With a soaring high expanse to provide yourself and your family with adequate medical support in times of need, it is super advisable to keep yourself and every member of your family adequately insured. And it is also necessary to opt for a health insurance plan that has all the proper features that would suit you and your family structure so that you can benefit fully from the plan when needed. Thus the two major factors that need to be taken into consideration are your family set up and the features of the plan you are trying to opt for.
The need for a family’s health insurance requirement would determine which plan is best for them. So, your requirement for a family health insurance plan could be completely different from any other.
Understanding the Need of Your Family
- Family with Aged Dependent Parents
If you have aged dependent parents in your family then it is an extreme necessity to have them adequately insured, as the chance of them falling ill and incurring medical expenditure is very high. Thus coverage of a proper amount which would guard you against financial erosion if they need to undergo some treatment can be avoided only if you have a proper policy to back it up. And in such cases, it is better to take an individual policy for each parent separately as you never know when the policy would be required and a floater might not be adequate in a specific year to provide for both or other members in the family. And if you add other members to your parents’ policy then the premium amount is also likely to go up.
- A Young Family
A young family means a family where the members are not past the middle age like it might be just you and your spouse or you, your spouse and small children. Then in that case the probability that you would need the insurance coverage is lower than those who have elderly people covered under the same insurance. Thus a family floater to keep all safe should be good enough.
- Medical Coverage Provided by the Employer
In case you are medically covered by your employer under any group insurance plan then also it is advisable that you privately obtain a medical insurance policy. You first need to check the amount you are covered for and then decide on the amount of extra coverage you would need. And it is also necessary to do so as if you need to discontinue your employer then your family would not be covered under the group policy provided by your employer and thus any sort of atrocity faced at that point of time might just drain you of your savings. So even if you are adequately covered by your employer then also you should keep a backup of a personal policy, and in case if you discontinue service, you would need to increase the sum insured of your personal policy to meet the match.
- If You are a Self Employed person or A Professional or A Business Personnel
In case you are self-employed, or a professional or business personnel then it is a mandate that you have the policy to support your medical expenses so that your savings are not eroded. Plus it would also be a clever move to take a policy that not only supports your medical expenses but also would provide you with a sum insured in case of loss of income due to medical reasons.
Such features of your family need to be thought over before you think of deciding for the right policy.
Features You Need to Consider Before Opting for the Best Health Insurance Plan
- Sum Insured
You would need to assess the amount of sum insured you would need to make an apt coverage for your family. That would depend upon the age of the dependent members of your family and their medical history.
- Waiting Period
Every medical insurance plan has a waiting period before they cover you for any pre-existing disease. It is necessary you compare the same with other policies before deciding on the plan you want to take.
Most of the medical policies have exclusion, which means that they do not provide cover for certain diseases. The exclusion list should be taken into consideration to decide whether the policy you are taking would be of use to you.
Sub limit in a policy means the limit in the maximum amount you would receive for certain factors like ICU charges, bed rents, doctor fees, surgery charges and so on. There are certain sub-limits in most of the policies. It is calculated as a percentage of the sum insured so you should keep yourself well aware of the same, as most of the time customers are not aware of the same and are taken by surprise at the time of the claim.
It is a better option to opt for a plan that gives you a cashless claim on your policy. Claiming a sum insured post-treatment can be really problematic as you might have short of funds at the time of need. Plus having a cashless settlement is much hassle-free.
- Hospital in the Network of the Policy
You should take a careful note of the network hospitals before deciding on the policy you take. Do check if the hospital you want to opt for in times of medical emergency is one of the network hospitals. Plus you should check if few nearby hospitals are also there within the list as at times medical emergency looms such that you might not get time to move to a hospital of your choice and might need to admit the patient in the nearby hospital and then shift later on. In such cases, it becomes necessary that you get coverage in both the hospitals.
Most of the general health insurance companies that provide medical insurance settle their claim through a third-party administrator, most commonly known as TPA, and in such cases, the health insurance claim takes a greater time to be processed. Thus it is better to opt for a policy that would be processed in house by the company.
It is thus better to take the above features into consideration before finally deciding on the policy.
Below are the 3 Top Health Insurance Policies that can Suffice Your Needs
National Mediclaim Policy
National Mediclaim Policy is a product of the National Insurance Company. This company provides general insurance and health plans are also a part of their array of products. This company is a general public sector insurance company and thus the number of insured customers in their list is quite high as compared to any private insurance company. Thus you can understand that customer reliability is also quite high for this company. Some features in the mediclaim policy make them quite popular and they are:
- Sum insured keeps increasing by 5% every year that goes claim-free. You can get such a growth in the sum insured up to 50%
- If you take a policy for your whole family then you would be entitled to a discount of 10% on your premium
- This plan covers expenses incurred in alternative treatment
- This plan under Sec 80(D) is eligible for a deduction of Tax from your income to a maximum of INR 25,000
Star Family Health Optima Insurance Plan
Star Health and Allied Insurance Company Limited is a public sector insurance company, but the number of people in their insured list is way more than any private sector insurer. It is so because they have obtained the reliability of the customers with their service and their products that suit most of the needs that you might look for in a policy. Following are the features that make the policy apt for most of your needs:
- Three times in a year, the sum insured of your policy would be restored.
- Coverage is provided for assisted reproductive treatments
- Infants are covered post 15 days of their birth, which is from day 16
- Coverage is given for the Day Care treatments too. The list for the daycare treatment that is covered is available in the brochure and also in the policy document. In daycare treatment, you need to be hospitalized for a few hours and not more than. Surgery like Cataract is included in the daycare treatment.
- Annual Health check-ups are provided for free as a part of the policy.
- Free auto recharge of sum insured is allowed
- Tax Redemption Under Sec 80(D) allows you to get a deduction of INR 25,000 from your income every year you pay for the policy.
This is a plan that has a good number of insured people in their list and can be demarcated as one of the popular plans in the market. This plan is provided by Religare Health Insurance Company Limited is now known as Care Health Insurance. This plan has various levels of sum insured that you can opt for and the product is categorized as per the sum insured only, and those categories are known as Global, Global Plus, Elite and Elite Plus. Following are few features of this policy:
- There is no maximum age limit to obtain this plan.
- A Sum insured of up to 6 crores can be opted for.
- Sum insured is restored in this plan whatever be the variant you had opted for
- You are entitled to get a Health check-up every year which is free of costs.
- If the insured person has been affected by a critical illness then the insurance company would provide for a second opinion free of any cost.
- Treatment procedures apart from Allopath, such as Homoeopathy and Ayurveda are also considered and entitled to receive a sum insured. But generally, there is a cap for this sum insured and is not equal to the entire sum insured.
- This plan has a number of optional coverage benefit like the no claim bonus, international second opinion, global coverage, personal accident cover and so on,
- You get a rebate of Tax Rebate of INR 25,000 INR, Under Sec 80(D). This amount is exempted from the annual income for every year you pay the policy.
As you can see that the best way to buy your mediclaim is to annualize the amount and type of cover that your family needs, then check the salient features of the policies available and choose accordingly.