All You Want to Know About Mediclaim Policy

All you want to know about Mediclaim Policy

There is a saying that ” an apple a day, keeps the doctor Away…” but this does not apply in today ‘s world . First of all, not everyone can afford to have an apple a day and even if people who can afford, eat impure apples, get sick and then meet doctors. End of the day, we meet doctors more regularly even more than we meet our near dear ones. Do some calculations on your own and find out, how much money you spend on monthly basis just to visit doctor, buying medicine and getting the RECOMMENDED test done. Don’t take into account any hospitalization cost you incurred, else you may well have a high BP.

India Vs USA

Bottom line, The medical expenses are increasing day by day, there is no escape to this. You will be astonished to know that in US, 15% US GDP is all spent on medical cost. 15 % of US GDP means, close to double of India GDP which is over Rs. 5,60,000 Crore. In US 15.3% population is not insured by health cover & another 35% of the population is under insured but in India 88% of the population is not covered by health insurance. Medical expense are now on the rise in India as well. In today’s fast moving and fast earning life, we spent our half working life in 5 star hotels and half in 5 star hospitals(Read: The rising strength of Indian Middle Class). There lies a huge risk with everyone about medical cost hitting ones finances in such a bad way,

that at times, it is beyond repairable. We meet many people who sell even their house/gold or withdrawing from retirement savings just to cover the medical cost. In such a scenario, one has to cover themselves from such a risk and get a good Medical cover in the formMediclaim policy.

What Mediclaim Policy covers

Mediclaim policy covers against hospitalization cost one incur, provide one is admitted for more than 24 hours. It covers various cost during hospitalization including that of medication, surgery, room cost, ambulance etc. It also covers the cost you incur on medication, test, doctor’s fees etc. 30 days and 60 days post hospitalization provided the cost is incurred for the same cause for which one is hospitalized.

Who provide Mediclaim policies Mediclaim Policy is typically offered by General Insurance Companies & health insurance cos.

both in public domain. There are many life insurance companies that also offers such similar products but it is better to take policy from specialist.

Type of Mediclaim Policies

Predominantly there are two types of medical policy available. The most common way of taking such policy is where, you buy a specific coverage called sum assured

for each of the family members for which you want the cover (Individual Plan). The other way of taking the policy is that you buy a sum assured not specific to any particular person in the family but for the whole family, this is known as Floater Policy(Family Plan). For example, a family of four, husband, wife and 2 kids. One may take Rs. 1 Lac cover for each of the person and if any one meets with casualty and is hospitalized, the insurer will pay up to the limit specific to the person. But if you have taken a floater policy, you buy a float cover, let say of up to Rs. 3 lacs for the entire family. Now if anyone in the family, meets with casualty, the cover is up to Rs 3 lacs. But if one has fully used that float, then for that year, insurance company will not pay anything if either the same person or someone else family incurs hospitalization cost. Special policies for senior citizens are also available. Consult a Certified Financial Planner near you before taking the policy because it’s important to first judge your requirement & then select best suitable policy. Also Read: Saving’s not enough, Invest your Money Financial Resolutions

Claim settlement process

There is a myth that taking claim from insurance companies is to difficult. Yes, it is, if you are not aware of methodology and at times, many people file claim for something which they are not covered for or not informing insurer at the time of hospitalization(in case of cashless claims). The system is such that most of the insurance company has a TPA (Third Party Administrator), TPA is an outsourcing agency of Insurance companies that services claims. Once the

policy is taken, insurance company issues card to the Policy holder with name of TPA on it. Policy holder have freedom to select it from list of TPAs with insurance company. In case, one meets with casualty, he/she has to produce the same card in hospital. Earlier, there was a system of reimbursement of expense where in you first spend the money from your pocket and then apply for claim. Now, TPA offers CASHLESS arrangements with many hospitals. if you get admitted such hospitals, the TPA would directly make payment for which you are entitled and hence there is no problem of you arranging Cash immediately.

Tax Benefits on Medicalim Policies

Mediclaim Policy offers tax benefit as well under section 80(D) when premium is paid by any mode other than

cash. A person who is 30% tax slab can income tax upto Rs 12360 by paying Rs 40000 as premium. Check Table:

Users of financial products make costly mistakes, either they buy costly life insurance policy or they ignore cheap Mediclaim Policy and then incur huge cost. Choice is yours.

