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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. 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 form Mediclaim 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.
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.· About The Author
Hemant Beniwal is
Principal Financial Planner at Ark Financial Planners. His firm serves Indians
across the globe. Apart from developing Financial Plans and guiding clients
meet their Financial Goals; he keeps interest in research & analysis of
various financial products. His Articles, Quotes & Query Section regularly
features in leading Newspapers & Magazines.
· Disclaimer
All the content on this blog (tflguide) is solely
for the readers general information. This blog contains our personal commentary
on issues that interest us. Nothing on this blog is intended to be a personal
advice and reader is himself/herself responsible for their decisions. Before
acting on any of the information provided, consult your financial advisor. Read More
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