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How to choose the right health insurance cover

Last updated on: July 1, 2011 08:47 IST

How to choose the right health insurance cover

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Suresh Sadagopan in Mumbai


It is almost a cliche to say medical costs have rocketed over the years.

We all tend to spend a lot of time and grey cells on how to save money for the future to fulfil our various goals like children's education, retirement, home purchase and others.

We generally don't give as much thought to medical exigencies as required. Considering, if one does not have a proper medical cover, expenses on medical emergencies can drain out his savings and even put a person in debt.

This means your entire future can get compromised by not having a proper medical cover. Medical emergencies don't announce themselves in advance before striking. Therefore, the only thing to do is to be prepared.

For this, you must start by assessing how much cover would be required and look at the probability of covering most events. A Rs 5 lakh (Rs 500,000) cover for an adult should cover 85-90 per cent of medical situations.

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How to choose the right health insurance cover

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The right approach would be to transfer risk by taking an appropriate medical insurance cover and being prepared to spend if expenses overshoot the same.

We generally recommend individual medical covers. A normal medical insurance policy covers hospitalisation and also includes an exhaustive list of daycare  procedures.

They also cover domiciliary hospitalisation and pre- and post hospitalisation medical expenses. In some cases even hospital daily cash and health check-up expense reimbursement may be included.

These days most policies allow cashless settlement of all the claims.

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How to choose the right health insurance cover

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Depending on the policy, there could be coverage for some atypical expenses like maternity, dental or even eyecare procedures, coming into effect after a certain number of policy years have lapsed. Before selecting a policy, one needs to clearly understand its benefits.

Premium alone cannot be the sole consideration for choosing the policy. Claim settlement is of paramount importance.

If your insurer of choice has a history of processing claims fast and the policy benefits, too, are good, this insurer's policy should definitely make it to your policy shortlist.

There are people who prefer floaters, which are comparatively cheaper. The benefits are similar, but there is one umbrella cover for the entire family. For a smaller premium, one will have to assume higher risks.

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How to choose the right health insurance cover

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Many who are employed enjoy cover from their employers. This would be a group insurance cover, that generally tends to be more beneficial than a general medical insurance policy.

The latter covers pre-existing illnesses from day one and maternity benefits on an immediate basis. Some of these may also allow coverage of parents, who may not otherwise be eligible for medical covers.

Some of these policies also allow one to pay further premiums and increase the cover. The premium in a group medical insurance policy are also lower as compared to normal policies.

There is one major downside to it though this cover ceases when one leaves employment. Today, when people are mobile and change jobs frequently, this can become a problem.

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How to choose the right health insurance cover

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When a person is in transition from one job to another, there may not be any cover at all. This is a pitfall of depending on a group medical cover.

Also, the next employer may or may not have a medical cover as comprehensive. Hence, it is always a good idea to have a separate medical cover, even if you already have one. The separate cover can be at an appropriately lower level.

There are several additional covers like critical illness cover, hospital cash, surgical covers, accident covers and so on. Typically known as riders, these provide additional benefits but are not must haves.

There is no end to the extent of security you may want. Whatever choice you make, make it carefully, after considering your your needs and premium outgo.

The writer is a certified financial planner.



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