Introduction to Health Insurance in India January 7, 2010 · 202 comments

3 Share How many accident you need to realise that you need Health Cover? It takes just one visit to a hospital to make us realize how vulnerable we are, every passing second. For the rich as well as poor, male as well as female and young as well as old, being diagnosed with an illness and having the need to be hospitalized can be a tough ordeal. Heart problems, diabetes, stroke, renal failure, cancer – the list of lifestyle diseases just seem to get longer and more common these days. Thankfully there are more speciality hospitals and specialist doctors – but all that comes at a cost. The super rich can afford such costs, but what about an average middle class person. For an illness that requires hospitalization/ surgery, costs can easily run into five digit bills. A Health insurance policy can cover such expenses to a large extent. Read why Health Insurance is more Important these days compared to Old days

Types of Health Insurance

There are mainly three types of Health Insurance covers:  Individual Mediclaim : The simplest form of health insurance is the Individual Mediclaimpolicy. It covers the hospitalization expenses for an individual for up to the sum assured limit. The insurance premium is dependent on the sum assured value. Example : If you have 3 family members you can get an individual cover of Rs 2 lacs each . In this case each of you are covered for 2 lacs , if 3 members face a need for hospitalization , all 3 of them can get expenses recovered upto Rs 2 lacs . All the 3 policies are independent .  Family Floater policy : Family Floater Policies are enhanced version of the mediclaim policy. The sum assured value floats among the family members. i.e each opted family member comes under the policy, and it covers expenses for the entire family up to the sum assured limit. The premium for family floater plans is typically less than that for separate insurance cover for each family member. Example : In this case if suppose there are 3 family members , you can take a Family floater policy for Rs 6 lacs in total . Now anyone can claim upto 6 lacs in expenses , but then the cover will go down by that much amount for that year . So if one of the family member is hospitalised and the expenses are 4.5 lacs . It will be paid and then the cover will be reduced to 1.5 lacs for that particular year . Next year again it will start from fresh 6 lacs. Family floater makes sense for a family because that way each one in family gets a big cover and probability of more than 1 getting hospitalized in same year is too low untill and unless whole family is travelling together most of the times in a year .  Unit Linked Health Plans : Taking the ULIP route, health insurance companies too have introduced Unit Linked Health Plans. Such plans combine health insurance with investment and pay back an amount at the end of the insurance term. The returns of course are dependent on market performance. These plans are very new and still in development phase. This is only recomended for people who can handle market linked products like ULIP and ULPP . Read who should buy ULIPs .

For a number of reasons, it is advisable to steer clear of unit linked health plans. The best way is to treat insurance purely as an expense. So if you are single, opt for an Individual Mediclaim policy and if you have family, opt for a Family Floater policy. The amount paid (by cheque or debit/ credit card) for health insurance premium provide tax exemption under section 80D for a maximum of Rs.15,000. [ad#big-banner] What is the Ideal Cover for Health Insurance

As mentioned earlier, the cost of Health Insurance depends on the sum assured , age, current health condition and your previous medical history. Higher the sum assured, higher the premium. So what is the ideal health insurance cover requirement? There is no standard answer or thumb rule for this. If we agree that health insurance is important, one has to look at his/ her own lifestyle, health condition, age/ life stage, family history of illnesses and affordability. Keep in mind that most insurance companies limit the sum assured to a maximum of 5 lakhs. Also note that many health insurance policies “provide additional benefits” such as daily allowance, ambulance charges, etc. for hospitalization. Not only are such “benefits” superfluous, they tend to drive the premiums higher. So it is best to avoid such plans and stick to something basic and simple.

Image courtesy Health Insurance provided by Employer

Many employers provide health cover for their employees. Isn’t that sufficient? Three aspects need to be considered in such a case – Is that cover sufficient? Is the insurer good enough? What happens if you change your job? Health insurance is provided as a perk to the employees. So it is important to understand the policy a bit more in detail and to check for coverage. The best way is to ask the HR Department for policy details. Get into details , what is covered , what is not covered ? Many times Employees just think that they have health Insurance and are just relaxed only to find later that it does not cover X and covers Y only upto a limit . That can be a painful situation . Health Insurance for the aged

