Know How Much Health Insurance Coverage You Need
There are different health insurance covers available in the market now. If you are an individual policyholder, maybe it is time to reconsider your health risk cover in 2017. There can be many reasons to revisit your options this year.
- Did you recently get married?
- Are you planning to start a family soon?
- Have you just been blessed with a daughter?
- Do you still find it hard to quit smoking?
- Have you been diagnosed last year with a health problem?
- Do you continue to worry about your parent’s health all the time?
These are some reasons, which are likely to increase your healthcare expenses. It is advisable to focus on your health insurance budget (cover), instead. An appropriate health insurance cover will give you many benefits. At this juncture, you are required to consider your options keeping in mind rising treatment cost closely.
What you need to know before buying a health insurance cover?
| Health (features) | Possible Scenarios (for Mr. X) |
| Your personal health risk assessment | X has a policy from last 5 years. Now he is 40 years old. He should now look at increasing his insurance coverage. |
| Your family health risk assessment | X has a family cover for his spouse and two children. X is 45 years old now. He has an insurance policy for 7 years now. His two children are 10 years and 12 years old. His wife is now 38 years.
His insurance policy should ideally be a comprehensive health cover. His children have grown, and susceptible to injuries, seasonal health disorders like Dengue, fever, etc. He and his wife are also prone to age-related health disorders, with lower immunity now.
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| Your family medical history | X should know his family medical history while buying a policy. If there is a family history of heart disease or diabetes, then he should count that as a high health risk. |
| Your lifestyle health risk assessment | If X is a chain smoker, then he should consider that. Also, an active social life means more eating out, physical stress, accompanying chances of high cholesterol, BP, and other sedentary lifestyle risks. |
| Treatment cost in your city | X is living in Mumbai, for example. His treatment expense will be higher than the one who is living in Indore. |
| Exact benefits of health insurance like cashless treatment, critical illness, etc. | Cashless, large network of hospitals, easy claim procedure, will make your treatment more accessible. |
| Risk vs. premium | Assess your risk (vis-à-vis) treatment cost, and then, arrive at a premium cost. |
| Premium vs. insurance coverage | Assess your annual premium in proportion to the insurance coverage benefit. This is especially applicable for critical illness cover, as you will be paid your total insurance amount in a lump sum. |
Types of health insurance policy
| Policy | Insurance cover | Benefits |
| Individual health insurance plan | Self | Individual health risks are covered. In-patient hospitalization expense is covered.
Benefits such as cashless treatment, no claim bonus, preventive health checkup, tax saving, faster claim procedure, should be included. Usually, Rs 5 lakh insurance coverage should work for a 30-35-year-old individual. The only exception will be critical illness cover (which can also be availed as an add-on cover). |
| Family floater health insurance plan | Whole family | If you need an insurance policy for your whole family, then it is cost-effective to opt for one policy. Your premium will be affordable, as compared to a single policy.
If you are insuring self, wife, and two children, then an insurance coverage of Rs 10 lakh should be sufficient. However, if X has a family history of diabetes, then it should be taken into consideration. Also, if you are planning to include your parents, make sure you take their growing age into consideration. If your father, for example, falls sick frequently, you will have to tread carefully. Your father may need frequent medical attention.
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| Senior citizen health insurance policy | Retired people | If you are retired, living on your pension and savings, then revisit your insurance plan. Include critical illness, increase your insurance coverage; because, if health calamity strikes, you will have to incur a high treatment cost.
It is also advisable for young adults to take this policy for their parents. |
| Critical illness health insurance policy | Individuals or parents | Due to our lifestyle and hereditary reasons, even young people are susceptible to critical ailments like heart attack, cancer, kidney failure, etc. Therefore, it makes complete sense to go for a critical illness policy cover that offers lump sum benefit on diagnosis of a critical ailment. For instance, if your critical illness cover is Rs 15 lakh, then you will receive the entire amount in a lump sum, irrespective of your actual medical expenses. |
In addition to the above cover, you can also go for top-up and super top-up covers to expand your health insurance coverage. These policies kick in once the threshold limit is over. While top-up policies consider the individual medical claims in a year, super top-up policies go with the total medical claims in a year. These policies are apt for people who either have a health insurance cover or covered under their corporate health plan.
Health is wealth, so make sure you buy a comprehensive mediclaim insurance policy that takes care of your medical treatment in case of unforeseen situations.
