PERSONAL FINANCE FINANCIAL PLANNING
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No one should have to choose between medicine and other necessities. No one should have to use the emergency room every time a child gets sick. And no one should have to live in constant fear that a medical problem will become a financial crisis.
- Brad Henry |
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TO KNOW THE LATEST GUIDELINES OF IRDAI ON HEALTH INSURANCE , CLICK HERE
PREMIUMS FOR HEALTH INSURANCE POLICIES : COMPARE BEFORE BUYING
05.08.2020 : To buy a Health insurance policy , you have to pay a fee called premium to the insurance company affront . Now IRDAI has allowed the monthly / quarterly / half yearly payment on the policies . Each insurance policy carries its own premium to be paid for a person of particular age . As each insurance policy was differing in coverage / inclusions / exclusions / co-pay / pre-existing diseases coverage / waiting period etc , it was difficult to compare the premiums of two policies even when the covered amount is same .
Bu during the the last six months , Insurance Regulatory & Development Authority of India ( IRDAI ) has come up with three standard policies to be mandatorily issued by all general and health insurance companies that deal in Health insurance . The three policies are
1. Arogya Sanjeevani Policy 2. Corona Kavach Policy . 3 Corona Rakshak Policy .
Terms of each policy is well defined by IRDAI and hence will carry the same features for the policies issued by different insurance companies . However they are free to quote premiums as they wish and hence IRDAI does not control the premiums to be paid by the customers . Yet it was expected that the premiums would be in the same range for a particular policy for a person of particular age .
To check how the premiums are quoted by different insurers , we compared premiums quoted by six insurance companies for each of the above policy . To our surprise , we found that the variations were huge and some times some companies quoted 10 times the premium quoted by another company for the same coverage . If the variation is so huge among just 6 companies , you can imagine the difference of premium you get if you look in to more and more insurance companies. To go through our survey on premiums , click below on each of the insurance plans .
1. Arogya Sanjeevani Policy Premiums
2. Corona Kavach Policy Premiums
3 Corona Rakshak Policy Premiums
Once you go through the above articles , you will come to know the actual variation in premium of each policy issued by various insurers .
Now it becomes necessary for you to get quotes from as many as possible companies before deciding on a insurance policy . Otherwise you will end up with paying a huge premium .
05.08.2020 : To buy a Health insurance policy , you have to pay a fee called premium to the insurance company affront . Now IRDAI has allowed the monthly / quarterly / half yearly payment on the policies . Each insurance policy carries its own premium to be paid for a person of particular age . As each insurance policy was differing in coverage / inclusions / exclusions / co-pay / pre-existing diseases coverage / waiting period etc , it was difficult to compare the premiums of two policies even when the covered amount is same .
Bu during the the last six months , Insurance Regulatory & Development Authority of India ( IRDAI ) has come up with three standard policies to be mandatorily issued by all general and health insurance companies that deal in Health insurance . The three policies are
1. Arogya Sanjeevani Policy 2. Corona Kavach Policy . 3 Corona Rakshak Policy .
Terms of each policy is well defined by IRDAI and hence will carry the same features for the policies issued by different insurance companies . However they are free to quote premiums as they wish and hence IRDAI does not control the premiums to be paid by the customers . Yet it was expected that the premiums would be in the same range for a particular policy for a person of particular age .
To check how the premiums are quoted by different insurers , we compared premiums quoted by six insurance companies for each of the above policy . To our surprise , we found that the variations were huge and some times some companies quoted 10 times the premium quoted by another company for the same coverage . If the variation is so huge among just 6 companies , you can imagine the difference of premium you get if you look in to more and more insurance companies. To go through our survey on premiums , click below on each of the insurance plans .
1. Arogya Sanjeevani Policy Premiums
2. Corona Kavach Policy Premiums
3 Corona Rakshak Policy Premiums
Once you go through the above articles , you will come to know the actual variation in premium of each policy issued by various insurers .
Now it becomes necessary for you to get quotes from as many as possible companies before deciding on a insurance policy . Otherwise you will end up with paying a huge premium .
