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Young man seeks advice on covering his mother's medical expenses

Milind

Milind Vadjikar  |1051 Answers  |Ask -

Insurance, Stocks, MF, PF Expert - Answered on Jan 23, 2025

Milind Vadjikar is an independent MF distributor registered with Association of Mutual Funds in India (AMFI) and a retirement financial planning advisor registered with Pension Fund Regulatory and Development Authority (PFRDA).
He has a mechanical engineering degree from Government Engineering College, Sambhajinagar, and an MBA in international business from the Symbiosis Institute of Business Management, Pune.
With over 16 years of experience in stock investments, and over six year experience in investment guidance and support, he believes that balanced asset allocation and goal-focused disciplined investing is the key to achieving investor goals.... more
Asked by Anonymous - Jan 23, 2025Hindi
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I am male,29, not yet married. Earn 80k, invest 28k in mf sip, 8k in emergency fund. Family pension 40k. My personal medical cover 3 lac and same amount cover from office. Term plan 50lac. In unforseen circumstances withdraw money from pension. We had medical benefit of cashless hospital treatment, but the same got withdrawn from long time now. Now we need to pay and claim reimbursement as per CGHS rate. My mother is 65. We don't have her medical cover as she has panel benefit but now it is not cashless. I want to cover for her hospitalisation. If I start medical cover now it is costing 1.5 lac to 1.8 lac for 50 lac cover. What should I do ?

Ans: Hello;

You may buy a base health insurance of 5 L for your Mother. (Should cost you ~20-25K/pa)

Then you may buy a super top up health cover for your Mom(~25 L).
It may cost you ~10-12 K/pa).

These are indicative costs for a person of 65 years of age with no disease, without GST. Actual costs may vary from company to company.

Do a thorough study of exclusions, room rent limit, other terms and conditions or consult an insurance advisor.

Also your term insurance is quite low(50 L) you should enhance it to 1 Cr now with the option to extend it to 2 Cr later when your responsibilities increase.

Best wishes;
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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Dear Sir, Greetings of the day. I have got a health insurance of family floater type from Tata AIG for a sum of four lakhs. Recently, I got hospitalised and full four lakhs was paid by Tata Aig. But my hospital bill was six lakhs and sixty two thousand. So there was a shortfall of two lakhs sixty-two thousands. I have an Aditya Birla health Policy of family floater type for 45 lakhs. But it will come in to effect after 5 lakhs expenditure. So I myself paid one lakh from my pocket. And for rest one lakh sixty two thousand only I applied for cashless to Aditya Birla .But they denied it. Finally I paid that amount myself and came home. Afterwards I kept continuous follow up with them. Reconsideration and reminder letter was sent by TPA and Treating doctor. But again it was rejected. Now Aditya Birla employee is saying apply for reimbursement. When Tata Aig is clearing full amount, how come Aditya Birla is denying it? And how can I bridge the gap one lakh between two policies? Tata Aig says you have taken full claim so we cannot make your limit from four to five lakhs this year. Pls advise suitably. Best Wishes
Ans: Hi Mr. Tripathi, greetings to you. To answer your first question as to why Aditya Birla won’t provide you with cashless claim as opposed to TATA AIG is because the policy you bought from Aditya Birla is a ‘Super top up plan’ which basically means it is an addition to your base policy which in your case is your TATA AIG policy.

Super top up policies do not offer cashless claims but only provide reimbursements.

The one lakh gap, unfortunately, cannot be filled at this point. However, while renewing your policy you can opt for increased sum insured with TATA AIG. The insurer will ask you a set of questions and schedule medicals to analyse your risk profile. Post that based on your reports, the insurer will take a decision on increasing the limit.   

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