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Freedom From Medical Bills Research Team | Posted On Tuesday, October 28,2014, 11:27 AM

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Freedom From Medical Bills



Life is short. So many things to do so less time. Oh…The dreaded nightmare of wasting time in a hospital. Looking out of the hospital bed window wondering …When will I come out …worse…will I come out.

But I have a good healthy body. A good diet and exercise can do wonders and I will never see a hospital bed. But what if… Oh the mosquito. Dengue…Malaria. Those roadside foods…Diarrhea. Then those costly medicines and Doctor visits and Yes finally…. I am broke.

So what can I do about those costly medical bills...

A health insurance policy popularly called a mediclaim policy is the way out. You have to pay a sum of money (Health insurance premium) to buy this health policy. Your medical bills will be paid back to the extent you have insured yourself.

Need of a health insurance policy

What about my family?

You can also take a family floater policy which pays back the medical bills of yourself, spouse and children. If your wife or child falls sick and is hospitalized the medical bills are paid back.

The family floater takes into account the medical condition of the eldest member in the family insured under the plan and if you are healthy the premiums for the family floater will be less.

See Also: What is E-way bill?

How much will a health insurance policy in India cost me?

If you are healthy and below 35 years of age you pay a health insurance premium of INR 1800-2500 a year and your medical bills up to INR 1 Lakh or lesser are paid back to you for an individual policy if you are hospitalized.

Individual plans

If you pay INR 3000-INR 4000 as a health insurance premium you get back INR 2 Lakhs you have spent on the medical bills. No medical tests are generally required if you are below 45 years of age.

Family floater

If you are below 40 years healthy, married and with 2-3 children you will have to pay a premium of INR 6000-10000 per year for a sum assured of INR 3-5 Lakhs. For a sum assured of around INR 10 Lakhs you would have to pay a premium of INR 15000-20000 per year. Certain policies also provide your family a health insurance cover of INR 50 Lakhs. Premiums could be as high as a Lakh.

See Also: What Are The Tax Deduction Available Under Insurance?

What do you need to check in a health insurance policy?

Sub-limits in a health insurance policy in India

  • The health insurance policy might have a sub limit clause where the hospital room rent is restricted to 1% of the sum assured per day.
  • If your hospital room rent exceeds this amount then the Insurance Company will not pay this. This is an out of pocket expense which you have to pay from your own pocket.

Copayment in a health insurance policy

If you are a senior citizen the insurance Company will insure you only if you bear part of the medical expense. This is a fixed predetermined percentage. You may have to bear 10% of the medical expense incurred and the insurance Company will bear the remaining amount.

Top up and Deductibles

A top up plan kicks in once a certain threshold (set limit) is breached. This set limit is called a deductible.If you take a top up health policy of INR 5 Lakhs with a deductible of INR 3 Lakhs then this policy comes into effect only once your hospitalization expense crosses INR 3 Lakhs.

How would you solve this problem?

You need to take another health insurance policy with a sum assured of INR 3 Lakhs which will cover all expenses below the deductible (Threshold of INR 3 Lakhs).

So why take a top up health insurance policy ?

If you have a person in your family who falls ill a number of times (Chronically ill) or an elderly person then he/she would incur heavy medical expenses.An expense of INR 5 Lakhs will blow the family savings away. A top up policy can save you in such a situation.

Why can’t I take a number of health insurance policies instead of a top up health policy in India?

A top up policy takes effect only once a certain threshold limit (deductible) is breached. As a concession the top up policy charges a lower premium.Savings of 20-40% on your health insurance premium if you take a top up policy instead of an individual health policy.

Conclusion : Read the fine print in a health insurance policy and ask the Insurer if there are any terms (Jargon) you don’t understand and what they mean. This will prevent you getting a nasty shock on your hospital bed when you have to pay medical expenses from your own pocket.

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