TO KNOW ALL ABOUT
AROGYA SANJEEVANI PLAN ,
A STANDARD HEALTH INSURANCE POLICY TO BE ISSUED BY ALL INSURANCE COMPANIES , CLICK HERE
PLAN N PROGRESS COMPARES
RETIREE BANKERS HEALTH INSURANCE -
IBA GROUP INSURANCE VERSUS AROGYA SANJEEVANI PLAN
AROGYA SANJEEVANI PLAN ,
A STANDARD HEALTH INSURANCE POLICY TO BE ISSUED BY ALL INSURANCE COMPANIES , CLICK HERE
PLAN N PROGRESS COMPARES
RETIREE BANKERS HEALTH INSURANCE -
IBA GROUP INSURANCE VERSUS AROGYA SANJEEVANI PLAN
READ OUR ARTICLES ON TOPICS IN HEALTH INSURANCE
COVID INSURANCE FLOATER POLICIES SENIOR CITIZENS INSURANCE
LATEST AROGYA SANJEEVANI PLAN HOSPITAL CASH PLANS
COVID INSURANCE FLOATER POLICIES SENIOR CITIZENS INSURANCE
LATEST AROGYA SANJEEVANI PLAN HOSPITAL CASH PLANS
NEW ARTICLE
SECURING HEALTH FOR SENIOR CITIZENS
WITH OR WITHOUT ENTRY AGE RESTRICTION
TO READ THE ARTICLE CLICK HERE
TO GET ANSWERS FOR FAQs on MANAGEMENT OF POLICIES , CLICK HERE
SECURING HEALTH FOR SENIOR CITIZENS
WITH OR WITHOUT ENTRY AGE RESTRICTION
TO READ THE ARTICLE CLICK HERE
TO GET ANSWERS FOR FAQs on MANAGEMENT OF POLICIES , CLICK HERE
TITBITS : From a recent report of Sample Survey Office , it is revealed that 80 percent of Indians , who mainly rely up on private health care , do not have any medical insurance . The government has brought only about 12 % of population under health protection schemes like Rashtriya Swasthya Bima Yojana . In the absence of health insurance , 75 % of Indians use their hard earned savings while 18% have to borrow . In order to escape from financial gloom in the events of medical emergencies , one has to definitely require some form of Health insurance .
PLAN YOUR HEALTH INSURANCE PRUDENTLY
MEDICAL INSURANCE - Basics
What is covered under Health Insurance Policy ?
A Medical Insurance Policy would normally cover expenses incurred under the following heads in respect of each insured person subject to overall ceiling of sum insured
a. Room, Boarding expenses
b. Nursing expenses
c. Fees of surgeon, anesthetist, physician, consultants, specialists
d. Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines, drugs, diagnostic materials, X-ray, Dialysis, chemotherapy, Radio therapy, cost of pace maker, Artificial limbs, cost or organs and similar expenses.
e. Ambulance charges
Sum Insured
The Sum Insured may have a maximum amount for each of the insured under the policy or cumulative for all the insured or a fixed amount to be paid out on particular type of disease or surgery needed or affixed amount per day for the period of hospitalization.
Pre and post hospitalization expenses
Expenses incurred during a certain number of days prior to hospitalization and post hospitalization expenses for a specified period from the date of discharge may be considered as part of the claim provided the expenses relate to the disease / sickness.
Cashless Facility
Insurance companies have tie-up arrangements with a network of hospitals in the country. If policyholder takes treatment in any of the net work hospitals, there is no need for the insured person to pay hospital bills. The Insurance Company, through its Third Party Administrator (TPA) will arrange direct payment to the Hospital. Expenses beyond sub limits prescribed by the policy or items not covered under the policy have to be settled by the insured direct to the Hospital. The insured can take treatment in a non-listed hospital in which case he has to pay the bills first and then seek reimbursement from Insurance Co. There will be no cashless facility applicable here.
For the list of TPA approved by IRDAI , CLICK HERE
What is covered under Health Insurance Policy ?
