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Not So Known Benefits In Your Health Insurance Policy

Every Policyholder might be quite aware of the broader benefits of his/her health insurance policy but there can be some sub limits or specific benefits which we generally miss out because we don’t take the pain to read the policy document in details. Sub limits as we know that can prevent you from getting all claims settled by the insurer so you should be very clear with them while comparing plans from different insurers’ .Similar on those lines there are few unknown benefits associated with a health insurance plan which we should know so that we can reap better benefits from it. Though these benefits might sound very small considering the cost that you might have incurred during your medical treatment but they can really add value.

Few of the not so known benefits associated with your health insurance plans are:

  1. Good health Bonus: This is quite similar to the non claim bonus that you get in a car insurance plan. So if there is no claim term in your policy may be because good health practices that you have followed , you insurer would incentivize you in this case by either increasing you sum assured or may give a discount in your premium in the succeeding term. In both the cases you end up pay less for a larger amount of benefit. The most common of the benefits which insurers give is increase in sum assured. The maximum amount of benefit which a policyholder may enjoy in this case may range between 5% to 20% to a maximum of 50% to 100% of the sum assured.
  2. Free health check up benefit: Most health insurers provide free health checkup in their network hospitals to any insured after a block of either two or five no claim years. We should know that the premium rates don’t get affected by these health checkups. There are some health insurance providers which provide these health checkups with sub limits whereas some provide without any cost regardless of the claim history of the policy.
  3. Ayush cover: With rising use of alternate medical practices like Homeopathy, Ayurveda ,naturopathy etc now insurers are started covering medical treatments cost done through these methods subject to the condition that the same is done in a government accredited facility with accreditation from either Quality council of India or National Accreditation Board on Health
  4. Recovery benefits: You should know that your health insurance plan does also cover recovery post discharge from the hospital. This benefit comes as recuperating benefit in health insurance policy. Say if there is an income loss due prolonged hospitalization you may be entitled to receive a lump sum amount for the same as per the policy terms.
  5. Cover for treatment in home: In case due to non availability of hospital beds or due to extreme medical condition you are forced to take a domiciliary treatment the same can be covered fully with sub limits as per terms of the policy but it is always to subject one condition that the same has to be prescribed by a medical practitioner.
  6. Daily hospital cash allowance: During a period of hospitalization it is not only the medical and treatment cost that is involved but there are many ancillary costs. This may include travelling, food, accommodation etc which also add up to a big expenditure. A health insurance plan sometimes provides a daily hospital cash allowance to meet these expenses also. In most of the cases this fixed allowance which is given to the insured for a fixed number of days.

Read Also- Deciding Upon How Much Health Insurance Cover Do You Need?

So from the above it is surely understood there are many underlying policyholders generally miss out while making claims. For an insured person to take more benefits under a health insurance policy should possibly be aware of all the benefits associated.

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How Can One Maximise Tax Benefits On Health Insurance In Fy-2016-17?

A popular section of the Income tax Act which is well known to every Indian tax payer is Section 80C under which things like life insurance premium, investment into provident fund etc fall but lot of tax payers are unaware of Section 80D which can give them an additional tax savings of Rs55000 to Rs.60000 depending upon the age category they fall into.

Section 80D as generally known to tax payers as an Income tax Rule by which they can get tax exemption on the premium they pay towards health insurance plan or a best mediclaim policy. But to maximize tax benefits during the financial year 2016-17 this information is not enough. You need to understand the nuance of every element get the maximum benefit. Here are few facts which every tax payer should know to avail more benefits:

Paying premium for your parents: Generally you claim tax benefits for the premium that you pay towards your individual policy or for the family floater under which your wife, your children and your parents are covered so the maximum benefit that you can avail in this case is Rs.25000. Now especially in case of family floater where it is always advised to keep your parents out of the plan so that you pay a less premium, you can always have an independent plan for your parents who are senior citizens and get additional tax benefits of Rs.30000. So the maximum becomes Rs.55000 rather than just Rs.25000.So you have save Rs.30000 more.

Read Also: New IRDA guidelines for Health Insurance Plans: How you can enjoy more benefits now?