Till a few years back, health insurance companies were reluctant to provide cover for the aged. But nowadays there are a lot of insurance companies providing policies for the senior citizens. Insurance cover paid for a person of age 65 years and above, can provide additional tax exemption of up to Rs.20,000. But keep in mind that the premium rates are higher for senior citizens. For the employed, another option is to approach the employer to negotiate with the official insurer to provide an option for additional cover to parents. Since the volumes are high, the insurer can provide such added cover at attractive premium rates. One of our readers Pattu has shared a great calculator which he discussed in his comment is uploaded here , If you want to download it , Click here Tax Exemption from Health Insurance Premiums

Sec 80D covers Health Insurance . You can get exemptions of  Upto Rs. 15,000 paid for self + spouse + cildren.  Upto Rs 15,000 paid for Parents (Rs 20,000 if parents are senior citizens) So in total if you pay your health insuance and your parents health Insurance premium , you can save upto maximum of 35,000 .

Note : If you take Health Insurance riders with Term Insurance like Critical Illness cover , the extra premium paid for that will be actually be covered under Sec 80D , not sec 80C . See Tax Rules What is TPA (Third Party Administrators) ?

TPA stands for Third Party Administrator. TPA is a middlemen between Insurer and the Customer . Customer can directly deal with TPA at the time of claim and TPA will help with with all the process of claim settlement . A TPA is a specialized health service provider rendering variety of services like networking with hospitals, arranging for hospitalization and claim processing and settlement. The concept of TPA has been introduced by the IRDA (Insurance Regulatory and Development Authority of India) for the benefit of both the insured and the insurer. While the insured is benefited by quicker & better health service, insurers are benefited by reduction in their administrative costs, fraudulent claims and ultimately bringing down the claim ratios. An insurance company can have more than one TPA and a TPA can serve more than one insurance company. Some of the services TPA provides are  Maintain database of policyholders  Issue of identity card to all policyholders  Provide ambulance service  Provide information to policyholders about hospitals.  Check various investigations  Provide Cashless service  Process claims Health Insurance Claims settlement process

A bit on how health insurance claims processing works. In most cases, the Insurance companies appoint a third part administrator (TPA) for claims processing. That means once the health insurance policy is sold, the insurer passes on the baton to the TPA. In case of a claim, the insured has to get in touch with the TPA for all versification and formalities.

There are 2 ways by which health insurance claims are settled:  Cashless : For availing cashless treatment (only at authorized network hospitals), the TPA has to be notified in advance (for planned hospitalization) or within the stipulated time limits (for emergencies). The insurance desk at hospitals usually helps with all paper work. The claim amount need to be approved by the TPA, and the hospital settles the amount with the TPA/ Insurer. Typically there will be exclusions and such amount will have to be settled directly at the hospital.  Reimbursement: Reimbursement facility can be availed at both the network and non-network hospitals. Here the insured avails the treatment and settles the hospital bills directly at the hospital. The insured can claim reimbursement for hospitalization by submitting relevant bills/ documents for the claimed amount to the TPA. The TPA mode of claims settling has its own problems. The TPA is incentivized to limit insurance claims and they are not the one’s who sells the policy. There are many cases where the insured had a tough time to claim for his hospital expenses. So before taking health insurance it would be useful to check who the TPA is and how good are they when it comes to claims processing. Internet search and a friendly chat with the hospital staff can give you good insight on the insurer/ TPA. There are also some health insurance providers who do not employ TPAs and does claims settlement directly (this is called Inhouse TPA) . Comments , What are the best health Insurance policies you are aware of ? Do you feel it makes sense to buy health insurance at early stage or after getting married only ? Please share your views on this . This is a Guest Article from Ganesh who is an avid follower of this blog and his blog is My Graffiti Page. Please note that this post is NOT intended to promote or suggest any Health Insurance plan. If anyone is planning to take Health Insurance this New Year, the post can possibly provide some useful tips

and pointers for selecting a suitable plan. Your comments and thoughts are most welcome.

Family Protect Premier Insurance

A comprehensive Health Insurance policy that ensures... Poorey parivaar ki poori suraksha. Secure your family against financial emergencies during sudden illness, surgery and accidents as well as against terrorist activities. Family Protect Premier Insurance plan lets you share the entire sum insured among the family members covered under the policy, without any individual upper limits.

