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Tips to Consider Before Buying a Cardiac Health Insurance Plan

Critical illnesses are on the rise in the modern times. Most of the credit, or should we say blame, for the same goes to our sedentary lifestyles. Given the level of uncertainty combined with exorbitant healthcare costs, we need a contingency plan lest we fall prey to critical illnesses! However, unlike regular hospitalization, critical illnesses often require multiple invasive procedures, expensive diagnostic tests, longer duration of treatment etc. In some cases, the condition is chronic and requires lifelong care. If this is the state of affairs, being diagnosed with a critical illness is not only bad news for your health but also your pocket! 

Apart from dealing with the emotional turmoil that you and your family might be going through, you will also need to shell out huge sums of money towards treatment of a critical illness. Apart from that, when it comes to your health you should not compromise on the quality of treatment either. The best is what you deserve. So, how do you deal with this predicament? That is where a well-chosen critical health insurance plan to your rescue! 

Critical illnesses include cancer, renal failure, heart attacks, multiple sclerosis etc. There are plans tailored for specific critical illnesses too, like cardiac health insurance plans.  Cardiac health insurances are designed to provide exclusive financial protection focused on cardiac diseases and procedures. So how do you choose the best cardiac health insurance plan for yourself? How do you decide if you need one? What are the illnesses you should look for in a critical illness plan? Will having just a cardiac health insurance plan be enough cover for you and your family? 

Here are a few points you should mandatorily take into account before buying a cardiac health insurance plan: 

  1. Your current life situation 

The first point to be considered while purchasing a cardiac health insurance policy is your current life situation. Do you want health insurance for your whole family? Do you have dependent elderly parents? If yes, purchasing a cardiac health insurance plan is a good choice as it provides cover for sudden ailments like heart attacks. 

Having a critical illness policy that covers cardiac illnesses as well as an additional layer of security for your family is always a good idea. This is more so if you have family members who are vulnerable to that particular illness or genetically prone. You can buy a cardiac health insurance plan as an add-on to your regular health insurance plan or as a standalone policy. 

  1. Your health status

Cardiac ailments are more likely to occur if you have a family history of hypertension, artery blockage, myocardial infraction etc. Your current lifestyle also affects your risk of contracting heart ailments. If you lead a sedentary life with little scope for physical exercise then you are generally prone to developing illnesses related to the heart. Similarly, if you have a stressful job or family responsibilities you are at greater risk of contracting cardiac illnesses than if you lead a relatively stress-free life. 

In addition, there are other lifestyle risks that make you more vulnerable. If you are a smoker, your chances of suffering from a cardiac ailment at some point in your life are higher than if you are not a smoker. Before buying a cardiac insurance plan, you should consider your current health status and decide if you fall into any of the risk zones. If you do, then you should definitely think about getting a cardiac insurance cover. 

  1. Your healthcare budget

Just like your regular health insurance plan, you should chalk out a budget for your cardiac insurance plan as well. Since it is impractical to buy only a cardiac insurance cover for you and your family, you would probably have an existing health insurance plan or would want to avail a comprehensive health insurance cover. The advantage of a dedicated cardiac insurance cover is that you don’t need to be hospitalized to be eligible to be paid by the insurance company.

It’s a good idea to factor in the amount you are spending on your health insurance premium as well as the amount you can spend on your cardiac insurance premium. Keep an idea of how much you can comfortably spend annually for at least the next 5-6 years before you start looking for suitable cardiac health insurance plans. The idea is to have a comprehensive healthcare package that is affordable and effective, at the same time. 

  1. Desired features of cardiac health insurance plan

Before you start your search for a cardiac health insurance plan that is the best fit, you should have an idea of what you want from your cardiac health plan. This clarity would help you in many ways. For example, if you know that you might need an aortic blockage removal surgery sometime in the future you would have a rough estimate of the expenses involved and in turn, the sum assured that you would like to keep for an emergency. Treatments for some ailments are more expensive than others, so depending upon your family history and the diseases you are at risk to suffer from, you should decide upon your coverage.

  1. Policy research and comparison

Research is one of the most important steps before you buy a cardiac plan or any health insurance plan. Policy research involves looking at the different cardiac health insurance policies available in the market and zeroing in on one that fits not only your budget but also your personal specifics like reimbursement versus lump-sum benefit payments, cashless facility etc. Shortlist a few cardiac insurance plans that suit your preferences, ask for quotes from the insurance company and compare them. 

  1. Sub-limits of your chosen plan

Once you have found the perfect cardiac health insurance plan for yourself and your family, just go out and check the sub-limits of the plan! What is the maximum number of claims they accept per policy year? Are you eligible for all heart attacks or only the first one? Are outpatient treatments reimbursed? How much of the sum-assured is capped for diagnostic tests and how much for surgery? 

While it might seem like a sum-assured of Rs.5 Lakh is great coverage, if surgery costs are capped at Rs.2 Lakh and you are recommended a valve replacement surgery that costs Rs.4.5 Lakhs, then you will have to pay Rs.2.5 Lakhs from your own pocket! To avoid this kind of an unprecedented scenario, you should read the policy document carefully and be aware of the sub-limits of your chosen cardiac insurance plan. Remember, when it comes to insurance contracts, the devil lies in the detail so read the fine print carefully.

  1. Maximum renewability age

If you are buying a cardiac health insurance plan for your elderly parents, be sure to check the maximum renewability age as many cardiac health insurance plans have a maximum renewability age of 65-70. If the maximum renewability age is 5+ years from the current age, then a cardiac health insurance policy is a worthwhile investment. Otherwise, you can consider going for a senior citizen insurance which is specifically designed to safeguard the health of elderly and vulnerable people. 

  1. Waiting period

When you purchase a cardiac health insurance be sure to make a note of the waiting period before you become eligible to avail benefits. If you have a pre-existing heart condition, you might have to wait for a few months to 1 year before the insurance company starts bearing the expenses. In some cases, the insurance provider might agree to waive off or reduce the waiting period in exchange for a higher premium. Just make sure that you are aware of the nitty-gritties in your policy document before making your final purchase. In short, read the fine print.

  1. Inclusions and exclusions

Although cardiac health insurance plans generally provide coverage for all cardiac ailments and procedures, there might still be inclusions and exclusions in your policy. The terms and conditions of the contract include specifics of the sub-limits, exact nature of benefits as well as information related to network hospitals, documents required for a claim, notice period etc. It’s best to be well-versed with your policy document so that you are prepared during the time of an emergency, and there are no last-minute nasty surprises in store for you.


How is a cardiac health insurance policy different from a regular health insurance policy?

Firstly, cardiac health insurance policies do not exclude pre-existing illnesses. Moreover, cardiac health policies offer extensive coverage for all cardiac related illnesses and procedures. In regular health insurance policies, a lot of critical conditions are excluded. Another major difference is that with a regular health insurance plan you need to be hospitalized to enjoy benefits but with a cardiac insurance plan just a cardiac-related diagnosis is enough.

How do I decide my sum-assured for a cardiac health insurance plan?

The ideal cardiac insurance coverage that you need would be a personal decision. Factors governing it would be your lifestyle, health status, family history of cardiac ailments, area of residence, existing health insurance cover, budget etc. Be sure to take into account not only the sum-assured but also the sub-limits of your cardiac insurance plan.

Are accident-related cardiac injuries or illnesses covered under a cardiac health insurance plan?

No, accident-related injuries or illnesses are usually not covered under a cardiac health insurance plan. If you have a personal-accident cover then you might be eligible to avail benefits under that. But again, this varies from policy to policy. Other exclusions from cardiac health insurance plans are ailments due to self-harm, war etc.

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