Another important case of remember in this case is that if you are also in the age category of 60 and above and you are still paying for premium of your parents you can get an additional benefit of Rs.5000 so rather than enjoying Rs.55000 benefit now you can avail Rs.60000 of tax benefits.

Life Insurance riders:  It not that just premium that you pay for health insurance plans qualify for Section 80D benefits but you can also avail benefits against Critical illness riders or medical insurance riders which are part of your life insurance plan. Even critical illness plans for specific diseases offered by General insurance companies also qualify for this benefit.

Health check ups: So you might think if you are pay a premium which is less than the maximum tax benefits of Rs.25000/ Rs.30000 then you might end up losing the benefits. But you should also know that the price that you pay towards preventive checkups also qualify for tax benefits under Section 80D to a maximum of Rs.5000.

Because of rising lifestyle disorders most prominent hospital have started to offer preventive health care packages so if you have subscribed to any of those packages you can easily claim the same as benefit.

Paying by cash:  Yes, you have a disadvantage in this case. if you are paying you premium in cash as per Income tax guidelines you can claim benefits under Section 80D so it is always advised that your should always pay premium through cheque if you want to pay offline or use internet banking and credit cards to make online premium payments. But one should keep in mind that if are paying for health checkups through cash they do qualify for tax benefits.

As per popular personal finance rule don’t just invest to save tax but in case health insurance which is actually a cost we should always look at savings maximum from it. It is also advised that please do a online comparison of competing health insurance plans to save maximum before you buy. Please also give an additional importance in the points discussed above to avail maximum tax benefits in 2016-17

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Health Insurance With Extended OPD Cover: Is It A Viable Option To Look For?

One of the main reasons behind people opting for health insurance today is primarily to the get the hospitalization cost covered in case of rising medical emergency. Over the last decade or so medical services inflation in which hospitalization contributes the most has registered a panic rise of 15% to 18% each year and which has lead to high consciousness about people to build a support system of funds through health insurance to finance those bad days.

Now coming to new set of offerings in the health insurance space from various insurers the new add on cover for OPD expenses. When we are talking about OPD treatment this involves the day to day medical cost which includes doctorial advise , medicine from pharmacy or  test which needs to done. In last one year or so insurance provider has always started offering plans which cover OPD expenses also. These plans are primarily designed in a way where the policyholder out of his/her total sum assured of the plan is given an allocation for handling OPD expenses. In case the in a specific term the amount remains under or unutilized a part of it transferred as a bonus to the succeeding term. This seems like an interesting feature both if you quite healthy and hearty the extra premium that you pay towards it is just a waste of money. On the other for people who are already suffer from diseases like diabetics or hypertension or for married couples with children the plan can work effectively as there is a regular need to medication. Though the add-on cover may be good for few people suffering some sort of critical illness which requires regular medication but the challenge is that in most of the cases insurance companies would deny covering these diseases in the first year or may up to the third year of the policy making  the proposition for very interesting for them also. Plus when we cost associated with taking this extra add-on over and above the base cover it can seriously hurt your pocket.

Read Also- Deciding Upon How Much Health Insurance Cover Do You Need?

Financial planners and team thinks that since the OPD cost are not that catastrophic in terms of yearly medical expenses of any policyholder unless otherwise there is medical emergency opting for OPD cover under your health is not a viable option to look for. It is always advised that you can better take a comprehensive health plan that suites health care requirement based upon your lifestyle, current health conditions and family health history. In case if you have family to protect floater plans are better options and build medical emergency corpus by investing into liquid assets like fixed deposits and mutual to take care of your regular medical needs.

So the underlying fact is planning for your health is critical decision one needs to make. Wasting money into something which has negative IRR not has bad effects today but can also affect your long term financial plan A better planning for Buy Health Insurance Online policies now can lead to a better financial health in the future.

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Health Insurance Plans For Diabetes Is A Rising Necessity Now, Why?

