When to Increase Health Insurance Cover, Benefits, Tips

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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.

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