On this article, we reply some questions on medical health insurance requested by listeners of the “Let’s Get Wealthy with Pattu” podcast. These are additionally FAQs that we obtain occasionally from our readers.
Q: This issues the medical Insurance coverage episode on Let’s Get Wealthy with Pattu. I’m a personal sector worker and have a bunch of questions round this:
1. I have already got group insurance coverage from my worker. Do I want non-public medical health insurance as effectively? What are the professionals and cons of it?
A: Most undoubtedly! Except your job is everlasting, you want non-public well being protection. We’ve got heard of instances the place individuals have gotten hospitalization within the two weeks’ time between jobs and needed to pay all prices out of pocket. Don’t take that danger! It might probably set you again severely!
2. Is simply hospitalisation lined below insurance coverage? Can I declare if I am going to the physician for a chilly, cough, abdomen difficulty, and so forth.? Can I declare medicines? Will this influence my premium(influence below each private and group insurance coverage)?
A: Medical insurance is just for hospitalization. Pre- and post-hospitalization bills like physician charges and medicines are lined. Some insurance policies cowl OPD fees however will not be price the additional premium.
3. We all know the sooner you purchase life Insurance coverage, the much less premium you would need to pay. Is it the identical with medical health insurance? I heard from somebody saying regardless of while you begin, you’ll should pay the identical premium. So it doesn’t matter if I begin right now or after ten years; I’ll pay the identical premium after ten years.
A: That is as false as it might get! The premium on buy and future premiums depend upon age, well being circumstances and the insurer’s profitability.
4. Let’s say I depart an organization. Can I carry ahead the group insurance coverage? Or convert it to non-public insurance coverage?
A: Carrying ahead is unattainable. Changing to non-public insurance coverage is, in precept, doable however can include restrictions. Additionally, see Group Insurance coverage Portability to Particular person medical health insurance cowl.
5. Let’s say, for some motive, my insurer will increase my premium. Can I change to another insurer with much less premium? How laborious would that be?
A: Portability is feasible, however the brand new insurer could not settle for your utility or load your premium larger than what you paid earlier! One ought to apply at the very least 45 days earlier than the renewal date. Additionally, see Well being Insurance coverage Portability: What you should know earlier than porting.
6. Ought to or can I’ve a number of medical health insurance? How ought to I plan it? What could be the professionals and cons of it?
A: You’ll be able to. There is no such thing as a benefit per se in doing so except your previous coverage has limitations, however you do not need to port (additionally see beneath). A base plus super-top-up mixture could be extra helpful. See: What’s one of the best ways to mix base and tremendous top-up medical health insurance insurance policies?
7. Is it higher to have separate medical health insurance for every member of the family? Or a bunch insurance coverage for all?
A: A big floater cowl for all wholesome members of the family is sweet sufficient. These above 50 could be lined individually.
8. Will my premium improve each time I declare? If sure, shouldn’t I periodically change my insurer?
A: Declare-based loading or premiums is prohibited. Nevertheless, insurers would discover methods to extend premiums occasionally, as talked about above. Switching a couple of times is smart, however not past that, as all insurers will hike premiums. Some insurance policies are designed to value extra annually!
9. Is there group medical insurance coverage exterior of personal firms? Like group insurance coverage for the entire society or some similar-minded individuals coming collectively for group medical insurance coverage?
A: One can not kind a bunch to purchase group insurance coverage. Even for present societies, group insurance coverage shouldn’t be sensible. The associated fee is not going to be low except there are millions of workers. Change in administration may end up in a change by way of procuring the insurance policies. Group insurance coverage can be getting costly and restrictive attributable to many claims paid out. It isn’t a sensible possibility except there’s an employer concerned.
10. Which medical health insurance do you’ve?
A: Disclaimer: I bought this coverage after I knew nothing about medical health insurance and have since continued it. This isn’t a advice to purchase. We’ve got a United India Coverage overlaying myself, my spouse and son and my mother since 2006. We’ve got made 5 claims up to now. We’ve got regularly elevated the sum insured, and presently, my spouse, son and I have Rs. 25 Lakhs particular person cowl. My 76-year-old mother has a Rs. 6 lakh cowl (hers couldn’t be enhanced).
As well as, we’ve got an excellent top-up from United, with a threshold of Rs. 5 lakhs and a canopy of Rs. 95 lakhs. It is a floater cowl amongst my spouse, son and I. My mother has a separate tremendous top-up of Rs. 15 lakhs with the identical threshold (deductible). Additionally see: United India launches Tremendous Prime Up Coverage with 95 lakhs sum insured.
Earlier than United India modified its room hire sub-limits on its household Medicare insurance policies – New options launched in United India Insurance coverage Household Medicare Coverage – I needed a second set of insurance policies for my spouse and son (I used to be not insurable anymore attributable to Myasthenia Gravis, an autoimmune situation and my mother was too previous). So, I received a base cowl from Future Generali and an excellent top-up from Liberty Insurance coverage through plancover.com. See: Why we bought a 2nd set of base & tremendous top-up medical health insurance insurance policies.
This mix of insurance policies is hardly perfect and fairly costly. Why didn’t I port? As a result of I belief PSUs greater than privates. The full premium is greater than Rs. 1 lakh, however greater than 50% is for my mother’s insurance policies. Once more, please purchase a coverage appropriate to your wants. The above shouldn’t be considered as a advice.
11. After having a coverage for 2 years, if we declare a situation for the third yr, will the ready interval exist for that situation?
A: If we renew the coverage with the identical sum insured, then declaring a situation that developed after coverage inception ought to usually not change a lot. Nevertheless, the insurer can deny a rise within the sum insured in future and even exclude that situation from the additional sum insured.
Say you had a coverage for 5 years and in that 5 years developed an sickness. Within the sixth yr, you want to improve the duvet. The ready interval will apply to the situation for the improved cowl alone. For instance, suppose the ready interval for pre-existing circumstances is 2 years, and you’ve got elevated the duvet from Rs. 5 lakhs to Rs. 10 lakhs. The extra Rs. 5 lakhs can have a ready interval of two years.
So in case you endure hospitalization for that situation inside two years of enhancing cowl, the efficient cowl will solely be Rs. 5 lakhs. After the ready interval, the complete Rs. 10 lakh could be out there.
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