Will Comprehensive Health Insurance be Sufficient for All Purposes?

Health insurance comes in various types. These include a comprehensive health insurance policy, dedicated plans, etc. Interestingly, a comprehensive plan covers all that a dedicated plan does. But, is the comprehensive plan coverage adequate? The name somewhat hints the same, but we’ll check the FACTS. Plus, what about its terms and conditions? All that you need to do before making the call. Let us do this analysis for you.

So, What is Comprehensive Health Insurance?

Comprehensive health insurance covers a wide range of health conditions – childbirth expenses, general to critical illness-related expenses. You can buy it on an individual or family floater basis. Individual plans will have a separate sum insured for all the policy members. Whereas family floater plans will have the same sum insured for all the family members.

The premium of family floater plans remains lower than that of individual plans. However, the premium of family floater plans depends on the age of the eldest member. In case you add your old-aged parents to these plans, the premium will rise around 2-4 times or even more. For them, you can have a specific senior citizen health insurance plan. We’ll talk about it later.

Comprehensive Health Insurance for Maternity & Newborn Expenses

The arrival of newborns makes the whole family happy through their presence. Planning for the newborns, however, is far more important given the prevailing delivery expenses, which could be around INR 30,000-1 lakh. But that’s not all! Tall prescriptions including numerous medicines before, during and after delivery would further your cost. So, how does comprehensive health insurance fare in terms of maternity & newborn expenses? Let’s find out!

Note – Delivery charges shown above could include pre and post-natal costs.

From the information, it seems a comprehensive health insurance policy covers maternity & newborn expenses adequately.

Terms & Conditions for Maternity & Newborn Expenses

You’ll need to contend with a waiting period of 24 months for maternity cover. A waiting period implies one has to wait before the cover commences. Similarly, the Newborn Baby Cover will begin after 91 days of childbirth. There may be a few plans covering newborns from Day 1 itself.

How Good Comprehensive Health Insurance Plans are for Lifestyle Diseases?

Diseases such as diabetes and hypertension are becoming very common owing to the unhealthy lifestyle most of us are following. Work and family pressures, combined with unhealthy eating habits have led to all these lifestyle diseases and the expenses that follow. To your pleasant surprise, comprehensive health insurance plans cover these diseases. The plan will cover complications related to these diseases before, during and after hospitalization.

Any Terms & Conditions to Contend with?

If you have these diseases before buying the policy, you will need to wait for up to four years. Don’t hide your diseases as claim applications will anyway get rejected. Health insurance companies accept claims based on the health assessments made by the doctors. If the assessment says you had these diseases before buying the policy, the claim will get rejected!

How Do Comprehensive Health Insurance Plans Cover Critical Illnesses?

The expenses involved in the treatment of critical illnesses, such as heart attack, coma, cancer, parkinson’s disease, among others, can make a serious hole in your pocket if left uninsured. Comprehensive health insurance does not cover these illnesses under the base plan. You’ll need to buy a critical illness rider for the same. That will imply an extra premium for you to pay. You will get a lump sum amount upon the diagnosis of a critical illness as specified in your policy.

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Senior Citizen Health Insurance

Above we advocated separate health insurance for senior citizens and gave reasons for the same. Senior citizen health insurance plans covering people aged above 60 years are becoming their status symbol. These plans would have a sum insured ranging from INR 5-25 lakh. These are, however, comprehensive plans only covering diseases and conditions senior citizens can have during the policy period.

Value-added Benefits of Comprehensive Health Insurance Plans

Besides covering people against numerous diseases and conditions, these health insurance policies offer value-added benefits such as sum insured restoration, no claim bonus, daily cash allowance, etc.

Sum insured restoration is defined by the same itself. Upon exhaustion of the sum insured due to claims, you will get all that back with the restoration facility.

Whereas no claim filing in a particular year raises your sum insured automatically with the no claim bonus feature. The increased sum insured will only help accommodate healthcare inflation that rises by around 10-20% a year.

Daily cash allowance is also offered to policyholders to meet their miscellaneous expenses during hospitalization. However, do read the cappings companies follow while disbursing the same.

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