical tests are covered.
  • There could be many other benefits apart from the above listed ones. You should get a comparison chart from your provider before applying for a high cover.

But the question arises, when should you consider increasing the health cover?

The answer will vary for each person. However the rules remain same. You should consider high value cover when:

  • You have a child. You MUST increase the cover once you have a baby. Best is to increase the cover when a woman is in her first trimester of pregnancy.
  • You are suffering from a condition whose treatment is available only in foreign country. Most of the companies who are selling high value insurance plans cover international treatment expenses.
  • However the condition is that the same treatment should not be available in India.
  • You live in metro city where treatment cost of critical illnesses are typically high and available in premium hospitals only. Adding to the cost are the expensive room charges.
  • Overall family income is good then buying a high value cover is a good option as you can expect medical facilities and other benefits as per your standard. Make sure you have carefully evaluated child’s education and your retirement corpus even when the income is good.
  • Your family member is nearing 60 when chances of aging related ailments increase.

Points to consider before opting for a higher plan:

  • The company has high claim settlement ratio
  • No claim is provided periodically and the amount is high
  • Hospital expenses such as room charges, food does not have any eligibility cap
  • Higher number of medical conditions are covered
  • Waiting period of pre-existing ailments is less

Although buying a high sum insured medical insurance is expensive as you will have to shell out extra money i.e. higher premium but at the same time, this will give you lot of benefits apart from the above mentioned ones.

However along with the benefits comes the drawback as follows:

  • If you do not get hospitalized in a specified year then the whole premium is wasted.
  • Even if you get hospitalized, then also the sum insured may not be 100% utilized. So eventually you end up losing money.

Few companies offering high value medical cover (check with your respective provider):

  • Bajan Allianz – Rs. 50, 00, 000
  • Cigna TTK – Rs. 1, 00, 000, 00
  • Tata AIG Insurance – Rs. 1, 00,000, 00

Irrespective of the insurance you choose or increase the health cover, make sure you read the customer information sheet containing various terms and conditions. Never trust blindly on your agent or the company.

Health Insurance Transfer: Benefits, Process, Reasons to Port

With health problems on rise in India, it has become very essential for a person to buy a health insurance policy to protect his/her family from financial turmoil. But the quality of service provided by the insurers on the other hand is very bad resulting in unhappiness amongst the policy holders. Considering this situation, in 2011, Insurance regulatory and development authority of India (IRDA) passed a regulation on health insurance portability. This allows policy holder to transfer health insurance to another company of his/her choice and at the same time retain all the benefits as follows:

  • Waiting Period: Suppose you have purchased a policy which covers pre-existing ailments after 3 years. And 1 year after renewing the policy, you decide to switch to another company where waiting period is 2 years. Then your waiting period in the new company will be 1 year only. And this transfer to the new company will not carry any additional premium and conditions. Read more on medical insurance for pre-existing diseases.
  • No-claim bonus: Similar to the waiting period, your no claim bonus and credit earned can also be ported. Check out insurance for angioplasty.

Porting Process:

  • Application for porting health insurance from one company to another should be made at least 45 days before the renewal date of existing policy.
  • Policy holder should correctly fill and submit the portability form available on IRDA website – ww.irda.gov.in
  • Company will then send your portability form and all the policy related documents on the IRDA website.
  • Other documents include all the previous policies, claim experience, proof of age and others. If any other documents are required then the new company will contact you.

In what cases, health insurance portability request will be denied:

  • Premium not paid i.e. there is no break in the existing policy.
  • The existing policy was newly purchased.
  • Portability application is made.
  • Transfer is requested during the policy term. As per rule, switching is possible only at the time of renewal.

When should you switch to a new insurer?

  • Unhappy with existing insurance company. This can be due to various reasons such as hidden fees, higher premiums charged without any intimation, your previous claim was rejected even when all details submitted were 100% accurate, tedious claim process and many others.
  • Beneficial features are available at the new insurer such as – low premium with more coverage, network hospital list is big, and claim process is fast and many others.
  • When you are relocating to another city where network hospitals are less.
  • Changed the job

Tips before you transfer medical insurance to another company:

  • Read all the terms and conditions of the new company and then decide. Don’t just look at premium cost. New company will have its own rules and can also demand higher premium.
  • Check claim settlement ratio.
  • Opt for a company which offers good customer support.

Health Insurance for Newborn Baby: Age, Documents, T&C’s

Arrival of new born baby is one of the joyous moment for the parents and family. It’s in fact a dream come true for first time parents. But this starts a phase of savings as expenditures rises. So how should parents manage to overcome this and yet secure their family’s financial future?

The first and foremost important step is to save on medical expenses and one of the best solution is buying a health insurance for new born child. As the cost of medical treatments/medicines are going up, it is utmost important to reduce these expenses as your child grows up. Sooner you consider taking policy better would be for you to save money during any medical emergency, as cost would be borne by the company. Also read about low cost medicines in India.

There are hardly any insurance companies in India providing separate medical insurance for new born child. So in such cases, parents should add their child under their existing group policy or family floater. Get to know why personal policy is important.

Criteria for adding new born child:

The three most important points to consider before insuring your child are:

  1. Age: Not all insurance companies permit adding new born baby under group or family floater unless he/she is 90 days old. But there are a few insurers who allow child to be covered right from the first day and these are typically offered under group insurance as a part of maternity benefit. Once your child is added, various medical tests can be covered such as vaccinations etc. which actually costs very high when done in a private hospitals. However under family floater, a child can avail health insurance benefits till they reach the age of 21 years.
  2. Intimating insurance companies: Once child is born, you should make a point of intimating your health insurer within a week, so that insurer will start processing immediately and this way you can avoid last minute problems. Insurer will also update you on additional cover as a part of the policy. If your child is covered after 90 days, then you should add the baby’s name while renewing the policy in the next year.
  3. Documents required: During renewal when you add child’s name under the policy, you would need copy of child’s birth certificate, maternity discharge card and medical history. These are the mandatory requirement by the insurance company.

Annual premium: Once all the documents are verified and child is added, the company will revise the premium amount. Once you pay the revised premium amount, policy would start covering your child. Also check out insurance for pregnant women in India.

Few insurers for newborn child in India:

There are many companies automatically covering new born baby or include them after 1 year of buying of the policy after baby completes 3 months. Here are the prominent ones:

  • Life Insurance Corporation (Health Protection Plus)
  • Star Comprehensive Insurance Policy
  • Religare Health Insurance – (‘JOY’) – Covers maternity and newborn baby
  • Apollo Munich – Premium Family Health Insurance – Also covers maternity expenses

Once your child turns 5 year old, insurance company can offer individual cover for the child.

Ok, we’ve discussed about health insurance for newborn. Now let’s shift focus from health to investments for girl child. Sukanya Samriddhi Yojana, a investment scheme launched aims to create wealth for securing the future of a girl child. For e.g. investing Rs. 30, 000/year will earn return of Rs. 15, 78, 153 after 14 years.