Diabetes is one of the prominent health disorders in the country today. With over 50 million type 2 cases registered in India makes it the Diabetic capital of the world. As per recent survey this number is going to cross 100 million mark by 2030 with worst majority of affected patients in the age group of 20 to 60 years. The average size of claim registered by diabetic policy holders is close to Rs.50000 as per latest industry data and the claim amount it rising at the rate of 15% every year. This rising vulnerability is registered more among men as compared to women. The rising number of disorders is because of bad lifestyle choices which are leading to higher cases of hypertension which is one of the major reasons behind people being affected by this deadly disease. A diabetic has go through various level of treatment from Amputation to bypass operations which increases the cost of treatment largely. This heavy cost of medication can lead to bad affects in the financial health of the sufferers and India being largely a society where the bread earners are mainly men raises the need for having special health insurance for diabetic people.

What you should at look while a buying health insurance plans if one is already a diabetic or the chances of getting one is high?

Buying a cover at the early age: if you have family history or you are already a patient of hypertension makes sure that you buy a health insurance cover at a very early age. If you are still not detected with disorder you can always get yourself covered by a regular plan which is much cheaper.

. Buying early has two benefits:

  1. If you compare a regular plan with diabetic plan which you can only opt for when you are detected is the premium cost. At an early stage a Rs.5 Lac cover would cost you closer to Rs.6000 a year when compared to a specific diabetic plan it would be close of Rs.17000.
  2. While buying early you should always keep in mind that there is always a gestation period after which the policy offers coverage for diabetic like health disorder. Buying early help to go through the waiting period and your coverage become more effective at the age when you actually need it

If you are already suffering: if you are already effected you have no other option other than specific diabetic plan where you need to pay high premium. Most of these diabetic health insurance plans cover type 2 disorders and you always need in mind the exclusions of the policy you select. Some common complications which diabetic plans covers are?

  1. Heart and kidney ailments
  2. Kidney donor related expenses
  3. Amputation and artificial limb related cost
  4. Recurring dialysis cost.

Factors you should while buying a diabetic health cover?

The cost of insurance would always be very high when you are already affected by the ailment but a smart strategy can help a lot in saving some cost. If you have regular individual indemnity plan then you should look at dividing the cover between a base plan and top up plan. Most of the top up health insurance plans cover diabetic related complications and the cost is generally half the price than your base plan. So it is always advised that you should have base plan and take a top up over it rather than buying separate policy.

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Fine Print Points Of Your Health Insurance Policy Document Which Can Fall You In Trap

The worst practice which we Indians follow while buying financial products is that we don’t even look beyond the application form where all the terms and conditions are written. The bad thing happening due to this practice is that we end up cursing the provider for not keep up with the promise. In fact, lot of customer complaints regarding miss-sales of financial products are because of this particular reason.

Take an example Mr. Ganguly who recently bought a health insurance policy following the same practice but after five months when we went get himself operated for cataract his health insurance provider cancelled his claims. For quite obvious reasons Mr. Ganguly filed a complaint and the Insurance company came with an answer that as per the insurance contract cataract was supposedly not to be covered in the first year so the claim was rejected. All these things were actually mentioned in the insurance contract document which Mr. Ganguly never took a pain to study otherwise he might planned the operation for next year and the financial loss he had wouldn’t be there.


This is a common phenomenon even while buying health insurance plans too. Though we try to use online websites to compare plans but we just do it on the basis of the amount of premium but you don’t actually go back of the policy contract to see the fine prints of the policy which are like detailed terms and conditions of the contract.

There are some important points which you should actually look every time before you buy a health policy are listed below. The foremost caution after reading all these points is don’t forget from next time.

  1. Condition regarding pre and post hospitalization expense: if you take a health insurance plans for family other than the cost of hospitalization your policy generally cover the costs involved in various medical test and doctoral visits and advice which you might have taken before hospitalization or post hospitalization. Though the number of days for which coverage would be there depend on the insurance company but it is a good benefit which people generally miss out. Also make sure you should know while raising claim for expenses happening during this period about the sub-limits.
  2. Waiting period in your policy for specific treatments:  The case of Mr. Ganguly is a classic example of waiting period. Most of the health insurance plans do have waiting period for specific ailments and for pre-existing medical conditions before you make a claim for expenses happening for their treatments. If you know this before you have chosen a policy to buy you can plan certain things well in advance and if you don’t, you will end up paying heavy amount of money out of your pocket just like Mr. Ganguly.
  3. Room rent limits: When we buy a health policy we generally have an impression that all the cost related to any type of medical emergency would be covered but if you try reading the important point of your policy contract you might find a lot of limits on many categories of medical expense which give a right to the insurance company to honour your claim to certain limit and deny the rest. This phenomenon is exactly similar in case of Hospital room rent related expense. Insurance companies generally have a benchmark in terms of a percentage of sum assured or a fixed amount which can limit your daily spending on room rent. In fact, the worst part of this sub-limit is the percentage of uncleaned amount out of the total claim raised will also decide the fortune of what has to paid in case of other expenses
  4. Maximum renewal ceasing age and the maximum age till you can carry your policy:  The insurance company generally sets a limits on different age bracket till the time you can pay your premium and time till which the policy will keep on covering you. This is an important point on your policy contract which you need to read to do an effective planning for any type of medical emergency at any age.