A Medical Insurance Policy would normally cover expenses incurred under the following heads in respect of each insured person subject to overall ceiling of sum insured
a. Room, Boarding expenses
b. Nursing expenses
c. Fees of surgeon, anesthetist, physician, consultants, specialists
d. Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines, drugs, diagnostic materials, X-ray, Dialysis, chemotherapy, Radio therapy, cost of pace maker, Artificial limbs, cost or organs and similar expenses.
e. Ambulance charges
Sum Insured
The Sum Insured may have a maximum amount for each of the insured under the policy or cumulative for all the insured or a fixed amount to be paid out on particular type of disease or surgery needed or affixed amount per day for the period of hospitalization.
Pre and post hospitalization expenses
Expenses incurred during a certain number of days prior to hospitalization and post hospitalization expenses for a specified period from the date of discharge may be considered as part of the claim provided the expenses relate to the disease / sickness.
Cashless Facility
Insurance companies have tie-up arrangements with a network of hospitals in the country. If policyholder takes treatment in any of the net work hospitals, there is no need for the insured person to pay hospital bills. The Insurance Company, through its Third Party Administrator (TPA) will arrange direct payment to the Hospital. Expenses beyond sub limits prescribed by the policy or items not covered under the policy have to be settled by the insured direct to the Hospital. The insured can take treatment in a non-listed hospital in which case he has to pay the bills first and then seek reimbursement from Insurance Co. There will be no cashless facility applicable here.
For the list of TPA approved by IRDAI , CLICK HERE
KNOW ABOUT TAX ON RETIREMENT BENEFITS , CLICK HERE
FOR INCOME TAX NEWS , CLICK HERE NEWS ON INTEREST RATES CLICK HERE
ARTICLE ON INVESTMENT OPTIONS FOR RETIREES , CLICK HERE WHAT IS SYSTEMATIC INVESTMENT PLAN ? CLICK HERE
NEW ARTICLES ON
SMALL FINANCE BANKS PAYMENT BANKS
UNIFIED PAYMENT INTERFACE BHARAT BILL PAYMENT SYSTEM
BHIM APP AADHAR
e-INSURANCE Account ( eIA )
WHAT IS NEW ON PLAN N PROGRESS ?
FOR INCOME TAX NEWS , CLICK HERE NEWS ON INTEREST RATES CLICK HERE
ARTICLE ON INVESTMENT OPTIONS FOR RETIREES , CLICK HERE WHAT IS SYSTEMATIC INVESTMENT PLAN ? CLICK HERE
NEW ARTICLES ON
SMALL FINANCE BANKS PAYMENT BANKS
UNIFIED PAYMENT INTERFACE BHARAT BILL PAYMENT SYSTEM
BHIM APP AADHAR
e-INSURANCE Account ( eIA )
WHAT IS NEW ON PLAN N PROGRESS ?
Additional Benefits and other Riders
Insurance companies offer various other benefits like “ Health Checkup “. There are also policies that give benefits like “Hospital Cash”, “Critical Illness Benefits”, “Surgical Expense Benefits” etc. These policies can either be taken separately or in addition to the hospitalization policy. A few companies have come out with products in the nature of Top Up policies to meet the actual expenses over and above the limit available in the basic health policy.
The actual exclusions may vary
FLOATER POLICIES
Family Floater is one single policy that takes care of the hospitalization expenses of entire family. The policy has one single sum insured, which can be utilized by any/all insured persons in any proportion or amount subject to maximum of overall limit of the policy sum insured. Quite. Family floater plans are better than buying separate individual policies all
TAX BENEFIT UNDER SECTION 80D OF INCOME TAX ACT
Deduction allowed on Medicliam Policies under 80 D is Rs. 50,000/- for senior citizens and up to Rs. 25,000/- for others from the financial year 2018-19 . For senior citizens , if no insurance amount is paid , hospital expenditure up to Rs 50,000 is allowed . An assessee can claim additional Rs 50,000 for his / her parents if they are senior citizens and Rs 25,000 in other cases . Overall claim cannot exceed Rs 1,00,000 . All payments should have been made in any mode other than cash . Cost of preventive health check up up to Rs 5,000 can be claimed within the overall limit and it could have been made in cash also .
