How To Find The Best Health Insurance Plan For Your Family?

While medical services are getting better day by day, the hospitalization is getting costlier. The cost of health care is touching the sky, which means that you have to be financially prepared to deal with unfortunate situations and circumstances. Health Insurance indeed is a life saver “In Literal Sense”, as it helps you pay the medical expenses when you need it the most.

Health Insurance is a kind of insurance coverage, which covers the cost of your medical and surgical expenses, based on the health insurance coverage you have invested in – i.e. either the company pays the bill directly or you are supposed to pay out of your own pocket, which is reimbursed by the insurer later.

There are many family health plans that you might like to invest in. Unlike an individual plan, a family plan gives insurance coverage to the entire family. This also means that anyone in the family can claim the benefit, in case of hospitalization and/or surgical expenses.

In this plan, more than one member of the family can avail the benefit of the plan simultaneously. Just like you pay for the individual plan, you need to pay a premium for the family floater plan. If you avail individual policies for every member of the family, it turns out to be more expensive.

Getting the Best Health Insurance Plan for You and Your Family

It entirely depends on the family member you are willing to cover and the use of the policy. Here are a few tips that can help you purchase the best health insurance plan for you and your family:

Who are you buying for?

If it is for your spouse and a maximum of up to 2 kids while your spouse and you are below 45 years of age, then go for a family floater health insurance plan.

If you are trying to cover your parents, who are above 60 years of age, then do not try and bundle them in the same plan as you or your nuclear family. The calculation of the premium for a health insurance policy is based on the age of the eldest member if your family. The premium goes up by 100% for people above 50 years as compared to someone who is say 35 or 40 years old. Therefore, cover your parents separately. Plans that are meant for slightly older ages make more sense.

The Amount of Coverage You Need

It is very tough to decide what the ideal amount of coverage one should have. So, here are some questions you need to answer:

1. Do I want insurance to cover all possible expenses?

Can I find something from my savings or self-insurance? Can my employer-provided insurance fund some parts?

If you have a low cover from your company, i.e. up to 2 Lakhs, then do not rely on that cover because when you switch your job or start your own venture, you might need health insurance to control any situation.

What do medical emergencies cost today and how much will it cost five years from now?

Medical inflation in India is about 15%. So, if you calculate in 5 years, the cost of medical procedure would nearly double. Remember that your health insurance should be able to pay your expenses for the next five years at the least.

2. What Else Should You Look At?

Room Rent Limit - This feature causes the maximum distress for those who buy health insurance.

The funny part is that hospitals’ charges are in package rates, which means that the cost of surgery or treatment under the observation of the same doctor at the same hospital may go up by 40-50% depending on whether you choose a shared room, a private room, an AC room, or a Suite.

The Solution: Seek out plans that have no limit on room rent. You can easily find many these days.

Claims Settlement Record - It is depressing to go with a company that does not respond when you need it the most. Look at the percentage of claims it reject and how many it settles each month. Many companies at this juncture would fall off your consideration list.

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How To Plan Your Health Insurance Premiums Well In Advance?

A 40 year-old man buying health insurance for his 35 year-old wife, and two young children has to spend Rs.20,000 annually to ensure a coverage of Rs.7.5 lakhs. Since most health insurance plans have lifetime renewability, he has to keep paying this premium amount, every year, for the foreseeable future.

Unlike term insurance or endowment plans, health insurance does not come with a fixed payment period; therefore, the burden of paying health insurance premium must be looked at as a lifetime commitment.

Therefore, keep your annual health insurance expense in mind when planning your annual budget, so that you do not have to depend on disposable income. If your annual insurance premium is Rs.20,000 and your due date is in August, that means you must have access to that amount in liquid form by the end of July. Suppose your Diwali bonus comes by October, or the Christmas bonus by December - will you have Rs.20,000 to spare in August?

If you keep aside Rs.4000 for 5 months, you will have Rs.20,000 ready by the time your premium payment is due. Timely planning will make sure that the money you had earmarked for a vacation or a wedding gift is not diverted for the sake of your health insurance.

