Some insurers may, however, have a cap on room category - which means they only allow a particular category of room. If you ever opt for a room above this category, u have to bear the difference and proportionate charges for the entire bill.
Never trade coverage for room rent limit. You must have best of both
Room Rent - Never opt for a policy with room limit. A 10L policy with limit of 10K may look adequate today, but the cover will degrade with inflation. (At 8% infln, 10K=2.1K in 20yrs)
But I buy a low cover today and upgrade later, someone said?
My take: You should never, I repeat never bet on future upgrades (unless you have genuine budget constraints) - since insurers might decline upgrades based on your age and health condition at the time of your request.
You must worry about the pre-existing disease waiting period - ONLY if you have disease while buying the policy.
If u don't, this waiting period is not applicable for u.
In fact, u must be aware of the 2 yrs waiting period for specified illnesses.
Always note, that apart from a) existing diseases before buying the policy, and b) specified listed illnesses c) permanently excluded treatments listed in the policy, all diseases that are diagnosed after the policy issuance are covered from day zero.
This is not right.
Most group insurance policies from employers do not have a waiting period for pre-existing diseases. They cover pre-existing diseases from day zero. The problem is different and explained in the next tweet.
Important:
- The policy does not cease to exist when the primary policyholder dies.
- The policy continues with remaining members without any change in cover or waiting periods. You simply have to make another family member the proposer. So chill.
Never buy a Topup, which is what seems to have been bought here.
Always look for a Super Topup. A topup works only on a single instance of hospitalization, while a Super Topup works on an aggregate of multiple hospitalizations during a year.
Apart from this, ensure the following: 1) All Daycare procedures (that take less than 24 hrs are covered) 2) Organ Donor cover without limits 3) Understand each financial limit in the policy. 4) Fill the proposal form, make disclosures like you are making your will :)
Summary
1 Always remain covered
2 Opt for cover u will need at 50+yrs
3 Do not opt for policy with room limit
4 Ensure all Daycare procedures are covered
5 Ensure Organ Donor is covered sans limits
6 Understand limits, exclusions before signing up
7 Fill proposal form diligently.
There is no doubt that insights from real users are extremely valuable. More and more aware buyers who read wordings should share. So not taking away anything from the effort.
The effort here is only to clarify, give a better understanding.
Do RT if you found this valuable.🙏
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🚨 Why a ₹1 Crore health cover may NOT be enough once you hit 30!
In 1999, my dad was proud owner of a bumper health insurance cover!
Cover of 2 Lakhs. He found it adequate.
In 2010, I felt ₹10L was a decent enough cover.
Today, ₹1Cr still seems a bit of a stretch. But is it?
Let’s break it down. 🧵👇
1. India’s private healthcare is only getting more expensive.
The government spends just 2.1% of GDP on healthcare - one of the lowest in the world. Public hospitals are struggling, and most middle-class families don’t prefer to go there.
That leaves us with private hospitals, and we all know how expensive they are.
Why?
Because the demand for quality healthcare far exceeds supply.
Just look at the top hospitals wherever you live - there’s always a rush.
Beds are perenially unavailable.
(Have seen the MD of a giant company waiting at Hinduja hospital, Mumbai, with their family member, late night, patiently negotiating for a vacant bed. )
India has only
- 1 doctor for every 1,500 people
- 1 hospital bed for every 1,000 people - far below WHO’s recommended standards.
Every year HR sends an "insurance" email most ignore.
You shouldn't.
The email usually has a deck that covers:
• The benefits you are entitled to.
• The process to enrol family members.
• The process to enrol and pay for parents’ covers and top up covers.
• The terms and conditions - which are a lot, believe me (this is ignored the most!)
Employer health insurance benefits are smoooooth!
👉 It is easy to enroll.
👉 It covers maternity benefits.
👉 It covers pre-existing diseases, damn it!
👉 It is even easy to claim.
Patient hospitalized for 6 days
Insurer pays for 2 days - says no "active treatment" after 2nd day.
Doctor shares logic for the 6-day treatment.
Insurer still disagrees.
Should patients consult insurers before taking medical decisions?
Why do patients suffer for lack of medical regulations?
First, let's understand why this happens.
So, health insurance as per the contract will pay only in case when the hospitalization is
a) "Necessary" and
b) " requires active treatment"
Ok - so what is "Necessary" treatment?
It is when patient can only be treated at a hospital and not at home or in OPD.
For instance, say I meet with an accident, and break my hand.
Now, the doctor needs to apply plaster on my hand.
But say the doctor asks me to get hospitalized for a day - This won't be covered under health insurance.