Essentials of Health Policy or good Medical Insurance

CS LLB Pulkit Gupta (   (16631 Points)

26 January 2011  


Essentials of Health Policy or good Medical Insurance Plan

Friends this article is sequel to my article 

 80D- Key deduction for good financial planning (For Both Experts and Beginners) 

(A) Intro - Why I am writing this article !!

$ Well after writing it's 1st part I felt the need to tell you the importance of good insurance plan. The main reason for that was our only objective to take Medical insurance is not only to take 80D deduction i.e. tax saving but to also get a medical cover in case of emergency like sickness or accidents. 

$ So my 1st article was basically for beginners like me which only dealt with basic info about 80D but this article is for both experts and beginners. 

$ Actually the main inspiration for this article is one of my friend. He called me and told me that earlier his Insurance Co. (read medical) was taking Rs.15000 as premium and in that it was providing a complete family cover but now it has changed it's policy and excluded some of the members from the plan and also increased the premium amount. So each one of us s'd have complete knowledge about it and with the help of this article I will try to give you basic idea about an ideal Insurance Plan.

(B) Questions you s'd ask yourself before choosing a Medical Plan

(1) What it covers and what it doesn't ??

(2) Is it sufficient according to the size of my family??

(3) S'd I take seperate plan for family members or a combined family plan ?

(4) What is the health need of my family members ??

(5) Coinsurance i.e. how much of my medical bill it will take care of ??

(6) Settlement of claim record of the company etc.

 (C) Features of an ideal Medical Plan

Well nowadays lot of options are available in the market as you can see it from the  commercials in your T.V. But multiple options attracts confusion too. So, we have to be careful while choosing our Health Plan.

Some of the features that we s'd look forward to :-  

(1) Cashless claim - All you have to do is to give your medical card provided by the Insurance Co. to hospital authorities and your expenses will be settled directly b/w your insurance Co. and the hospital.

(2) Coinsurance - How the Hospitalisation expenses will be shared b/w you and your insurance Co. More is their share in expenses more is the premium. You can choose it according to your need.

(3) Reputation - Your Co. s'd have a good reputation in the market when it comes to settlement of claims.

(4) Renewable provision - Well you s'd look for a long-term relationship with your Co. and for that this point is must. No claim in the initial years helps you alot in case of settlement of future claims.

Insurance is available to a person between the age of 18 to 59 years.  However, the Policy can be renewed upto the age  of 80 years.

(5) Sum Insured - Minimum sum insured shall be Rs 50,000/- and can be increased in multiples of Rs 25,000/-upto Rs 5 lacs.  The sum insured must be identical for primary insured and the dependents. In case you or your family member generally doesn't keep well then you s'd go for high insurance cover.

(6) Cover in case of Hospitalisation- his ensures that medical expenses incurred on hospitalisation for more than 24 hours are covered by the insurance company. This may include room charges as well as the money spent towards the surgeon, medicines and other tests.

(7) Tax Saving - Your Insurance Co. s'd be approved by IRDA

(8) Floater(family) Plans - Floater plans cover the entire family under one policy and allow the coverage of the medical insurance policy to be shared among the family member.

(9) Coverage of pre-existing condition- If you have a pre-existing condition, then find out what coverage is offered as part of your health insurance plans comparison. Many times, the company will not cover any part of a condition which was diagnosed prior to the coverage start date. I have seen peolpe facing bitter experience in it.

(10) Emergency coverage - Another must for your health plan is coverage of your emergency medical services. 

So this was all about health insurance plans.....


Pulkit Gupta

pulkit_1988 @