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Ex-serviceman seeking additional health insurance: Can I have both ECHS and a private Mediclaim policy?

Ramalingam

Ramalingam Kalirajan  |7014 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on Aug 23, 2024

Ramalingam Kalirajan has over 23 years of experience in mutual funds and financial planning.
He has an MBA in finance from the University of Madras and is a certified financial planner.
He is the director and chief financial planner at Holistic Investment, a Chennai-based firm that offers financial planning and wealth management advice.... more
Asked by Anonymous - Aug 18, 2024Hindi
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My father is an ex service man and he and his dependent s are covered under echs if he wants, can go for private mediclaim policies along with echs card?

Ans: Your father, being an ex-serviceman, and his dependents are covered under the Ex-Servicemen Contributory Health Scheme (ECHS). ECHS offers comprehensive healthcare benefits, including cashless treatment at empaneled hospitals. However, there are situations where a private mediclaim policy might complement the ECHS coverage.

Benefits of Having Both ECHS and Private Mediclaim Policies
Extended Coverage
While ECHS provides good coverage, it may not cover all hospitals or specific treatments, particularly in non-empaneled hospitals or for certain advanced procedures. A private mediclaim policy can bridge this gap, ensuring broader coverage.

Additional Sum Insured
With healthcare costs rising, the sum insured under ECHS might not be sufficient for all situations. A private mediclaim policy can provide additional financial security, covering expenses beyond the ECHS limits.

Faster Reimbursement
ECHS reimbursement processes can sometimes take longer. A private mediclaim policy could provide quicker claims processing, reducing the financial burden on your family during emergencies.

Coverage of Non-Dependents
ECHS primarily covers dependents, which may exclude certain family members. A private mediclaim policy can ensure that those not covered under ECHS are still insured.

Cashless Treatment at Private Hospitals
If your father prefers treatment at a non-ECHS empaneled hospital, a private mediclaim policy offering cashless treatment at a wider network of hospitals can be beneficial.

Points to Consider Before Opting for Private Mediclaim
Premium Costs
Private mediclaim policies come with a premium. Ensure that the additional coverage is worth the cost, considering your father's healthcare needs and financial situation.

Policy Exclusions
Review the exclusions in the private mediclaim policy. Some policies might have waiting periods for pre-existing conditions or specific illnesses, which ECHS might cover.

Coordination of Benefits
When having both ECHS and a private mediclaim, it’s essential to understand how claims will be coordinated. Usually, ECHS would be the primary insurer, and the private mediclaim would cover any remaining costs.

Age and Health Condition
Depending on your father's age and current health status, the availability and cost of private mediclaim policies may vary. Some insurers may impose higher premiums or limit coverage for older individuals.

Final Insights
Your father can certainly opt for a private mediclaim policy alongside the ECHS card. This dual coverage offers an extra layer of security, especially for treatments outside the ECHS network or for large medical expenses. However, it’s important to carefully assess the benefits against the cost and ensure that the policy aligns with your family's healthcare needs.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in
DISCLAIMER: The content of this post by the expert is the personal view of the rediffGURU. Users are advised to pursue the information provided by the rediffGURU only as a source of information to be as a point of reference and to rely on their own judgement when making a decision.
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Sanjib

Sanjib Jha  | Answer  |Ask -

Insurance Expert - Answered on Jun 10, 2022

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My family is covered under Ex-serviceman Contributory Health Services (ECHS). She is having health insurance coverage from three other insurance entities. Still continuing. So, there was no pre-existing conditions. Two and half years back, we have opted for claim re-imbursement only for blood transfusions during the pre-diagnosis period. Later, her medical condition was diagnosed and the same was falling under IRDA exclusions. She was treated once in-patient and afterwards as outpatient. All claims for admission and medicine re-imbursement were availed from ECHS. (Once I have opted for enhancement of insurance coverage from one insurer and the TPA has refused under these clauses). Now, after two and half years, she has recovered better (Even Doctor's perception). But she is continuing medicine with lessor dosage. Presently, her condition is fine. My questions are: 1. Can I avail insurance facilities from insurance companies for the same issue in future?  2. Can I avail insurance facilities from the insurance companies, for other issues than the specifically excluded? 3. Can I prefer ECHS for any eventualities for the specified issue to the extent admitted, and remaining expenditure from other insurance companies? Please guide.
Ans: Hi Thangavelu, good to know that your wife is doing better. Coming to your questions, yes you can avail the insurance facilities for the same ailment in future from your existing insurance companies. However, if you purchase a new insurance policy from another company, then whether you get the coverage or not will depend on the ailment and the insurer.