Having an emergency fund is also a good idea, something most wage-earners already practice. This emergency fund should not be used for paying your premium on a daily basis - it should cover a variety of contingencies (the urgent repair of your car, for example).

Financial experts suggest you to keep up to a month’s necessary expenses in a savings account for immediate access. Three to six months of expense can be kept in a savings-cum-fixed account for bigger emergencies.

In case you do not have ready funds when your annual premium payment is due, withdraw from this source and replenish it once you are at ease financially. If all else fails, consider using your credit card to pay your health insurance premium.

Two basic things to keep in mind are:

• Don’t Buy More Insurance than You can Afford: If your annual income is Rs.3.5 lakhs, then a premium of Rs.20,000 will put too much strain on your budget in the long run.
• Keep a Close Watch on Premium Due Date: Assign a number of alerts, ideally at least two - one a month before your due date, and the other a week before. This will give you a month to get hold of enough funds, and if you are unable to do so you will still have a week to gather emergency funds

Failing to pay health insurance premium on time has a number of unique and unpleasant consequences -

1. Your policy will enter a grace period, if you fail to pay by the due date - if you pay within this timespan, the policy will continue with all the benefits you had accrued till date. However during this period of 15/30 days, you will not have coverage.
2. If premium payment is not made within the grace period, your policy will lapse. Your insurance provider may ask you to get a new policy, which means all diagnoses made within your coverage period can now be considered as pre-existing diseases.
3. You will miss out on tax deduction benefits under Section 80D of the Income Tax Act, as well as lifelong renewability benefits as per IRDA regulations. If a 65 year-old man fails to make the payment even during the grace period, after having paid premium regularly for 30 years, the insurance provider may refuse his proposal citing age and pre-existing diseases.

Payment through EMI is a feasible alternative for those who struggle with long-term financial planning. Monthly installments reduce the payment into manageable chunks that put less of a strain on your finances.

"It's very useful for a policyholder for whom say Rs.10,000 is a big pinching amount to pay at one go," said Yashish Dahiya, co-founder and CEO of PolicyBazaar.com.

Things to keep in mind about EMI payments for health insurance:

• This mode of payment is available only for policies exceeding a certain amount.
• The rates will be up to 5% higher, if your payment mode is per month instead of per year.
• If you make a claim in September, then premium for the last 3 months will be deducted from your claim amount.

Industry experts believe that EMI allows greater flexibility to insurance seekers in terms of higher insurance coverage. In many cases, people planning to buy individual policies can consider investing in a family floater policy as the investment is easily spread over a longer time period.

Over to You!

We’re sure now you understand how you can easily manage your health insurance premium payments, well in advance, without having to burn midnight oil. Now, it’s time to put the learning into practice. Go ahead! It’s never too late to being your health insurance payments back on track.

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Dental Insurance In India: Covers And Benefits

Sumit recently discovered the excruciating pain of when one’s wisdom tooth starts to come in. Having endured it for quite some time, he decides to get the tooth extracted before it gets even worse. After asking around a bit about the possible dental options he could take up, he realizes having this surgery will be expensive. Looking at his health insurance plan, he realizes he never opted for the dental cover.

Which insurance companies offering dental insurance in India can Sumit opt for? Are there insurance plans that cater solely to dental health?

When it comes to standalone dental insurance plans in India, there aren’t that many options to choose from. Previously, Pepsodent (HLL) in partnership with New India Assurance had offered dental insurance worth Rs. 1000 on purchase of certain Pepsodent products. This covered only teeth extraction procedures and certain other specific dental issues; no cosmetic dental surgeries were included under this.

However, the good news is that various general health insurance plans do cover oral health or dental care as part of their coverage options. These companies offering dental insurance in India structure their general policies to include health advantage schemes or Mediclaim covers where oral care is covered. At times, one will be able to claim dental expenses along with other reimbursements like cost of hospitalization and cost of medicines. These will also fall under tax benefits up to a specified amount under the Income Tax Act.