Insurance companies offer various other benefits like “ Health Checkup “. There are also policies that give benefits like “Hospital Cash”, “Critical Illness Benefits”, “Surgical Expense Benefits” etc. These policies can either be taken separately or in addition to the hospitalization policy. A few companies have come out with products in the nature of Top Up policies to meet the actual expenses over and above the limit available in the basic health policy.
The actual exclusions may vary
FLOATER POLICIES
Family Floater is one single policy that takes care of the hospitalization expenses of entire family. The policy has one single sum insured, which can be utilized by any/all insured persons in any proportion or amount subject to maximum of overall limit of the policy sum insured. Quite. Family floater plans are better than buying separate individual policies all
TAX BENEFIT UNDER SECTION 80D OF INCOME TAX ACT
Deduction allowed on Medicliam Policies under 80 D is Rs. 50,000/- for senior citizens and up to Rs. 25,000/- for others from the financial year 2018-19 . For senior citizens , if no insurance amount is paid , hospital expenditure up to Rs 50,000 is allowed . An assessee can claim additional Rs 50,000 for his / her parents if they are senior citizens and Rs 25,000 in other cases . Overall claim cannot exceed Rs 1,00,000 . All payments should have been made in any mode other than cash . Cost of preventive health check up up to Rs 5,000 can be claimed within the overall limit and it could have been made in cash also .
ISSUERS OF HEALTH COVERS
Mediclaim policies are issued by specialized Health / Medical Insurance companies , Life Insurers as well as General Insurers .
To get the list and visit their websites , Click Here
Mediclaim policies are issued by specialized Health / Medical Insurance companies , Life Insurers as well as General Insurers .
To get the list and visit their websites , Click Here
What is not covered in Health insurance ?
What is not covered in a policy ?
We would have bought medical insurance by paying substantial premium . When we submit our claims , we would be shocked to learn that our claim is rejected or substantially reduced as the policy doesn't cover the illness / treatment we have undergone . Hence we should carefully go through the policy document while / before purchasing an insurance to know what the health insurance covers and what is not covered .
Each policy has its own sets of inclusions and exclusions and we give below some general exclusions which are normally covered in an insurance policy . But carefully study the policy document while purchasing the health insurance .
General Exclusions :
a. All pre-existing diseases . But some policies allow after certain lapse pf period called waiting period which is between 24 to 60 months . Many policies will also not cover the new ailments arising out of pre-existing conditions . Even if they allow , some policies would have limited the cover to certain percentage .
As per IRDAI GUIDELINES ( click here to read the IRDAI CIRCULAR )
Pre-existing Disease means any condition, ailment, injury or disease:
a) That is/are diagnosed by a physician within 48 months prior to the effective date of the policy issued by the insurer or its reinstatement or
b) For which medical advice or treatment was recommended by, or received from, a physician within 48 months prior to the effective date of the policy issued by the insurer or its reinstatement.
b. Under first year policy, any claim during the first 30 days from date of cover, for sickness / disease. This is not applicable for accidental injury claims.
c. During first year of cover – cataract, Benign prosthetic hypertrophy, Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Hydrocele, Congenital Internal diseases, Fistula in anus, piles, sinusitis and related disorders. Some policies do not allow treatment for certain diseases like cataract for a period of 24 months to 48 months , even when it was not a pre-existing condition.
d. Circumcision unless for treatment of a disease
e. Cost of specs, contact lenses, hearing aids
f. Dental treatment / surgery unless requiring hospitalization
g. Convalescence, general debility, congenital external defects, V.D., intentional self-injury, use of intoxicating drugs / alcohol, AIDS, Expenses for Diagnosis, X-ray or lab tests not consistent with the disease requiring hospitalization.
h. Treatment relating to pregnancy or child birth including cesarean section
i. Naturopathy treatment.
j. Cosmetic procedure / Fertility treatment
k. Off-label medicines
l. Health issues on account of war , radiations etc .
Further some policy require prior authorization from them before hospitalizations for certain types of ailments .
Hence as a precaution , go through the policy while buying a health policy and follow the procedure / terms & conditions while undergoing a treatment and making a claim . Normally insurance companies offer a free- look period of say 15 days after issue of the policy . If you are not satisfied with the policy terms , you may surrender the policy and look for a fresh policy .