For other ailments, at the time of issuance an insurer analyses the risks, given the ailment of the insured. Accordingly, the insurer takes a decision whether the policy can be issued or not, there are few insurers in the market that will keep the pre-existing diseases excluded or will have a waiting period for it. However, if your ailments have developed after the policy issuance then you can avail insurance facilities for those ailments.

Answering your third question, yes you can prefer ECHS for this specific issues and the remaining expenditure can be claimed from other insurers.

..Read more

Sanjib

Sanjib Jha  | Answer  |Ask -

Insurance Expert - Answered on Jun 21, 2022

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My family (aged 54 years) is covered under ECHS (Ex-servicemen Contributory Health Service) for the last thirty years. I have family floater health hospitalisation policy in two different insurance companies. Three years back, she had some issues related to her blood disorders. During the blood transfusions, we have made claims in the insurance cover. It took few months to diagnose the issue. Finally it was diagnosed as 'a type of blood disorder'. I have availed the hospitalisation and treatment facilities from ECHS. Now she has recovered (and under medication) for the last two years. She is leading normal life. My query is: Can I declare and have Critical illness included coverage in the health insurance? (Earlier I was denied as permanent exclusion -IRDA). Can I continue the existing health coverage from the insurance from other than Critical illness? (I can get ECHS facility, but there are limitations). Since she is alright, will the insurance companies accept? We are ready for relevant medical tests as required. We seek your advice.
Ans: Hi Thangavelu, good to know that your wife is doing well. To answer your first query, yes you can declare your critical illness and avail the rider for it. Another option is to purchase a new plan for critical illness from an insurer of your choice. The insurer will ask a set of questions and based on that the coverage will be provided. However, most of the insurers will keep the PED in the Permanent exclusion list. As far as your query on continuation of policy is considered, you can continue with the existing health policies you have.

Any medical condition which arises after the waiting period of the policy will be covered in the health policies. Which is why check for the waiting periods associated with different ailments in your policy document.

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Ramalingam

Ramalingam Kalirajan  |7014 Answers  |Ask -

Mutual Funds, Financial Planning Expert - Answered on Jun 11, 2024

Asked by Anonymous - Jun 05, 2024Hindi
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Hi sir i have both echs and bank insurance plan can i take any one for my treatment or should have to go only for echs
Ans: Having both Ex-Servicemen Contributory Health Scheme (ECHS) and a bank insurance plan gives you flexibility and additional options for healthcare. Here’s a detailed look at how you can navigate using both:

Understanding Your Options
ECHS (Ex-Servicemen Contributory Health Scheme):

Eligibility: Available to ex-servicemen and their dependents.
Coverage: Provides comprehensive medical care including outpatient care, hospitalization, and medication at ECHS empaneled hospitals and clinics.
Costs: Generally, there are minimal or no out-of-pocket costs when using ECHS facilities.
Bank Insurance Plan:

Eligibility: Typically provided by your employer or purchased individually.
Coverage: Can vary widely based on the policy but usually includes outpatient care, hospitalization, surgeries, and sometimes dental and vision care.
Costs: Usually involves premiums, co-pays, and deductibles.
Choosing the Right Option
Cost Efficiency:

ECHS is usually more cost-effective since it often has no or very minimal costs compared to private insurance plans which may have deductibles and co-pays.
Availability of Services:

ECHS has a network of empaneled hospitals. If a particular treatment or specialist is not available within this network, you might opt for your bank insurance which could provide access to a broader range of hospitals and services.
Geographical Convenience:

Consider the location and convenience of the healthcare providers. If the ECHS facilities are far or not easily accessible, you might prefer using your bank insurance.
Quality of Care:

Both ECHS and private insurance plans generally offer good quality care, but sometimes private hospitals may offer additional amenities or shorter wait times.
Specific Conditions and Treatments:

For some specialized treatments or conditions, one plan might offer better coverage than the other. Check both policies for specific exclusions and benefits.
Practical Approach
Consultation and Minor Treatments:

For routine check-ups, minor ailments, and consultations, using ECHS can be beneficial due to minimal costs.
Major Treatments and Hospitalization:

Evaluate the facilities and specialists available under both plans. If ECHS provides adequate care, it would be the economical choice. However, if your bank insurance offers better facilities or faster service for major treatments, you might prefer using it.
Emergency Situations:

