At the time of selecting a health insurance plan, one should select the amount wisely as it covers the medical expenses for a year.

What are the factors I should look into to choose a health insurance policy

I am a 43-year-old with two kids, currently posted in Mumbai. The age of my spouse is 39. I want to buy a health insurance policy for my family with three dependents. Please suggest me suitable health insurance policy options, how much insurance cover would be enough in Mumbai, and what are the factors I should look into to choose the right health insurance policy.

Ashish

One should have at least 10 -15 lakh of base plan in combination with a low-cost super top-up plan from the same insurance company. We recommend the below-mentioned options with premiums:

1. 10 lakh of Reassure Plan from Niva Bupa + 40 lakh of Recharge super top-up from Niva Bupa – Rs. 24,788(Base)+ 2,079(Super Top-up)= 26,867

2. 10 lakh of Prohealth Protect Plan from Manipal Cigna+ 30 lakh of Super top-up plan – 28.524 (Basic) + 2,490 (Super Top-up) = 31,014

3. 50 Lakh of Lifetime Health Plan – Domestic from Manipal Cigna Health insurance Co. – 32,214

Factors to consider before choosing the right health insurance:

1. Selecting the right insurance amount/Sum insured: At the time of selecting a health insurance plan, one should select the amount wisely as it covers the medical expenses for a year. One should also take a look at his or her income levels to analyze the premium affordable. One should have a sum insured which is 1.5 times of your annual income (Self + Spouse put together).

2. No Claim Bonus: NCB refers to the incentive offered by the insurance company for all the years that you have not filed a claim. Typically it varies from 5 to 50% pa depending on the insurance company and plan. Your coverage amount is increased at the time of subsequent policy renewals for all claim-free years. This factor ensures that the policy is future-ready to get a sizable sum insured enhancement every year. It will ensure that ever so increasing medical inflation doesn’t eat into your sum insured over a period of time.

3. No disease wise capping: This refers to a capping put on various illnesses irrespective of the sum insured in the policy. There shouldn’t be any capping of diseases.

4. Cappings on room & ICU charges in a hospital: This refers to the limit on Room rent and ICU charges on a per-day basis. One must look at buying a policy that covers rooms on a single occupancy basis with actual charges covered for ICU admission.

5. Additional features: There are features like Refill/Annual Free health check-up every year/Wellness features /OPD etc which makes a health insurance policy a “New Age health insurance Plan.”

Query answered by Sanjiv Bajaj, joint chairman and MD of Bajaj Capital. Queries and views at mintmoney@livemint.com

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