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Different Types of Mediclaim Insurance

With the changing lifestyle of people all over the world, the choices of people have shifted from healthy to junk, from good to bad, and from safe to unsafe preferences. It has become difficult to imagine a world without accidents, diseases, and illnesses. To go back to a safe and healthy world has almost become impossible and so, precautionary steps have been taken to protect one. With the introduction of Mediclaim insurance, it has become safer for a person to live in today’s world.

Mediclaim insurance is a product that protects the health of an individual from various hazardous diseases and accidents that may arise in the unseen future. It helps an individual financially but also helps the person’s stress and emotional trauma to decrease. A Mediclaim is a product to financially secure your family and helps to cover small to medium levels of dangerous life diseases and illnesses.

Earlier only one type of insurance was in existence, the basic policy is:

  • Individual Mediclaim policy

 Under an individual policy, a single person is covered. In this plan, the policyholder is the premium payer and receives coverage for himself. The premium rate of such a plan is determined after assessing the age and medical conditions of the individual. The benefit and cover are for one individual only.

An individual Mediclaim policy is the simplest form of insurance and is generally preferred by most people. Such a plan allows the person to customize their plan as per their requirement. It also helps the individual to use up the entire coverage for fragile health conditions.

 A person receives coverage for pre-and post-hospitalization, in-patient hospitalization, maternity, pre-existing diseases (after serving a waiting period), and more. The policyholder can also enjoy income tax exemption under section 80D of the Income Tax Act.

  • Family floater policy

 A family floater policy is a plan that covers all the chosen members of a family. Under this policy, all the members are covered under one annual premium paid by the policyholder. The sum assured can be used for multiple hospitalizations of the members of the family floater.

The family floater policy is cheaper for a nuclear family that has a median age of under-40. The floating rate of which member shall be applied varies and is decided by the eldest member of the family or the policy purchaser. Floater policies are cheaper than individual cover in most cases and also more meaningful in covering the risk.

Adding members to a family plan is very easy and flexible. The entire sum assured cannot be used by only one member as the proportions are pre-decided. The validity of a policy is until the end of the term or the upper age limit set by the insurance company whichever comes first, beyond that the policy lapses. A family floater policy also qualifies for tax exemption under section 80D of the Income Tax Act.

In the case of pre-existing disease, both in the case of individual policies and family floater policies, the insured needs to serve a waiting period. In the case of individuals above the age of 40 years, undergoing medical screening is compulsory. As kids cannot have an individual policy of their own, it is possible to cover them under a family floater plan. 

  • Critical illness plan

Critical illness policies cover serious and long-term ailments that usually require special treatment. Critical diseases like cancer, heart stroke, tumour, kidney failure, etc; are coverable under such a policy. Under this policy, the insurance company pays-out a lump-sum once the insured is diagnosed with any such critical diseases.

Treating critical illness costs a fortune over a period of time and these required prolonged treatment and care. If one were to pay these costs from their pockets, it will impose a huge burden on the family resources. With the rise in the treatment costs of illnesses, the expenses may hit the ceiling very soon, thus making treatment unaffordable. A critical illness plan helps cover these costs and receive broader coverage of such diseases.

  • Senior citizen plans

 A senior citizen policy is mainly designed for covering people above the age of 60 up to the age of 75 years. With increasing age, it is more likely that elder people fall sick and suffer from diseases. Normal health insurance does not provide immediate cover to pre-existing diseases, and thus senior citizens cannot depend on such policies.

The plan helps the senior citizen to receive quicker coverage for protecting themselves from diseases. The individual may be already covered under basic health insurance or a family floater plan, but the cover is not adequate to pay the treatment costs.

In senior citizen’s plans, they can enjoy the benefit of the co-payment clause. Co-payment means out of the total hospitalization bill, the insurance company agrees to pay a particular percentage or amount, whichever is lower. Senior citizens enjoy a higher tax exemption of up to Rs.50,000 under section 80D of the Income Tax Act, 1961.

