Gone are the days when a minor illness could lead to hospital bills in the lakhs. People once believed an insurance policy of Rs. 5 lakhs was sufficient.
However, healthcare costs have soared due to medical inflation and advancements in treatment methods. Today, even an insurance coverage of Rs. 10 lakhs may need to be revised.
In this context, it is crucial to review your health insurance policy and consider adding additional coverage, such as a top-up policy.
A recent report indicated that the average claim amount for health insurance policies has risen to Rs. 81,025, marking a 30.7 percent increase compared to the previous year.
Notably, individuals aged 18-25 are making the most claims, driven by factors such as robotic surgeries, expensive medications, unlimited treatment payments, and enhanced healthcare facilities. Insurance providers are adapting to these changes by offering new policies.
When selecting a health insurance policy, start by assessing your health needs. Consider age, pre-existing conditions, and potential future medical expenses to determine the appropriate coverage.
Review the benefits offered by various health insurance policies. Ensure the policy covers hospitalization, outpatient treatment, ambulance services, and pre and post-hospitalization expenses.
Additionally, check the list of contracted hospitals before finalizing your decision. If you have a family of four, it’s essential to opt for a family floater policy with coverage of at least Rs. 20 lakhs.
Choosing an Insurance Provider: You should carefully select a policy and choose an insurance company based on its claim settlement turnaround during emergencies.
Some companies may promote high coverage amounts and low premiums to attract customers but may complicate claims with extensive questioning or refuse cashless treatment, forcing you to repay expenses and submit bills later. To avoid such issues, select a company with a strong payment history.
Regular Reviews Are Essential: Medical inflation is projected to increase by 12-15 percent yearly. Regardless of your current coverage, it may need to be revised within two years. Review how many years you’ve held your policy and how much you have accumulated, including bonuses.
Keep in mind that a policy with coverage less than Rs. 5 lakhs is no longer practical, especially in cases involving heart issues, kidney failure, neurological diseases, or unexpected accidents, all of which can lead to significant medical expenses.
Therefore, conduct a thorough review of your policy. Increase your existing coverage or purchase a new one. Consider switching to another insurance provider without canceling your current policy if necessary.
Consider a Super Top-Up: When basic health insurance coverage falls short, add extra protection through a super top-up. These policies cover expenses that exceed the limits of your basic health insurance, offering more coverage at a lower premium.
It is advisable to secure a super top-up of up to Rs. 50 lakhs alongside a fundamental policy of at least Rs. 10 lakhs. Some top-up policies even offer protection up to Rs. 2 crores.
However, be aware that there may be limitations. You can purchase an essential policy and super top-up from the same provider or select separate policies for each.
Some top-up policies might not offer cashless treatment, so understand the terms and conditions before deciding.
Avoid Relying on Bonuses: Insurance companies often grant bonuses for claim-free policy years. However, making a claim can result in the forfeiture of these bonuses.
When selecting a policy, focus on obtaining strong protection rather than banking on future bonuses.
While bonuses can increase policy value and provide additional security, it’s essential to ensure that the baseline coverage is substantial enough to protect you immediately, especially in your first year of coverage.
Thoroughly read all relevant documents when taking out a policy. Familiarize yourself with the terms and conditions, and double-check exclusions, the waiting period, and the onset of coverage for pre-existing conditions.