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How to choose the best Health insurance/Mediclaim policy in India?

Updated on February 28, 2016

How to choose the best Health insurance/Mediclaim policy in India?

Often, most people overlook the need for a health insurance/medical cover. The fact is that we never know what medical contingencies we may encounter in our life. A friend of mine recently met with an accident and had to shell out Rs. 2 lakh for a minor surgery and associated medical expenses. He never thought about the importance of a Medical insurance before the accident. With increased stress and mishaps in daily life, more people are availing healthcare and lot of this is met through out-of-pocket expenses that strain your purse. In India, secondary and tertiary care is largely provided by the private sector, thereby raising the costs of Healthcare to individuals.

Most people think that if they are covered by their employer, there is no need to buy a separate health insurance cover. Often, cover provided by your employer will be insufficient and may not cover entire costs for most illnesses or accident. Also remember that if you change your job and even if you buy a new cover immediately, there is a cooling period during which certain type of claims will not be entertained. Further, for self-employed persons or those working in the informal sector, there is a need to insure against loss of income due to hospitalization. Therefore it is prudent to get covered comprehensively even if it means spending a little more for premiums. Tax exemption is available for Health insurance under section 80D of Income Tax act.

Difference between Health insurance and Mediclaim Policy: There is a lot of ambiguity in the way people associate health insurance with Mediclaim and the manner in which companies sell policies to people. Mediclaim is a form of Health insurance but it’s not comprehensive enough to cover the illnesses and health conditions that have become common in today’s world. The main feature of Mediclaim is the cover it provides for hospitalization and treatment for accident and illnesses that are pre-specified. The premium is calculated based on the sum assured for treatment

Health insurance, on the other hand is more comprehensive and broader than a Mediclaim policy. It offers cover against a wide range of illnesses. Some plans offer cover against nearly 25-30 major illnesses. It also offers flexibility to reduce the insurance premium and policy term after a specified period.

courtesy: Times of India

How to select the right Health Insurance policy?

You must choose your insurance policy based on your age, income and family size. If you have a nuclear family, you can go for a Family Floater plan. The cover is shared by the entire family. The premium may be higher but the premium per head will be lower. Some plans cover maternity costs which are suitable for newly married couples. If you are self employed or if you are employed in the informal sector, you need cover for loss of income in case you are hospitalized.

Floater Plan vs Individual plan: Individual plans will cover only a single individual while Floater plans cover the whole family i.e, Spouse and children. Some Floater plan covers parents as well. However, there is a maximum cover limit for a Family as a whole. As such, if multiple members of the family get hospitalized at the same time, the cover may not be adequate in certain cases

Types of Specific Health insurance Plans:

  1. Personal accident cover: Pays a lump sum in case of accidental death or permanent disability. The sum assured is generally based on the person’s income. In certain cases, the sum assured can be as high as 120 times the monthly income
  2. Specialised plan: They provide higher cover and are meant for long-term illnesses like Diabetes, cancer etc
  3. Income protection insurance: Provides cover for loss of income in case you are unable to work due to illness or accident. It pays out an assured monthly amount to meet your regular needs. PNB MetLife offers income protection insurance in India
  4. Travel insurance: This type of plan will cover healthcare needs for people who travel regularly. For example, Tata AIG offers specialized Travel insurance plans in India

Compare Quotes: Before buying a policy, obtain policy quotes from various companies. Compare the features and premium amounts and choose the policy that suits all your needs. Read the policy brochure carefully and immediately clarify any hidden or ambiguous terms and conditions

Consult an insurance adviser: It’s advisable to consult an insurance adviser before buying a policy. Most companies offer such services for free

Top Health insurance plans in India: Some of the popular Health insurance plans are Bajaj Allianz General insurance, HDFC Life, Apollo Munich Health Insurance, Max Bupa Health insurance etc


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    • JvicIndia profile image

      John 22 months ago from India

      Hey, my new hub on Health insurance....hope this is helpful