Key Benefits        

Comprehensive coverage for your family with floater benefit Cashless claims facility at over 4,000+ network hospitals across India Continue to enjoy quality service even during claim settlements with - ICICI Lombard Health Care - our own in-house health claim processing and wellness team No sub-limits on room rent, doctor fees, and hospital charges or for any disease (except Cataract where 20,000 per eye is applicable). No co-payments for any disease or any hospitalisation expenses Now get a Free health check-up coupon for any one insured family member, valid for the policy period Called a Convalescence benefit, the insured, once during the policy period, is eligible for a benefit amount of 10,000 if hospitalised for any bodily injury or illness as covered under the policy, for a period of 10 consecutive days, or more. The insured will be eligible for a daily cash of 1000 per day for a max. of 7 days, in case the insured is hospitalised for any injury or illness as covered under the policy, for a minimum of 5 consecutive days.

Eligibility and Coverage EC011028MI ^Maximum of 2 adults & 2 kids # If it's not a pre-existing illness

All About Health Insurance Mediclaim 71 rate or flag

By FREEWORKING Ads by Google

National Health InsuranceApnaPaisa.com/Top-6-Factors What to look for before choosing your health insurance plan Royal Sundaram FamilyRoyalsundaram.in/Health-Insurance Good Health. Up To 10% Discount For 3+ Family Members. Buy Now! HDFC ERGO™ Health PolicyHDFCERGO.com/Health_Insurance Cashless Claims with Tax Benefits Covers Hospital expenses. Buy Now! Health insurance: - Health insurance is the insurance which protects from any health emergencies & incurred hospitalization expenses. In this busy and hectic life everybody should have a health insurance policy which can be very useful in emergencies. Health insurance also known as mediclaim policy means medical policy which have the same meaning. Why Mediclaim policy needed? 1- Every human suffers from some illness or injury in lifetime. 2- Emergencies or illness can come anytime without giving any warning. 3- There are no good facilities in government hospitals whereas private hospitals are too expensive. 4- Doctor’s fees, diagnostic charges as well as the medicines value are too expensive. 5- Health is wealth. When should the Mediclaim policy take? Young age, yes this is the right reply for this question because the premium tends to increases with the age and insurance companies gives “no claim bonus” for every year in which no claim is taken against insurance policy. Also this policy also comes with tax benefit of 80D of income tax. Income tax Rebate of Mediclaim Income Tax Rebate Types of policy There are 3 types of Mediclaim policies. 1- Group Insurance: - Group insurance is the insurance in which a group of people of same nature of work under a policy insured. E.S.I is the good example of this policy. 2- Individual Insurance: - individual insurance is the insurance to one person. 3- Floater: - Floater is the insurance plan in which you and your family insured in one plan. The value of sum assured can be used either one person or all divided on one plan. This plan is very popular among Indians as it insured all the family in one plan. Although, the premium amount under this plan is slightly higher than individual insurance plan.



MEDICLAIM IS NOT CASHLESS ANYMORE Mediclaim policies or health insurance is not cashless anymore. Government companies as well as private companies offers a lot of scheme of mediclaim to cover health insurance to the customers of which health...  Health Insurance Policy Mediclaim and Income Tax Rebate Health insurance: - Health insurance is the insurance which protects from any health emergencies & incurred hospitalization expenses. In this busy and hectic life everybody should have a health insurance... Factors which should keep in mind while buying Mediclaim Policy:1- Buy health policy which incurs all the cost of hospitalization as well as medicines and diagnostics. 2- If you have a life insurance plan, buying health policy with same company can give you some rebate in premium. 3-

One can add some features in basic insurance plan.

4-

Every company gives some no claim bonus while re-insuring the policy.

5-

Premium is tax deductible under section 80D of income tax up to Rs. 15000.

6-

Have a floater plan to insured you and your family.

7- Choose cashless plan in which you needn’t to pay the medical expenses initially and then need to claim. 8-

Read carefully the inclusion and exclusion of the mediclaim policy.

9-

If need any medical test for policy do that.

Mediclaim for overseas hospital very soon the mediclaim will be available for the treatment of overseas hospitals. Numbers of companies are launching premium services of Mediclaim which are private as well as state owned companies which do the mediclaim insurance by which a insured person can make his/her treatment overseas. For this the companies target high networth people who wants to cover mediclaim for about 50 lakhs. APPOLO MUNICH INSURANCE COMPANY is planning to launch its overseas mrdiclaim very soon. They also have an optional mediclaim for terrorism too. the company says that our next launch of mediclaim insurance will have no geographical boundries. 

