Monthly Archives: January 2016

Things to Keep in Mind Before Buying Health Insurance



It is very important to choose a correct health insurance broker. He should be knowledgeable about the various options available in the market. A broker offers unbiased comparison of different policies and helps you make a decision. They are also capable of handling claims and different insurance related matters effectively.


It is important to go for a sum insured that would cover all your family members. A person living in a metro city would require a higher sum insured in comparison to a person who lives in a village, since hospitalization costs are higher in metros. While buying an Insurance Plan, the first thing that needs to be decided is the Sum Insured i.e. how much should the company cover you for.


There are several health insurers in India which provide the cashless facility to the insured person. Before buying a health insurance it is important to check the list of network hospitals that are offered by the insurer. Cashless facility is a major factor as an individual does not have to bother about making payments to network hospitals and then run for reimbursement.

The insurance company will directly pay the amount to the hospital provided all conditions laid by the insurance company are properly met. It is imperative to check the list of network hospitals covered by the insurance company.

Cashless hospitalization at network hospitals must be a key feature that the health insurance policy offers. It makes sure of the fact that you and your family members get cashless treatment, while you get peace of mind from the unreasonably high medical bills.


It is important to understand the maximum permissible age limits offered by the health insurance company. You should check if the health insurance that you are buying discloses the premium to be charged in future. It is always a better option to have a health insurance plan that has a lifetime renewable option because at an older age, it is difficult to get insurance when you need the most.

Earlier it was difficult to get a health insurance for people above 55 years of age. This was rather upsetting since that is the time when the health problem arises. But now, there are several companies which also provide a health policy at an age of 55 years or above.

So it is better to check with your insurance provider about the entry age limits. Renewal Option is one of the important things to check and it basically means the age till when you can renew your health insurance. There are companies which limit it to 70 years whereas few provide till 90 years. The more, the better.


Insurance companies introduced the idea of Co pay and sub limits to prevent unusual expensive hospital’s room rents than required. In a co pay an individual has to the expenses incurred regardless of the amount covered.E.g. If there is 10 % co pay in a single policy, the insurance company will pay only 90 % of the covered expenses and the insured individual will have to bear the 10 % of the bill.

Sub limits: There are many treatments which are capped by health insurance companies to reduce the claims by the hospital. It is always a better idea to choose a policy with less sub limits. There are various general insurance companies which do not have any maximum limit on room rent, so it is always a better option to look for such health insurance plans. Ideally look for health insurance plans which do not have any copayment and sub limits.


Most health insurance companies cover pre existing diseases only after a certain waiting period. Please note that a pre existing disease is not only the disease you are suffering from at the time of purchasing the policy. Any illness caused due to a pre existing health condition is also considered to be the same. It is also important to check the list of permanent exclusions in the policy. E.g. if the insured individual has diabetes at the time of buying the policy, a kidney failure may also be excluded in case it is caused due to diabetes.

Thus it is important to pay attention to these factors and then come to a final decision. If you feel it is difficult to make comparisons, take the free advice of a dedicated health insurance broker. Once you buy a health insurance plan, you might feel satisfied by the fact that you have insured yourself and your family against any possible hospitalization in future. But if you don’t go through the exclusions and waiting periods of the policy, then you might get shocks at the time of claims. So before finalizing any health insurance plan select the one which has least number of exclusions and are precisely defined.



Travel Insurance vs. Travel Medical Insurance: Is There a Difference?

medical insurance

Buying insurance for an overseas trip should be a priority for all travelers. However, the wide variety of policies can be confusing for many applicants.

Americans heading abroad are often presented with choosing travel insurance or travel medical insurance. Many individuals may question if there is a difference between the two types of insurance. In short, the answer is usually that there is a difference. However, the provisions of each policy can vary significantly among insurance providers.

Typically, travel insurance can help tourists who have lost personal possessions or suffered the inconvenience of flight cancellations while travel medical insurance can pay for potentially life-saving treatment abroad.

Here are the fundamental differences between the two policies, as outlined by the U.S. Department of State:

• Travel Insurance

Insures the costs associated with your trip, including cancelled flights and lost baggage. In most cases, it does not cover any medical expenses you may incur while traveling abroad.

• Travel Medical Insurance

Covers the cost of medical attention you may receive while abroad.

Quality travel medical insurance will likely cover overseas medical expenses up to a certain value, and provide for medical evacuation to the nearest suitable medical facility in the most serious cases. This type of insurance also may also cover the expense of medical repatriation, which can cost tens of thousands of dollars.