What are the types of general insurance policies that may cover dental insurance plans in India?

• Individual Health Policies: These insurance policies will have dental insurance covered under their basic plan, additional benefits or premium covers wherein the customers will have to pay additionally to acquire this benefit.
• Surgery and Critical Illness Policies: This can be seen as a standalone policy that specifically caters a particular kind of illness. Some policies may offer dental surgeries that fall under critical medical procedures as part of their plan.
• Family Floater Health Insurance Policies: Since most of these plans are linked with Mediclaim’s cashless benefits, dental insurance is generally covered as part of the plan for the insured and the family members covered in the plan.
• Preventive Healthcare Policies: Sometimes, policies that cover preventive care like regular medical check-ups, consultation costs can also cover dental requirements.
• Travel Insurance Policies: A few policies may cover dental costs and this can include dental treatments required due to any accident caused during the travel period.
• Personal Accident Cover: Like travel insurance, sometimes personal accident cover will cover dental expenses in the form accidents that may have caused injury to one’s teeth.

Let’s look at a few of these health insurance policies that also accommodate dental insurance plans in India:

Policy	What is it?	Dental Insurance Cover
Bajaj Allianz Health Guard Policy	This individual health insurance package covers in-patient hospitalization costs that may occur due to illness or accidents.	This policy covers dental surgery or treatment of all sorts. This, however, does not cover hospitalization costs for accidents that caused harm to one’s teeth.
Apollo Munich Maxima Health	This individual plan takes care of certain out-patient benefits to take care of illnesses and other regular ailments.	Under its Specialist Cover, this plan aims to take care of specific dental treatments as long as they have not been caused by any accident. This cover also provides treatments for contact lenses and spectacles.
Bharti Axa Smart Health	This is a family health insurance plan which covers costs and expenses by the entire family. This can be for hospitalization, domiciliary treatment, pre and post hospitalization costs, critical procedures, and more.	Unlike the previous two insurance policies, this one covers dental care only when caused due to some kind of accident.
BSLI Saral Health Plan	This has an entry age for up to 65 years and is an individual health plan. This covers regular medical expenses provided the insured supplies the company with the required bills.	Very briefly, this policy mentions under its OPD section that dental expenses incurred for medical check-ups, surgeries, treatments, etc, will be covered.
ICIC Prudential Health Saver	This individual policy will cover claim reimbursements for health care expenses in the form of medicines, diagnostic expenses, and more.	Dental expenses incurred in the form of treatments, consultations, surgeries are covered under this policy.
LIC Health Protection Plus	This is a long term plan for the entire family with hospital cash benefits, major surgery benefit and a ULIP investment component.	This plan does cover all dental expenses incurred.
SBI Life Smart Insurance	This is a comprehensive policy that provides a list of health benefits like hospitalization cum surgical benefits, day care treatments and more.	This covers dental expenses as long as it has not been caused by an accident.
Chola MS Travel Insurance	This policy is taken up for those who want to be insured while they travel. This has different plan types from basic to comprehensive coverage.	Dental expenses incurred while on travel is covered by this policy, under all types of plan (Gold, Silver, Annual Multi-trip) listed.

Over to You!

While there are many plans that will provide dental coverage, standalone dental insurance plans in India are yet to be set off. Thankfully, most general insurance policies will ensure different dental coverage is provided either in the form of hospitalization and surgical costs or in the form of personal accident cover.

Make sure to read the fine print before selecting one’s health insurance to ensure your teeth are insured.

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Does Your Health Insurance Cover Overseas Cost?

Many high-income individuals prefer to get treated overseas in case of critical illnesses, in order to take advantage of the technological advancement in medicine in the. Alternatively, in case of life-threatening diseases you may be compelled to look outside your country for a cure. A major impediment in both cases is the cost.