New income tax return form for assessment year 2012-13 Income tax department has released new income tax return forms for assessment year 2012-13. These are much awaited forms as the financial year 2011-12 ends. However income tax department only released five ITR forms which are to be filled by... -46 hours ago



New TDS tax deducted at source rules for financial year 2012-13 In this annual budget of 2012, some changes are made in the rules of TDS (Tax deducted at source) as well as of TCS (Tax collection at source). These changes are made in different section of income tax act in which some has limit increased whereas... -



Tax planning for salaried person in India Salaried persons are the persons who have calculated income in a year. They have a fixed monthly or yearly income. So because of fixed income there are few sources left for

8 days ago







tax planning. The employer and the employee should fix the salary structure in such a way so that the maximum benefit of saving tax is entertained. There are few steps for saving the tax and fixing the pay structure of the salaried persons. - 18 months ago ALL ABOUT CREDIT RATING credit rating is now a days must to get the company on high profile and approve for loans and public subscription. It also must for creating a company. - 20 months ago TAX CONSIDERATION FOR SETTING UP A NEW BUSINESS While setting up a new business, one has to consider the location of the business and the nature of the business. A number of factors have to be taken into consideration in deciding about the location and... - 16 months ago How to submit online rectification request for intimation by CPC Bangalore Sometimes there can be some errors in the intimation send by CPC Bengaluru under section 143(1) of income tax act. One needs to make it correct as this is the matter of money. There is a complete procedure of how to rectify the intimation from CPC... -8 days ago



ALL ABOUT AMALGAMATION When one or more companies merge in one existing company or two or more company merge to form a new company, it is known or called amalgamation under section 2(1B) of income tax act. For valid amalgamation in income tax point of view, these points... - 13 months ago



Changes in TCS tax collection at source in budget There are some changes made in Tax collection at source(TCS) rules in which some transactions are added in the TCS scenario. TCS se the other mode of TDS in which tax is collected on sale of different goods. The tax is collected under section 206C... - 7 days ago







New income tax return form for assessment year 2012-13 Income tax department has released new income tax return forms for assessment year 2012-13. These are much awaited forms as the financial year 2011-12 ends. However income tax department only released five ITR forms which are to be filled by... - 46 hours ago Changes in TCS tax collection at source in budget There are some changes made in Tax collection at source(TCS) rules in which some transactions are added in the TCS scenario. TCS se the other mode of TDS in which tax is collected on sale of different goods. The tax is collected under section 206C... -7 days ago How to submit online rectification request for intimation by CPC Bangalore Sometimes there can be some errors in the intimation send by CPC Bengaluru under section 143(1) of income tax act. One needs to make it correct as this is the matter of money. There is a complete procedure of how to rectify the intimation from CPC... - 8 days ago









New TDS tax deducted at source rules for financial year 2012-13 In this annual budget of 2012, some changes are made in the rules of TDS (Tax deducted at source) as well as of TCS (Tax collection at source). These changes are made in different section of income tax act in which some has limit increased whereas... - 8 days ago Central Excise duty list on all products in India There is always confusion and less knowledge about the central excise duty on different products. The excise duty is vary from product to product and in manufacturing line, it is necessary to know the excise duty rate well before the start of... - 11 days ago Income tax Excise Custom and Service tax rates after budget In this annual budget, Finance minister has purposed some changes in the total taxes including income tax slabs, excise tax as well as service tax. The changes in the tax structure area as follows. Income tax slabs Income tax slabs for the... - 2 weeks ago Excel based form 15G and 15H with auto fill facility



It is high time to give form 15G and 15H of income tax to the deductor of TDS on your deposit. Form 15G and 15H are the declaration to the deductor that his/her income falls below the income tax taxable limit. Income tax has various acts in which... - 2 weeks ago All about scrutiny assessment section 143 3 of income tax act Where the assessee has furnished the return of income, either suo moto under section 139 of income tax or on the order of the assessing officer under section 142(1) of income tax act and the assessing officer wants to verify its correctness in all respects, he may proceeds to make scrutiny assessment in accordance with the following provisions - 3 weeks ago

Health Insurance - 8 Things You Need to Know By PersonalFN | PersonalFN – Wed 15 Feb, 2012 3:19 PM IST

    

3 Email Print

When taking health insurance, what we have noticed is that most people don’t actually do any sort of structured research. Luckily, that’s what we’re here for. This article will go into the salient features of a mediclaim policy that you need to know, address types of mediclaim policies (individual and floater), and also run a brief comparison between mediclaim policies from some popular insurers - all in easy-to-read FAQ format.

