My research on health insurance

[abhiaj98]

Recently I had to buy health insurance for my parents (nearing 60) and myself (26). I thought I will share my learnings in very short bullet points.

Firstly, my goal of health insurance is to save my family and myself from financial ruin from those 20L,40L bills and not fret about extracting “value” from it. Ideally I would like to pay premiums for eternity and hope never to use it!

Some non-negotiables:
1. Very high cover. >= 20L.
2. NO copay
3. No room rent limit. Even if your insurance has single pvt ac room, hospitals may cause issue with this and you may end up doing copay.
4. No disease wise sub limits
5. Purchase policy through a well informed agent or agency, who has a history of getting claims approved. Getting insurance claims is a battle sadly, and you WILL HAVE to fight for your claims, big or small, irrespective of insurer. Make sure you have an informed someone on your side.

Now some tricks to lower the overall premiums:
1. Opt for a 25k-1L aggregate deductible. Aggregate deductible is something you pay once a year. So if it gives good discount on your premiums, go ahead. Typical discounts are 25-50%. Can also use company insurance for this deductible. Please check the aggregate deductible is only payable once a year if claim incurred.

2. Get base cover of 10L and then a good super top up. Not a top up but a super topup. Super topup is almost like a separate insurance with (for example) a 10L deductible. Sadly most super topups have a single pvt ac room rent limit. Still, try to get the best super top up.
Pro tip: What some people with company insurance do here is only get a very good super topup plan with 5L deductible, and use company policy for base cover.

3. Check no claim bonus, renewal bonus or other bonus in insurance cover. They can increase cover to 3x or even 4x (like in Hdfc ergo Optima Super secure). For example: a 25L cover becomes 75L cover instantly, and 1cr cover after 2 years in Hdfc ergo Optima Super secure.

Some good to haves:
1. Unlimited restore
2. Opd facilities, but only when you dont compromise with non negotiables.

Now I have gone for Hdfc ergo Optima Super secure (as you may have guessed). It has hefty premiums, especially for parents, but I am thinking to go for a 15L base cover (45L instant cover), with a 25k deductible. This gives me 25% discount on premiums.

 

[Stephen25]

Hi, first of all am telling u that DEDUCTIBLE is a worst feature..

What about if u claim Amount is less than 1 lakh and below..
U have to out of pocket here..

For Base cover using company policy and for super top up using Retail policy is OK but,

Company based all policies comes with room rent and all limits, hence u have pay some amount from your pocket here too..

Optima Secure Plan is OK ( am also having this plan only) but while looking for 10 years down the line 4X of Sum insured is not sufficient in the current medical inflation of 14%.

My wish is check ICICI ELEVATE Policy once, which is leading all Terms and conditions...
Such a GOOD no brainer policy..

Also finally if possible take separate CRITICAL ILLNESS cover policy too...

 

[abhiaj98]

Hi, first of all am telling u that DEDUCTIBLE is a worst feature..

What about if u claim Amount is less than 1 lakh and below..
U have to out of pocket here..

For Base cover using company policy and for super top up using Retail policy is OK but,

Company based all policies comes with room rent and all limits, hence u have pay some amount from your pocket here too..

Optima Secure Plan is OK ( am also having this plan only) but while looking for 10 years down the line 4X of Sum insured is not sufficient in the current medical inflation of 14%.

My wish is check ICICI ELEVATE Policy once, which is leading all Terms and conditions...
Such a GOOD no brainer policy..

Also finally if possible take separate CRITICAL ILLNESS cover policy too...

1. Take the 25k deductible then. Also it’s aggregate deductible, so paid once perhaps year in case of multiple claims and not per claim. Please read my main reason for taking health insurance again.

2. Not all company policies are crappy. Nowadays a lot of employers are giving policies much much better than any retail policy possible, even optima secure, covering all PEDs including cancer from day 1 and maternity cover and what not. So it depends.

3. Agreed, medical inflation is crazy. Min should be 50L cover or as much as possible.

4. Not sure about ICICI elevate. Agent is as important as policy in my opinion. We have a decent hdfc agent assisting multiple members of our family.

5. What is a critical illness cover policy? Doesnt optima secure cover critical illnesses like cancer?

 

[Stephen25]

1. Take the 25k deductible then. Also it’s aggregate deductible, so paid once perhaps year in case of multiple claims and not per claim. Please read my main reason for taking health insurance again.

2. Not all company policies are crappy. Nowadays a lot of employers are giving policies much much better than any retail policy possible, even optima secure, covering all PEDs including cancer from day 1 and maternity cover and what not. So it depends.

3. Agreed, medical inflation is crazy. Min should be 50L cover or as much as possible.

4. Not sure about ICICI elevate. Agent is as important as policy in my opinion. We have a decent hdfc agent assisting multiple members of our family.

5. What is a critical illness cover policy? Doesnt optima secure cover critical illnesses like cancer?

Hi,

Deductible payable once year only I know...
Am asking about.. Suppose u take 50k or 25k deductible in your policy... Then what about the claim Amount of 50k and 25k if arise...
U have to pay from urself..

My suggestion is always don't take DEDUCTIBLE..

Some companies are offering Gud Corporate policy having something like BUFFER for disease related...
Depending on corporate policy only on if u are lifetime working with that company only....
If u don't rely on that company then take separate Retail HI policy...

And HDFC OPTIMA SECURE does not cover Maternity benefits Bro...

Always take policy through Gud knowledge Agent... Instead of Online..

Critical illness cover hdfc is having but taking separate policy is better Bro...

Disc: am also having Optima Secure Policy only... Thought to port to ELEVATE this year...

Refer ICICI CRITI SHIELD policy for Critical illness cover once Bro....