We get a lot of reader queries asking for the right amount of health insurance cover to buy and the most efficient way to buy it. We asked the experts on how much health insurance cover is necessary and the most efficient way to buy it.
Priya Sunder, director, PeakAlpha Investment Services Pvt Ltd.
When you buy health insurance, remember to buy for the future. If a heart surgery cost Rs5 lakh today, it may cost Rs80 lakh 20 years later. The lowest cover you must have is Rs20 lakh, going all the way to a crore. Look for policies that increase your insurance cover every claim free year. Avoid including elderly members in a floater cover. Consider a top up cover with a deductible to enhance your existing insurance. Such covers are cheaper than basic plans since they kick in only after a threshold has been crossed. Buy medical insurance when you are young and healthy and don’t depend on your company’s group health insurance.
Mahavir Chopra, director-health, life and strategic initiatives, Coverfox.com
With advancement of medical science, people are more likely to suffer and survive a lifestyle disease that will result in medical treatment. Looking at the healthcare inflation coupled with the lifestyle disease epidemic across cities and towns, a future proof health insurance cover for a young family living in an urban area should be a floater cover of Rs10 Lakhs, supplemented with the maximum top-up available, taking the cover to around Rs20-25 Lakhs. Major treatments that today cost an average of Rs5-6 Lakhs and at a 10% inflation will be billed at around Rs10 Lakh in 8 years and Rs20 Lakh in 15 years, that is when you are most likely to need a medical cover. For senior citizens an individual Rs5 Lakh cover with a super top-up cover of Rs5 Lakh should be adequate.
Nayan Shah, managing director, Paramount Health Group
For a middle class family, minimum sum assured of Rs5 lakh is necessary. One can opt for a floater policy and if the parents are included the sum assured can be Rs7.5 lakh. Over and above this a ‘top-up’ plan can be bought that kicks off after the basic sum assured is utilized. One can also look at a critical illness insurance policy that pays the insured a lump sum irrespective of treatment cost. In Urban areas and for those who want to get treated in the higher class of admissions like a single room or deluxe room, the treatment cost can high and they should consider an overall coverage of Rs10 lakh for the entire family in a floater policy. They can go up to Rs15 lakh to Rs20 lakh through higher top-ups.
Antony Jacob, chief executive officer, Apollo Munich Health Insurance Co. Ltd
Before finalizing a policy, one should take cognizance of factors such as current health status, life-stage, city of residence, medical history, nature of job, and the extent of coverage an individual can afford. One should be mindful that premium comparison is not the right evaluation parameter while choosing an insurance policy. It is also important to choose the right insurer. It is prudent to take into account the claim settlement ratio. Cashless and reimbursement turnaround times are a reasonable indicator of how fast the processing of claims is managed by an insurer. For a family of two adults and two children living in a metro, a health insurance plan offering features like restore and multiplier with Rs10 lakh sum insured should be adequate.