Remember,

insurance

is

a

vital

part

of

living

a healthy

financial

life.

Let’s get started.

1. What is a Mediclaim policy?

A Mediclaim policy is a health insurance policy which covers all medical treatment expenses up to the sum assured in case you are hospitalized due to an illness / accident.

Mediclaim policies are issued for a period of one year and are renewed annually.

2. What are Pre - Hospitalization Expenses?

These are expenses you incur before you are hospitalized. They can include doctor’s consultation fees, medical tests, medication, and related expenditures. Mediclaim policies generally cover 30 days expenses immediately before you have to be hospitalized.

3. What are Post - Hospitalization Expenses?

These are expenses you incur once you are discharged from hospital. They can include things such as doctor’s consultation fees, medication, further tests (checkups), and even physiotherapy. The medical expenses you incur in the 60 days immediately after you are discharged from the hospital are usually covered by your mediclaim.

4. What is the Tax Benefit of taking mediclaim?

While this is not a reason for taking mediclaim, it does help that you also get a tax benefit on your health insurance. The premium paid for these policies are deductible under section 80 D of Income Tax Act up to a maximum limit of Rs. 15,000 and Rs. 20,000 in case the person insured is a senior citizen. In case an individual pays health insurance premium for his or her dependent parents then an additional deduction up to a maximum limit of Rs.15,000 is allowed and in case parents are senior citizen then Rs. 20,000 is allowed. To know more about various tax deductions you can avail, read our article titled Easy Tax Saving Tips Beyond Section 80C.

So if you are paying for yourself and your senior citizen parents, you can claim a maximum of Rs. 35,000 p.a. under Section 80D.

5. What is Cumulative Bonus / No Claim Bonus?

In short, it is the insurer’s way of rewarding you for paying a premium and not making any claim. Generally Mediclaim policies provide an additional cover of 5% of Sum Assured in the subsequent renewal of the policy in case there is no claim in the current policy year. This increase in sum assured of 5% every year is restricted to a maximum of 50% of the initial Sum Assured for most policies. If there is a claim in the policy then this additional cover is decreased by 10% on the next renewal. These percentages can vary depending on the insurer and the policy you choose.

6. What are the types of mediclaim policies available?

Mediclaim policies are of two types:

1.

Individual Mediclaim Policy

Individual policy covers only one single person under one policy. The premium in this type of

policy is calculated according to the age of the person to be covered under the policy. Under this policy, if the sum assured is Rs. 5 Lakhs then the person insured can claim up to the maximum limit of Rs. 5 Lakhs. 2. Family Floater Mediclaim Policy

Family floater policy covers the entire family i.e. self, spouse and the dependent children under one single policy. The premium under this type of policy is calculated according to the member with the highest age in the family. Under this policy, if the sum assured is Rs. 5 Lakhs then any one person individually or the entire family jointly can claim up to the maximum limit of Rs. 5 Lakhs. 7. Can you briefly compare some key insurer’s mediclaim policies?

Definitely. Below is the comparison between features of Mediclaim policies provided by different insurance companies:

COMPANY

NEW INDIA

ENTRY AGE 18 - 60

RENEWAL UP TO AGE

PRE-EXISTING DISEASES COVERED FROM th

Lifetime

5 year

NO CLAIM BONUS 5% of SA

CASHLESS FACILITY AVAILABLE

FAMILY DISCOUNT

Yes

10%

Yes

5%

5% Discount UNITED

1 - 60

th

Lifetime

5 year

every year (max 25%)

th

-

Yes

-

th

-

Yes

10%

Yes

-

ORIENTAL

18 - 45

Lifetime

5 year

BAJAJ

1 - 65

80

5 year

5% of SA NATIONAL

18 - 59

th

80

5 year

every year (max 50%)

The policy you choose will depend on the cover you require, the features you feel will be most beneficial to you, and of course - your financial planner’s insurance recommendation based

8.

on

What

is

your

a

Top

needs.

Up

plan?

Earlier, most insurance companies limited their mediclaim to Rs. 5 lakhs. This is no longer the

case, there are many insurance companies which allow even more than Rs. 10 lakhs of health insurance cover. However, this was not always the case. And also, some of the companies that allow higher cover might not be your first choice of insurer. So earlier, if you wanted more than Rs.

