Overview of Health Insurance Plans in India
Since there exist several health insurance plans in the market today, selecting a plan for yourself may seem daunting. While there exist generic health insurance plans designed to cater to a wide number of medical crises, some plans have been designed to pander to expenses arising from specific diseases that individuals might be diagnosed with like cancer and diabetes. Now, while different factors impact the likelihood of a given individual developing a serious medical condition, it is important to understand how to select a health insurance plan that provides you with adequate coverage. Continue reading to understand how to do so.
How Much Health Insurance is Required for an Individual
If you happen to be in your mid to late 20s, you may not suffer from any pressing health conditions. This makes the time ripe to consider purchasing a comprehensive health insurance plan that features out-patient department (or OPD) coverage. By selecting a health insurance plan that permits you to enhance your coverage in line with your age, as well as, the current inflation rate, you can lay the grounds to get financial assistance in case of a medical emergency.
After taking into account your lifestyle as well as your long-term plans, you can select a sum insured in health insurance that suits you along with key add-ons that provide you with additional coverage. Popular riders that are often selected include maternity coverage, accidental death rider and critical illness rider.
How Much Health Insurance is Needed for a Family
If you have dependents such as a spouse and children, availing of a family floater plan is recommended. This is because it features a coverage amount that can help financially secure any risks that your dependents may incur without any trouble. This kind of plan enables your family members to take advantage of health insurance benefits. Add-on riders that are popular for such a health insurance plan include newborn cover and maternity cover.
How Much Health Insurance Do You Need for Senior Citizens or Your Parents
It isn’t unusual to include your parents in your family floater plan. That being said, if your parents are over 60 years old, it makes more sense to purchase a senior citizen health insurance policy that is tailored to satisfy their health insurance requirements. If you do add your parents to your family floater plan, you run the risk of driving up the cost of your premium considerably. Selecting a suitable plan that boasts of features and benefits that help cover health risks that your parents might be exposed to is a far better alternative.
Is There Ever a Right Amount of Coverage That One Needs to Look At?
The right amount of coverage is dependent on a number of factors like age, health conditions and the kind of hospital you prefer. Healthcare costs vary to a large extent depending upon the hospital and facilities you select.
Let’s look at an example about a knee replacement surgery. While the cost associated with choosing a domestically made implant will cost you x, the cost associated with using an imported plant is nearly 2x. Income and lifestyle are important factors that one must consider when discerning what their health insurance coverage ought to be.
Although there is no right amount of coverage applicable to a given health insurance policy, there exist two rules one must consider when calculating what the right amount ought to be.
Firstly, health coverage should amount to at least 50 percent of your annual income.
Secondly, the insurance coverage should be able to offset the cost of a coronary artery bypass graft in the hospital of your choice.
Given the rising costs of medical treatment and medicines, individual health insurance coverage may fall short of covering all medical expenses. Enhancing health coverage with riders and top-ups can help offset these costs.
What Does Being Underinsured Mean?
Lifestyle changes have increased the need for a health insurance plan. Although more individuals are in the market to avail of health insurance plans in India today, the instances of individuals being underinsured have also risen. As far as most people are concerned, the process of purchasing health insurance comes to a close once they have selected the plan of their choice and paid the premium applicable to it.
That being said, only once they raise a claim against their policy, do they realise whether or not their coverage is sufficient. Given what medical expenses amount to today, being underinsured is almost akin to being uninsured. Listed below are the two ways in which individuals may be underinsured.
1. Having an Inadequate Sum Insured
Despite owning the right health insurance plan you may find that the sum insured is low. This may arise if your future requirements have been inaccurately assessed. Also, certain policyholders may have voluntarily opted for less coverage to pay lower premiums.
2. Having Inadequate Coverage
In this scenario, the policyholder may have purchased a health insurance plan that features a sufficient amount of sum insured. However, he (or she) may only realise at the time they raise a claim that the said policy doesn’t extend coverage towards certain critical ailments. This scenario can arise if the policyholder hasn’t done adequate research before purchasing his insurance policy. This highlights the importance of reading the fine print before buying a health insurance policy.
How Can You Avoid the Risks of Being Underinsured
To avoid the risk of being underinsured, follow the steps mentioned below which will help you avail of sufficient health insurance coverage.
Take a look at and assess your current financial situation. This involves you taking into account your lifestyle, habits and family medical history before purchasing a health insurance plan.
Make it a point to read the fine print of a health insurance plan. Exclusions and conditions must be taken into account before buying a health insurance plan.
Select a sum insured amount that is more than enough to provide coverage for you and your dependents. Ideally, this figure should amount to 30 to 50 times your current annual income.
Don’t hesitate to reach out to the concerned insurer and have your queries about your health insurance terms and conditions addressed.
Factors to Consider While Opting for Health Insurance
When selecting an appropriate health insurance plan, you must always take into account the following factors.
Your current health condition along with your family’s medical history play an important rolewhen selecting a health insurance plan. Certain health complications are taken into account by insurance providers when determining the risk associated with insuring an individual. Certain insurance providers may offer to provide coverage for pre-existing conditions only after a predefined waiting period in health insurance has passed. Else, they may choose to exclude such conditions from the policy. Opting for a comprehensive health insurance plan is particularly important if you suffer from a disease or have a history of family illness. It is recommended that you don’t conceal any details from your insurance provider as it may lead to your claim being rejected in the future.
Today's affordable health insurance premium plans encourage young people to invest in health insurance. This means you can enjoy the benefits of a low premium-high coverage plan as a twenty something. Also, it is also possible to complete the waiting period in time to safeguard your health.
The higher the sum insured, the higher the premium. While other factors are also taken into account at the time the premium is determined, you must only select a plan that you can afford to pay. If you haven’t begun earning a salary yet it may not be feasible for you to pay a high premium. The premium amount must also help you decide whether to opt for an individual health insurance plan for yourself and your dependents or a family floater plan. Ensure that you have sufficient coverage so that you can cover your healthcare expenses in case of an emergency.
Insurance providers take into account your annual income when determining what insurance coverage you will be eligible to avail of. It is recommended that you select the maximum sum insured available to you that is appropriate for your insurance needs. In case you are purchasing a family floater plan you must take into account your family members’ considerations and set them against your income.
Tax benefits apply to health insurance plans as per section 80D of the Income Tax Act of 1961. These benefits entitle you to make a claim on the premium you paid towards your policy with a cap amounting to INR 25,000 provided you, your parents or spouse fall below the age of 60. If you are a senior citizen, this claim is capped at INR 30,000. You can plan your insurance coverage accordingly in order to avail these tax benefits.
Conclusion
After having read this article, you should be well versed with the merits associated with availing adequate coverage under your health insurance plan. It is recommended that you evaluate your insurance requirements and assess your health insurance plan with regularity such that you are familiar with your coverage. If you would like to learn more about health insurance plans that provide comprehensive coverage, visit the Bajaj MARKETS website.