In conclusion, there is a difference between travel insurance and travel medical insurance. The difference may be ignored by many people leaving the United States, but it is nonetheless critical to their health and safety abroad.


How Coming Health Insurance Exchanges Will Drastically Impact Career And Retirement Decisions


just a few months, open enrolment begins for individual health insurance on the newly launching health insurance exchanges, and with it comes the onset of a new era in health insurance. While the general media focus has been on the penalties associated with the new individual insurance mandate, the reality from the planning perspective is that the new health insurance rules – including guaranteed access to coverage without any health underwriting – will drastically impact client financial planning decisions.

After all, separating health insurance from employment status by ensuring individual coverage is available directly from an exchange allows clients to be far more flexible with their job decisions. Deciding where to work will no longer need to be tied to the availability of health insurance, freeing clients to make job changes, start new businesses, or simply retire before age 65 Medicare eligibility, without worrying about how they’ll get access to health insurance. How many clients would still be working where they are today if health insurance availability was guaranteed regardless of where (or whether) they worked?

On the other hand, the new health insurance rules will require new knowledge and skills for planners, as the health insurance exchanges will ensure access and availability to health insurance, but introduce complex rules regarding affordability.

Health Insurance Under The Affordable Care Act

While a great deal of controversy has been made regarding the provisions under the Affordable Care Act that establish an individual “mandate” beginning in 2014 to purchase health insurance or pay a penalty tax assessment, the real planning impact of the coming new health insurance rules is not the requirement to purchase coverage, but the fact that insurers will be required to offer coverage to anyone and everyone, without any exclusions for pre-existing conditions and without any underwriting based on individual health issues. In fact, under the new health insurance rules, premiums can be adjusted based on four – and only these four – factors: age, number of people in the family, tobacco use, and rating area (essentially an adjustment for cost of living and health care in the geographic region). Notably, pre-existing conditions, getting sick, or other changes in health, are not factors on the list.

Separating Health Insurance From Employment Status

Perhaps the greatest significance of the new health insurance policy rules that take effect in 2014 is not just that anyone will be able to obtain health insurance regardless of their actual health, but how that health insurance can be obtained: for those who don’t receive it through a small or large group employer already (or via Medicaid), anyone will be able to go to the health insurance exchange in their state and obtain the coverage directly, in one of four standardized packages (labeled Bronze, Silver, Gold, and Platinum in rising order of both benefits and costs). Although some state health insurance exchanges will be run by the states themselves, with the rest operated by the Federal government, the distinction is mostly about the control that the states will have for managing their own exchanges; from the client/consumer perspective the reality is simply that health insurance will be available through a health insurance exchange in all 50 states, with no underwriting or restrictions based on individual health conditions.

Financial Planning For Health Insurance

Financial planners will need to begin to prepare for helping clients plan in the new world of health insurance. While coverage for 2014 will be available through health insurance exchanges with open enrolment beginning October 1st, the reality is that most clients have not spent any time considering the implications of this on their current career or retirement decisions. The first step is to begin that conversation, perhaps by asking clients: “If you were assured of having access to health insurance and you (or your spouse) didn’t have to work where you do in order to get access to it, would you still be working and doing what you are doing now?” For many of them, the answer may well be “no” and a planning process to something better can begin.


Known / Unknown Benefits Of Your Health Insurance!


Unaware of what your health insurance plan can provide you with? Never mind most of us fall into the same league. Most of us believe the said about health insurance policies. i.e they cover hospitalization charges, but there is much more to a health insurance than hospitalization charges.

Unaware of what your health insurance plan can provide you with? Never mind, most of us fall into the same league. Most of us believe the said about health insurance policies. i.e they cover hospitalization charges, but there is much more to a health insurance than hospitalization charges.