  • Top-up and Super top-up plans

 Top-up plans are the ones that provide additional coverage over and above just a single claim, whereas super top-up is the plan that provides additional coverage over one or multiple claims. The main idea of introducing the top-up and super top-up plans is provide adequate cover to individuals who tend to believe that their existing individual health policy coverage is not enough.

Both these plans do not have any sub-limits. Buying a top-up or super top-up plan is of no use unless and until you have existing personal insurance, as you can claim under these plans only after exhausting the owned policy.

For claiming under these plans, you need to surpass the deductible amount or percent that had been pre-decided while purchasing these plans. Although in a super top-up plan, the deductible level needs to surpass only once, after that, all insurance plans are reimbursable.

While purchasing any one of these plans, an individual needs to choose the deductible amount wisely. The deductible amount shall be less or equal to the base plan. It will help to reduce losses and helps avoid you from paying from your pocket.

  • Personal accident injuries policy

An accidental policy began with the main motive of reimbursing the costs that are incurred during accidents. Although health insurance covers accidental injuries under their policies, accident policy provides broader coverage.

Accident policies cover the costs in the case the policyholder gets disabled, their treatment costs, and, if due to the accident the policyholder expires, then the insurance company is liable to give a pay-out to the beneficiary of the policy.

The different types of accidents that can take place are:

Slip and fall, fire, bites and stings, car accidents, drowning, and more. The policy does not provide coverage to individuals involved in terrorism or acts of terrorism.

Before buying any one type of Mediclaim insurance, you must understand the market and the types of policy for offer. Apart from that, you must understand your requirements from a policy and accordingly to look for such a plan that fulfils your given criterion and works in your interest.

A tip: 

It is always advisable for you to purchase Mediclaim insurance at a young age it will help you enjoy various benefits, which inter alia include:

  • Saving tax
  • While you are young, suffering from a long-term disease is less likely, and thus it is the best time to purchase insurance 
  • It helps you enjoy the benefit of lower premium and broader coverage
  • No waiting period will have to be served, and it will be easier to get your preferred type of plans

Different Types of Mediclaim Insurance

What is the process of filing a claim for a car accident under an accident insurance plan?

For filing a claim, the insured needs to attest the copy, and send it to the insurance company. The other person’s details that are at fault also need to be submitted. Once the investigation has begun, the insured shall gather different types of proofs such as photos, videos of the incident, and other types of proof like eyewitnesses are also considered. Once, the verdict has been decided, the insurance company reimburses all the medical bills.

Individual health plans or Family floater plans; which one is better?

Choosing one of the two types of policies is very subjective. A few points given below can help you make your decision. The points are:

1. Have a look at the age group you want to cover. In case the individual’s age is below 40 but, as family insurance policy considers the entire member’s ages it can lead to an increase in the premium due to a senior citizen being included in the plan.
2. The premium you can afford shall also be considered. Individual plans are more expensive than family policies and the coverage also varies accordingly.
3. The risk factor of falling ill is to be taken into consideration.

After you understand these factors, it will help you to make the right decision of choosing between individual and family insurance plans.

How do I choose the best senior citizen plan?

Some of the factors you should consider while choosing the best plan for senior citizens are:

1. Age of the individual is important, as getting a good coverage plan at an older age is very difficult. The younger the merrier; that is the principle.
2. The waiting period one has to serve before receiving coverage for the pre-existing disease of the individual. Lower the waiting period, the better it is.
3. Sub-limit factors. In many policies, the insurance company sets sub-limits. For example, for a heart attack, the sub-limit is Rs.4 lakhs; this means that even if the coverage is Rs.10 lakhs and the hospitalization bill is Rs.5 lakhs, the insurance company will not reimburse more than the sub-limit amount Rs.4 lakhs.
4. The network of hospitals registered with the insurance company. As the geographical location, of the policyholder, and the network hospital need to be close by, in case of emergency.

These are some of the significant factors one should look into while choosing the best senior citizen Mediclaim insurance.

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