In emergencies, the closest and most suitable healthcare provider should be prioritized, whether it falls under ECHS or your bank insurance.
Coordination Between Plans
Check if Coordination of Benefits is Available: Some insurance plans allow for coordination of benefits where costs are shared between two plans. This can reduce out-of-pocket expenses.
Final Recommendation
Primary Use of ECHS: Given its comprehensive coverage and low cost, ECHS should be your primary option for healthcare needs.
Supplement with Bank Insurance: Use your bank insurance for situations where ECHS services are not accessible, or the bank insurance offers significantly better or faster care.
Always review the specific terms and coverage details of both your ECHS and bank insurance plans to make informed decisions.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in

..Read more

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Ravi

Ravi Mittal  |414 Answers  |Ask -

Dating, Relationships Expert - Answered on Nov 13, 2024

Asked by Anonymous - Nov 04, 2024
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Ans: Dear Anonymous,
Refusing for a kiss isn't as concerning as her saying she will have feelings for you. Not everyone is ready for intimacy at the same time in all their relationships. As I mentioned earlier, there can be several reasons for this behavior. Please have an open conversation with her. Let her know that her behavior is bothering you and you want some clarity. If she still continues to say the same thing, you have the option to rethink the relationship.

I understand that you are feeling disturbed; it's not easy being on the receiving end. Please feel free to pick yourself first. You deserve someone who loves you completely.

Best Wishes.

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Ravi Mittal  |414 Answers  |Ask -

Dating, Relationships Expert - Answered on Nov 13, 2024

Asked by Anonymous - Nov 07, 2024Hindi
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I am 28, will be engaged in 3-4 months. It's an arranged marriage. I have met the girl one time, that too she was accompanied with her parents as her family is very conservative. We spoke privately for about half an hour. I know it's still not enough but I was able to have a good conversation. She was nervous at first but I made her feel comfortable and it was then time well spent. She is a sweet girl, even my maa papa like this girl but on the other hand, I am also getting worried as the days are coming near. Sometimes I feel like postponing the event. Is this normal? I also fear of things that happens in nowadays like getting divorce, extra marital affairs, alimony etc. What if she finds a better partner after marriage? Will she leave me? Due to this I cannot have proper sleep recently. Any suggestions to calm my nerves?
Ans: Dear Anonymous,
Many people get cold feet before getting married. It is very normal. All your questions are valid but you need to understand that in every relationship, it all comes down to trust. Whether you marry this woman or someone else, you have to trust her. And no one can really tell what the future holds. So we focus on the present and hope for the best.

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Physiotherapist - Answered on Nov 13, 2024

Asked by Anonymous - Sep 15, 2024Hindi
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Hi sir , Iam male 27 years planning to reduce my current weight of 86KG hence planning to hit the gym. Iam concerned of abdominal fat. I left gym 3 yrs back when my weight was average 69kgs. However due to no physical activity weight increased. Now iam planning for reducing weight and also improve my strength with good muscular lean body not bulk. Please guide me sir thanks
Ans: It’s wonderful that you’re enthusiastic about getting back into the gym to work towards weight loss and a lean, toned physique! As a physiotherapist, I suggest scheduling regular check-ins with a physiotherapist to monitor your progress and make any necessary adjustments to your exercise routine. To effectively lose fat, particularly around the abdomen, while building muscle, try a balanced approach that incorporates both cardio and strength training. Start with 20-30 minutes of moderate-intensity cardio—like brisk walking, cycling, or jogging—three to five times per week to increase calorie burn. For strength training, focus on compound exercises such as squats, lunges, push-ups, and rows, with three sessions per week. Begin with lighter weights, increasing gradually as your strength builds, and focus on good form to develop lean muscle without bulk.

Including core exercises, like planks, Russian twists, and leg raises, will help to strengthen and tone your abdominal muscles; however, remember that fat loss from specific areas requires overall body fat reduction. A high-protein, balanced diet will be crucial for supporting muscle growth and managing hunger, so aim to reduce processed foods and sugars. Consistency is essential—maintain a regular exercise schedule, and ensure you have rest days for recovery. With dedication, you’ll see steady improvements over time. Best of luck, and don’t hesitate to reach out if you need further guidance!

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DISCLAIMER: The content of this post by the expert is the personal view of the rediffGURU. Investment in securities market are subject to market risks. Read all the related document carefully before investing. The securities quoted are for illustration only and are not recommendatory. Users are advised to pursue the information provided by the rediffGURU only as a source of information and as a point of reference and to rely on their own judgement when making a decision. RediffGURUS is an intermediary as per India's Information Technology Act.

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