5

lakhs

cover,

your

best

option

was

to

go

for

a

Top

Up

Plan.

Top Ups provide you additional coverage at a low cost. Top up plan covers medical treatment cost over and above the actual Mediclaim policy and thus increase the total sum assured. Top up plan can be taken for an individual as well as for the entire family. However top up plans are available only if the sum assured taken in the Mediclaim policy is between Rs. 3 to Rs. 5 Lakhs.

For

example:

Our favourite fictional character, Mr. Shah has taken a Mediclaim policy for a sum assured of Rs. 3 Lakhs and a top up plan for Rs. 7 Lakhs, so his total sum assured is Rs. 10 Lakhs. If a claim arises for a sum of Rs. 8 Lakhs then the first 3 Lakhs has to be borne by the Mediclaim insurance company and next Rs. 5 Lakhs is to be paid by the company from which top up plan has been taken.

Remember that the Insurance Company from which the top up plan has been taken will not be responsible

for

claims

arising

up

to

the

sum

of

Rs.

3

Lakhs.

Top up insurance plans are targeted by insurance companies to those customers who already have Mediclaim insurance policies but find their cover to be low and hence these customers want to add additional cover. Now, if you are also thinking that your Mediclaim policy is not sufficient to cover your expenses in case of hospitalization and the present insurer is not ready to increase the cover, then a top up policy from another insurer is the solution for you.

Conclusion

Remember, there is absolutely no reason to not have enough mediclaim insurance. The costs you will incur on increasing medical expenses as inflation continues and as you grow older can be greatly reduced by the right insurance policy. And these savings can be channelized towards building a strong mutual fund portfolio to help you achieve your life goals faster. So be sure to take the right policy, and if you have any questions, don’t hesitate to Contact Us.

This note is authored by PersonalFN, a service brand of Quantum Information Services Pvt. Ltd., which has over 10 years of expertise in researching Mutual Funds and also provides

unbiased views on Mutual funds, Insurance, Gold and Fixed Income instruments in India. PersonalFN provides premium mutual fund research and financial planning solutions to individuals. and also powers research services for Quantum Equity Fund of Funds, a product of Quantum Mutual Fund. @YahooINFinance on Twitter, become a fan on Facebook FEATURED PHOTOS AND VIDEOS

Let's Uncomplicate Health Insurance Plan Easy Health Insurance Plans are designed in a way to suit your need and fit your pocket. They will not only guard you against the spiraling medical costs but will also guide you on the path of wellness, providing you a double protection of prevention and cover. The Easy Health Insurance Plans are available for Individuals (Easy Health Individual Health Insurance Plan) and Families' (Easy Health Family Health Insurance Plan). These Plans manage you and your families health-related needs right from consultation and hospitalisation to the post-hospitalisation. These policies are available on a cashless basis in over 4000 network hospitals thus managing your expenses and providing hassle-free transactions. To let you decide the right policy that suits your needs, we have made three variants available, which give you a choice and freedom to decide your premium. The Easy Health Insurance policies are power-packed with unique features like cash credited on daily basis on choosing shared accommodation, daily cash for accompanying an insured child, maternity expenses*, health check-up, spectacles, contact lenses, etc. and out-patient dental treatment**. *waiting Period of 6 years (Easy Health-Individual Health Insurance Plan) and 4 years (Easy Health-Family Health Insurance Plan) ** waiting period of 3 years Let's Uncomplicate With best-in-class benefits

 

Wide options Choose from the wide choices of the sum insured starting from Rs 1 lac to 10 lacs.



Pre-Hospitalization and Post-Hospitalization cover Pre-Hospitalization and Post-Hospitalization cover takes care of medical expenses incurred for treatment before and after hospitalization. It gives you relief from the medical expenses incurred before and after the hospitalization, that can sometimes prove to be as costly as the hospitalization expenses. Intimate your insurer about the hospitalization as per the policy guidelines and enjoy benefit of it.



Cumulative Bonus-The insured receives an increment on the sum insured on account of a claim free year. The policy entitles the insured to a bonus amount on every renewal. In case of no claim the bonus gets accumulated, hence increasing the coverage amount at no extra cost.



Tax Benefits Get tax benefits for the premium amount under Section 80D of the Income Tax Act.