We would have bought medical insurance by paying substantial premium . When we submit our claims , we would be shocked to learn that our claim is rejected or substantially reduced as the policy doesn't cover the illness / treatment we have undergone . Hence we should carefully go through the policy document while / before purchasing an insurance to know what the health insurance covers and what is not covered .
Each policy has its own sets of inclusions and exclusions and we give below some general exclusions which are normally covered in an insurance policy . But carefully study the policy document while purchasing the health insurance .
General Exclusions :
a. All pre-existing diseases . But some policies allow after certain lapse pf period called waiting period which is between 24 to 60 months . Many policies will also not cover the new ailments arising out of pre-existing conditions . Even if they allow , some policies would have limited the cover to certain percentage .
As per IRDAI GUIDELINES ( click here to read the IRDAI CIRCULAR )
Pre-existing Disease means any condition, ailment, injury or disease:
a) That is/are diagnosed by a physician within 48 months prior to the effective date of the policy issued by the insurer or its reinstatement or
b) For which medical advice or treatment was recommended by, or received from, a physician within 48 months prior to the effective date of the policy issued by the insurer or its reinstatement.
b. Under first year policy, any claim during the first 30 days from date of cover, for sickness / disease. This is not applicable for accidental injury claims.
c. During first year of cover – cataract, Benign prosthetic hypertrophy, Hysterectomy for Menorrhagia or Fibromyoma, Hernia, Hydrocele, Congenital Internal diseases, Fistula in anus, piles, sinusitis and related disorders. Some policies do not allow treatment for certain diseases like cataract for a period of 24 months to 48 months , even when it was not a pre-existing condition.
d. Circumcision unless for treatment of a disease
e. Cost of specs, contact lenses, hearing aids
f. Dental treatment / surgery unless requiring hospitalization
g. Convalescence, general debility, congenital external defects, V.D., intentional self-injury, use of intoxicating drugs / alcohol, AIDS, Expenses for Diagnosis, X-ray or lab tests not consistent with the disease requiring hospitalization.
h. Treatment relating to pregnancy or child birth including cesarean section
i. Naturopathy treatment.
j. Cosmetic procedure / Fertility treatment
k. Off-label medicines
l. Health issues on account of war , radiations etc .
Further some policy require prior authorization from them before hospitalizations for certain types of ailments .
Hence as a precaution , go through the policy while buying a health policy and follow the procedure / terms & conditions while undergoing a treatment and making a claim . Normally insurance companies offer a free- look period of say 15 days after issue of the policy . If you are not satisfied with the policy terms , you may surrender the policy and look for a fresh policy .
TIPS FOR BUYING MEDICLAIM POLICIES
1. Various Insurance companies offer health / mediclaim Policies . But the terms , diseases covered and premiums vary . Hence first write down your needs like whether you have parents & children to be covered , Medical history of your family members , and the amount of coverage you require . Please remember the medical costs are increasing year after year and what looks like suffice today may not cover fraction of your requirement after 5 years . Hence keep cushion while having the amount fixed .
2. You check the hospitals in your city , especially which are convenient to you , are covered under cashless facility by TPA .
3. Compare the premiums from three or four insurance companies for the least . and you can find huge variation from company to company and chose the one which suits your budget and requirements .
4. Floaters policies covering all the members of your family are cheaper than taking individual policies and hence get a policy which can cover your family members .
5. Check whether premiums are kept at the same level as offered for at least for few years . Otherwise every year you will have to pay higher demanded premiums .
6. Check up to what your age the policy will cover . There are policies which cover up o maximum age of 80 years . Otherwise at the ripe age when you require insurance , umbrella of insurance would be removed .
7. Check towards the conditions on pre-existing diseases . Lesser period will be better .
8. If you have already covered by a Mediclaim policy taken by yourself or your employer and if you feel the amount covered is not sufficient , you may go in for a Top up Health Insurance or Super top up health insurance which will cover you beyond the amount covered by your initial policy .
9. Health policies get income tax rebates under SEC 80D . For details , CLICK HERE
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VIDEO ON " HOW TO BUY A MEDICAL POLICY IN INDIA "