A traditional health insurance policy provides you with

  1. Peace of mind: With health care coverage, your plan pays some of your medical costs and makes you more at ease.
  2. The FFF- family’s financial future: Having health coverage lessens the likelihood that you’ll have to dip into savings to pay for unexpected medical costs.
  3. Pre and post hospitalization expenses.
    • Room, Boarding expenses
    • Nursing expenses
    • Fees of surgeon, anesthetist, physician,consultants, specialists
    • Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines, drugs and similar expenses.
  4. Sum Insured: The Sum Insured offered may be on an individual basis or on floater basis for the family as a whole.
  5. Cumulative Bonus ( CB) :Health Insurance policies may offer Cumulative Bonus wherein for every claim free year, the Sum Insured is increased by a certain percentage at the time of renewal subject to a maximum percentage (generally 50%)
  6. Cost of Health Check-up: Health policies may also contain a provision for reimbursement of cost of health check up. Read your policy carefully to understand what is allowed.
  7. Minimum period of stay in Hospital: Usually this is 24 hours of hospitalization to be able to make a claim.
  8. Cashless Facility: Insurance companies have tie-up arrangements with a network of hospitals in the country.
  1. Earlier buying health insurance was like buying Nokia phone very few options to choose from. The policies that were available had standard features with a nominal difference in their premiums.
  2. In the past, health insurance buyers had the options of choosing only from PSU companies, of late, with the entry of exclusive health insurance companies in India, you can see the much needed innovation in terms of customer friendly benefits such as lifelong renewal, restoration of cover, portability offered by these key players.
  3. To simplify things, here are some of the good, unique, known and not-so-known health insurance benefits offered by the insurance companies in the recent time:

1. Lifelong renewal

  1. A traditional mediclaim policy has a fixed age limit but some of the policies have eliminated the exit age clause i.e. the customer can enjoy the benefit of renewing the policy and enjoying the health insurance coverage all through his life. This is an important benefit as most individuals need a health insurance policy in the latter years of their life.
  2. Coverage for larger families in one health insurance policy
  3. Typically, a traditional policy would cover only one insured member for the coverage or sum insured but in the recent times family floater health insurance is designed to cover the family’s medical expenses under one umbrella. The sum assured is available to all members.
  4. Oriental insurance family floater covers your immediate family members (spouse, dependent children, parents or parents in laws up to the age of 60 years) while Max Bupa Family First covers up to 13 relationships under one umbrella.

3. Cover restoration

Some health insurance product undertakes to restore the basic sum insured in case the policy holder utilizes the entire cover in a particular year.Along with other companies Under Apollo Munich’s product, the restoration facility can be used to bear the expenses for any ailment/condition that is dissimilar to the one for which the claim has been made. The Religare Care offers an improved restored option where the insured individual does not have to wait for the sum insured to be exhausted.

4. Second Opinion

Standard health insurance policies would cover only one doctor’s consultation fee but in the recent times specialized health insurance companies know the importance of getting second opinion from a specialized doctor and hence offer the benefit of second opinion from a medical practitioner for selected major illnesses. Eg. Religare offer the Second opinion coverage.

5. Vaccination cover

Previously mediclaim polices did not cover maternity expenses, but of late health insurance plans cover maternity expenses and also provide the vaccination expenses for the children. Please note, that this benefit is covered post waiting period for maternity ranging from 2 years to 4 years.
Eg. Max Bupa, Star Health, Apollo.

6.Health Insurance covering OPD expenses

24 hour hospitalization for reimbursement was the traditional way , new health insurance providers cover outpatient department (OPD) expenses, like routine doctor consultations, medical checks, dentist consultation and treatment bills. The inclusion of OPD benefits means that the insured individual need not be hospitalized to seek insurance benefits. E.g. ICICI Complete health and Star Health Comprehensive offer health insurance with OPD benefits.

7.Take advantage of health and wellness tools

Beside from providing financial protection, many health insurance plans offer benefits, resources and incentives to help you and your family get and stay healthy.

These may include coverage for annual check-ups and screenings, and discounts on exercise programs and alternative care treatments. Review your plan materials and take advantage of the programs offered.

8.Varied premium structures

Earlier the premium structures of the health insurance policies remained same all over India, but in the recent times some companies like Bharti AXA, Max Bupa, New India Assurance, Star Health, and L& T Insurance have introduced the concept of Zone based premiums for Metros and Smaller Towns.

The pricing structure for the health insurance policies for smaller towns is lower than the pricing in metro cities mainly because the medical expenditure and cost of treatment is higher metro cities.

9.Daily hospital cash allowance

Really! did any of you know that all the food, commuting, family expenses, all are paid by the insurer! After all even these add up to substantial amount. Yes, the solution to this is your policy. Check for daily hospital cash allowance, in form of pre-fixed, per day cash handouts,this is usually provided without any produce of bills or documents.

10.Convalescence Benefits

Is your recovery not costly? Oh yes hospitalization charges apart some companies also take care of the recovery charges. Also termed as recuperating benefit, this feature promises a lump sum in case of a prolonged stay at the hospital. The duration of prolonged stay usually varies between 7 and 10 days among policies.

In case of some policies, the post-hospitalization stage could be treated as the recuperating period. You need to be
aware of the predefined benefit amount and period.