Portability-A customer-friendly policy that ensures that you avail of most of the accrued benefits when you opt for Apollo Munich Health’s Easy Health Insurance Plans. Assuring the availability of best healthcare, they promise wide ranging benefits. It assures a trouble free medical care giving a provision for a secured tomorrow. The reasonable insurance cost resolves the affordability issues for all.

Let's Uncomplilcate With value-added services Health Risk Assessment We offer our customers maximum health benefits with minimum efforts. The globally validated online health risk assessment is provided to all our customers. This helps them to profile their health status, and will also offer personalised wellness recommendations on diet, lifestyle, nutrition, etc. Cashless Hospitalisation Our policies, in addition to reimbursement of claims at all hospitals, are valid on a cashless basis in over 4000 hospitals.

All insured members can call the Healthline and quote their unique customer ID (provided with the policy) to reach our experts and avail primary consultation, health-related consultation, individual referrals, health information, nutrition and diet, at no extra cost.

Let's Uncomplicate With wide choices We offer three plan variants, to help you choose what’s best for your needs. The cover amount ranges from Rs.

1,00,000 to Rs. 10,00,000 according to the product variant you choose.



Standard Plan The plan is formulated with an objective to get adjusted in varied budgets. It makes health insurance easily accessible by starting the range of sum insured from Rs. 1 lakh. It facilitates the services like day care procedures and emergency ambulance. Health insurance has been simplified with such affordable health care services.Read more…



Exclusive Plan It offers the basic health coverage along with certain extra and unique features. It takes care of the maternity expenses and provides an additional optional coverage for eight critical or life-threatening illnesses. Under the canopy of a comprehensive health cover it assures quality health services to the insured. Read more…



Premium Plan This plan provides more extensive benefits like access to an e-opinion. The advice from our expert panel of doctors guides you through your illness or medical situation. The feature of health check up makes this plan replete with beneficial services. This variant is the one for those looking for comprehensive coverage and value added services. Read more…

Terms of Renewal



We offer life-long renewal unless the Insured Person or any one acting on behalf of an Insured Person has acted in a dishonest or fraudulent manner or any misrepresentation under or in relation to this policy or the Policy poses a moral hazard.



Maximum Age –There is no maximum cover ceasing age in this policy. For Additional cover of Critical Illness maximum cover ceasing age in this policy would be 70 yrs.



Waiting Period - The Waiting Periods mentioned in the policy wording will get reduced by 1 year on every continuous renewal of your Easy Health Insurance Plan.

 

Renewal Premium- Renewal premium are subject to change with prior approval from IRDA. Sum Insured Enhancement – Sum Insured can be enhanced only at the time of renewal subject to no claim have been lodged/ paid under the policy. If the insured increases the sum insured one grid up, no fresh medicals shall be required. In cases where the sum insured increase is more than one grid up, the case shall be subject to medicals. In case of increase in the Sum Insured waiting period will apply afresh in relation to the amount by which the Sum Insured has been enhanced. However the quantum of increase shall be at the discretion of the company.

Download brochure Disclaimer This is only a summary of the product features. The actual benefits available are as described in the policy, and will be subject to the policy terms, conditions and exclusions. Please seek the advice of your insurance advisor if you require any further information or clarification.

Mediclaim Policies in India Health and medical care has become the need of every individual. Everybody wants to have quality healthcare solutions. But huge treatment expenses keep them away from quality care that they require. The above mentioned scenario has augmented the importance of mediclaim policies in India. As we know that large number of Indian citizens belong to middle class society and thus, cannot afford the evermounting medical costs. But, this does not mean that they should end up with poor quality health care services. The only solution to their problem lies with Health insurance companies. They can pay a small premium amount and can get the required health cover through mediclaim policies in India. Different insurance companies offer different Mediclaim services. In order to avoid running for the arrangement of funds in case of an emergency, insurance companies offer you cashless hospitalization, where you can avail the quality treatment for free. Your payment would be settled by the insurer. So, you can visit one of the network hospitals and get the treatment. This cashless hospitalization facility is only for inpatients and available only in insurer's network hospitals. Apollo Munich Health Insurance Company gives you this facility for free with each product. If you want to avail treatment in non-network hospital, your expenses will be reimbursed against the medical bills. So, no matter wherever you reside in the country, your treatment expense, up to the sum assured, during the risk period will be paid by the company. Hence, these mediclaim policies in India have helped a great deal in providing a quality healthcare solution to the masses.