The average cost incurred in the US in case of a heart attack is $760,000 (over 5 crore rupees), compared to Rs.3.5 lakhs in India. Because of the high cost of healthcare overseas and the unfavorable exchange rate, Indians going abroad find it difficult to make the payment out of their own pockets.

SO, Can the Coverage of Your Health Insurance Extend to Overseas Expenses? Probably not!

LIC’s popular health insurance solution, Jeevan Arogya, makes the following statement in their brochure:

“The Hospital Cash Benefit shall be payable only if Hospitalization has occurred within India.”

HDFC Life’s Health Assure includes the following under the heading of Permanent Exclusions:

“Treatment outside India - Any medical expenses incurred for or arising out of treatment outside India.”

Indian health insurance providers do not, as a rule, include overseas treatment within their coverage; in fact, they explicitly exclude it. As a result, high net-worth individuals often purchase insurance from insurers in their country of preference in order to pay for treatment.

Recently, a number of Indian insurers-three to be exact-have also introduced health insurance plans which specifically target treatment in countries other than India. Considering the rapid economic development in India, this is a good move. Here is a look at your options.

1. Max Bupa Heartbeat:

• Comes in Silver, Gold and Platinum variety, and only the Platinum plan gives worldwide coverage.
• Individual and family floater plans, both available-for Platinum plans, coverage is from Rs.15 lakhs to 1 crore.
• The Family First policy offers coverage across the world, while Heartbeat Platinum offers coverage in all countries except Canada.
• Provides coverage to 9 critical illnesses, as well as emergency medical evacuation and hospitalization.
• Family floater coverage for up to 6 people-2 adults and 4 children (at most)

2. Religare Health Insurance – Care:

• Comes with a variety of options, like Floater plans, Co-payment, and No-claims bonus.
• Does not cover maternity or pregnancy related expenses, other than ectopic pregnancy
•  Minimum age of entry is 5 years.
• Discount for e-policy, family plan, loyalty, co-pay and long tenures.
• International costs will be reimbursed only in India, and in Indian currency.

3. Cigna TTK Prohealth:

• Provides international coverage only in case of emergencies.
• Coverage can be between 2.5 lakh and 1 crore rupees.
• Comes in 4 varieties- Protect, Plus, Preferred and Premier. The first two offers emergency worldwide coverage up to the value of full sum insured, while the last two provide maximum international coverage up to the sum of Rs.10 lakhs.
• Robotic surgery or surgery by remote techniques are not covered under this plan.
  Check all Plans of CignaTTK Health Insurance Here

The annual premium for these plans is much higher than a plan providing equivalent benefits but restricted to India. Here is an estimate of the premium rates for a 40 year-old male with a coverage of Rs.50 lakhs, and other basic features:

Benefit	Cigna TTK Prohealth	Max Bupa Heartbeat	Religare Health Insurance - Care
Policy coverage	2.5 lakhs to 1 crore	15 lakhs to 1 crore	50 to 60 lakhs
Number of diseases covered	International coverage only for emergencies	9	5
Rate of premium	Rs.44,343	Rs.70,474	Rs.40,646
Cashless payment	Not available	Available	Not available
Pre-existing illnesses	International coverage only for emergencies	After two years	After four years

So your typical health insurance plan does not cover international expenses, but you can go for one of these specialized policies which will cover the cost of treatment abroad. As these plans cost more than twice what a similar domestic plan would, the demand is limited as of now.

Here are a few things to keep in mind while purchasing health insurance with worldwide coverage:

• Cashless facility is available in select plans only. It is difficult for insurers to maintain a global network of associated hospitals, so claim is usually entertained with a reimbursement after the fact.
• Unless it is an emergency, make sure you give proper notice before travelling abroad for the purpose of treatment.
• To avail insurance in US and Canada you may have to pay more premium. Consult your insurer before you make specific plans.
• International travel insurance can also come with medical coverage, but in that case the primary purpose of travel cannot be treatment, and coverage is also limited.
• Unlike travel medical insurance, health insurance with international coverage also includes treatment in your home country.

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