So if you still feel like not reading the policy contract points in detail it can really act a back burner and you always be spending money out of your pocket even though you have a policy in place.

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Deciding Upon How Much Health Insurance Cover Do You Need?

Keeping in view rising cost of medication and hospitalization Health insurance has become an important component of your financial plan. It is very true that an immediate medical emergency can actually ruin your long term financial goals but the most serious question that need to answered is the amount of health Insurance one should looking into?

You always know that the money that goes into premium of a health insurance plan doesn’t accumulate as savings if the cover in the policy is not utilized during your life like any life insurance plan but still it is important. It is a mandatory spending that one should look into as a part of the household budget and it is an important part of your risk management strategy of your financial plan so that without getting affected by uneven expenses that arise out of a health emergency you reach all your financial goals.

Though truly speaking there is no thumb rule by which you can decide upon what is that amount of health cover one should look into but for doing so you should look at answering few important questions

  1. Does it depend just on my health conditions?
  2. Is my current job profile or my household income has any relevance?
  3. How much my family history of diseases plays an important role?

There may a lot of other questions which we might try and answer the question of the amount of health cover so let try and answer the few important thing:

  1. How much my current income matters?

Practically speaking you should always have a cover which should be something close to 50% to 100% of your annual income. The amount of cover would decide the amount of premium that you need to pay. Looking at the aspect of having a good financial life you spending towards your needs or what you call as mandatory expenditure should be not more than 50% of your annual income and of which the health insurance premium is also a component. Another aspect of looking into it is 50% of the annual income plus 100% of last 3 years of medical expense already incurred which can be considered as a benchmark to decide upon the health insurance cover.

  1. How much you can pay?

Trying to answer this you should look at your family budget but you should not ignore it. As per your affordability you can have a low health cover at the starting of your age and in fact during the early ages you are always healthy and hearty so a lower cover of Rs.2lacs would be able to suffice your medical emergency and will also cost you less and as your financial conditions improve and you grow in age when the amount of cover required also increase you can increase your cover accordingly. So depending on your affordability you can plan the health cover accordingly and without getting into any financial stress.


  1. How much your family health history is important?

You technically can’t give an exact factor to it but it is important. If your family has a history of lifestyle diseases then there is high probability that the same would be transferred to the next generation. So genetically if you fall into high risk category then you should always look at having an higher health insurance cover for Family.

In case if you feel there is a high probability of contracting a particular disease due to family history you can opt for specific disease cover.

  1. Age:

Your age in an important factor deciding your health insurance cover. At an early age you can have a lesser amount of cover but as you grow old with the rising health complications you should always increase your health cover. There is no specific formula relating amount of health cover with the age but to say by the age of 40 you should have the highest health which you might require as per future health condition because post the cost would be very high and many pre-existing ailments will not be covered and which is very dangerous once you have crossed the age of 60.

  1. The quality of health services that you intend to use

The pricing of health services taken from different hospitals can be quite different because there is no regulation in the country which standardizes the same as in some developed nations. So you should always this thing in mind while deciding upon the health cover.

Technically speaking there is no thumb rule that can help you decide the amount of health insurance cover that you make but it is always mandatory. You can plan it better so there it doesn’t creates problem when you actually require by comparing different plans online and check for effective add on cover to suite your needs.

A better planning for Buy Health Insurance Online policies now can lead to a better financial health in the future.

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