On this article, we reply some questions on medical insurance requested by listeners of the “Let’s Get Wealthy with Pattu” podcast. These are additionally FAQs that we obtain every now and then from our readers.
Q: This considerations the medical Insurance coverage episode on Let’s Get Wealthy with Pattu. I’m a non-public sector worker and have a bunch of questions round this:
1. I have already got group insurance coverage from my worker. Do I want personal medical insurance as properly? What are the professionals and cons of it?
A: Most undoubtedly! Until your job is everlasting, you want personal well being protection. We now have heard of circumstances 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 threat! It may well set you again severely!
2. Is simply hospitalisation coated beneath insurance coverage? Can I declare if I am going to the physician for a chilly, cough, abdomen problem, and many others.? Can I declare medicines? Will this affect my premium(affect beneath each private and group insurance coverage)?
A: Medical health insurance is just for hospitalization. Pre- and post-hospitalization bills like physician charges and medicines are coated. Some insurance policies cowl OPD prices however aren’t 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 insurance? I heard from somebody saying regardless of if you begin, you’ll must pay the identical premium. So it doesn’t matter if I begin at this time or after ten years; I’ll pay the identical premium after ten years.
A: That is as false as it may well get! The premium on buy and future premiums depend upon age, well being circumstances and the insurer’s profitability.
4. Let’s say I go away an organization. Can I carry ahead the group insurance coverage? Or convert it to non-public insurance coverage?
A: Carrying ahead is not possible. Changing to non-public insurance coverage is, in precept, doable however can include restrictions. Additionally, see Group Insurance coverage Portability to Particular person medical insurance cowl.
5. Let’s say, for some cause, my insurer will increase my premium. Can I swap to another insurer with much less premium? How onerous 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 not less than 45 days earlier than the renewal date. Additionally, see Well being Insurance coverage Portability: What it’s essential know earlier than porting.
6. Ought to or can I’ve a number of medical insurance? How ought to I plan it? What could be the professionals and cons of it?
A: You possibly can. There is no such thing as a benefit per se in doing so except your previous coverage has limitations, however you don’t want 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 insurance insurance policies?
7. Is it higher to have separate medical 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 will be coated individually.
8. Will my premium improve each time I declare? If sure, shouldn’t I periodically swap my insurer?
A: Declare-based loading or premiums is prohibited. Nonetheless, insurers would discover methods to extend premiums every now and then, 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 price extra annually!
9. Is there group medical insurance coverage outdoors 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 will not be sensible. The associated fee won’t be low except there are literally thousands of staff. Change in administration may end up in a change when it comes to procuring the insurance policies. Group insurance coverage can also be getting costly and restrictive as a consequence of many claims paid out. It isn’t a sensible choice except there may be an employer concerned.
10. Which medical insurance do you’ve?
A: Disclaimer: I bought this coverage once I knew nothing about medical insurance and have since continued it. This isn’t a suggestion to purchase. We now have a United India Coverage overlaying myself, my spouse and son and my mother since 2006. We now have made 5 claims thus far. We now have progressively elevated the sum insured, and at present, 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 a brilliant 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 High 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 wished a second set of insurance policies for my spouse and son (I used to be not insurable anymore as a consequence of Myasthenia Gravis, an autoimmune situation and my mother was too previous). So, I bought a base cowl from Future Generali and a brilliant top-up from Liberty Insurance coverage through plancover.com. See: Why we bought a 2nd set of base & tremendous top-up medical insurance insurance policies.
This mixture of insurance policies is hardly supreme and fairly costly. Why didn’t I port? As a result of I belief PSUs greater than privates. The overall 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 seen as a suggestion.
11. After having a coverage for 2 years, if we declare a situation for the third 12 months, 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 sometimes not change a lot. Nonetheless, 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 12 months, 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 could have a ready interval of two years.
So in the event 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 accessible.
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