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Stuck paying for insufficient health insurance: Should I switch?

Milind Vadjikar | Answer |Ask -Follow

Insurance, Stocks, MF, PF Expert - Answered on Nov 02, 2024

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

Question by ajaykumar on Nov 02, 2024Hindi

I have taken parents health insurance in office coverage is 1 lack base and top up is 3lacks and premium is 38.5k. Since im paying more for less coverage planning to take outside. Taken care supreme with rider for mother which doesn't have waiting period. Father has gone through heart surgery no insurnace is willing to give the insurnace except care heart with the waiting period 2 years and co pay 20% and consumables will not be covered and heart related will not be covered. For both mother and father i need to pay 5k per month for care insurnace. Its like a burden paying office insurnace 38.5k and outside 60k . What should i do, I'm really confused to take outside health insurance or not. Cannot stop office insurnace since it does take have waiting period for parents. Please help me

Ans: Hello;

What is the current age of your mother and father?

Based on your reply I may be able to guide you suitably.

Best wishes;

Asked on - Nov 02, 2024 | Answered on Nov 02, 2024

Mother is 50 father is 58.

Ans: Okay.

Is it possible for you to enhance parental health insurance offered through office by paying additional 10-12 K?

Do not opt for plan offered by Care.

Instead do two things:

1. Start a monthly sip of 5 K into an equity mutual fund for long term meant to cater to medical emergency of parents. It will grow into 50 L in 20 years assuming modest return of 12%.

2. Keep a corpus of 6-8 L in Arbitrage or liquid fund which together with health insurance provided through office will meet any exigencies for father's ailments.

Best wishes;

Asked on - Nov 03, 2024 | Answered on Nov 03, 2024

Should i keep mother care insurnace which i need to pay 2800/- per month and for father should i increase in office? Im not sure weather i can increase in mid of the year in office need to wait for next year. Paying 5k sip in equity, if there is any emergency after 2-3 years what should i do? I need to make 6-8l corpus again. Really confused Mother care supreme is 10l cover Father care heart provides 10l cover

Ans: Based on information provided in your earlier query, I had presumed that Care supreme plan will not cover heart related complications for your father.

If it is covering it, without any caveats, then it makes sense to sign it.

While we have been used to buying private companies health care online, govt owned health care insurance companies like New India Assurance, Oriental Insurance and United India Insurance also have cashless claim plans but we may need to visit their office or approach them through an insurance advisor since they are bit weak in online business.

I am sure their plans will be more cost competitive and once all disclosures/test results are recorded, chances of claim rejection are remote.

And most importantly if the Care healthcare plan is covering for your dad's possible health care complications related to heart,in future , then don't hesitate to sign up for it and don't carry a guilt feeling of spending more.

Ultimately if we spend a few thousands more on well-being of parents, it's a money well spent.

Asked on - Nov 03, 2024 | Answered on Nov 03, 2024

So instead of taking care health insurnace for mother and father outside you are suggesting to pay extra 1k per month in ofc from next time and do sip 5k equity for parents and keep 6 lacks in debt fund. This would be helpful. Instead of paying office and outside both. Correct me if im wrong.

Ans: Yes, that is what I had proposed to you when you stated that Care healthcare won't cover heart related issues for your father.

Asked on - Nov 03, 2024 | Answered on Nov 03, 2024

Thanks for the suggestion. Im planning to take for my self and spouse and kid 3 months old boy. Can I go with 1cr policy with hdfc erg, the premium 42k yearly or 50 lacks coverage is fine? With hdfc ergo 38k. Would you suggest any other best insurnace which i should not face any problems at the time of claim and 100% paid by the insurance.

Ans: Hello;

You may check out Niva Bupa Aspire Titanium and Bajaj Allianz offerings too before signing up.

Best wishes;

Asked on - Nov 03, 2024 | Answered on Nov 04, 2024

May i know why not hdfc or star or care? Whats the coverage needed for our family I'm 34 my wife is 28 kid is 3 months old.

Ans: Star health insurance reputation has taken a severe beating due to high claim rejection offlate. Similar thing with Care.
I am just asking you to evaluate their (Niva Bupa/Bajaj Allianz) plans before you sign up for HDFC ergo.

Asked on - Nov 04, 2024 | Answered on Nov 04, 2024

Ok my office is providing 4 lacks cover for mine and spouse and kid, similarly my wife office has provided another 4 lacks. Whats the cover amount needed for our family . Ik from Hyderabad city.

Ans: 25 L should be okay.

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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Question by Pradeep - Oct 12, 2022Hindi

I am an employee of central govt. PSU. My family consists of myself, spouse, two minor children and mother. I am covered by a corporate group medical insurance policy for Rs 2 lakh with an additional emergency coverage of Rs 4 lakh by the employer. I also have a personal Family Floater policy for Rs 3 lakh and a Sr. Ctzn. Policy for Rs 1 lakh. I have not used the personal policies till date for any hospitalisation claim. I am aware that a claim exceeding the corporate policy limit can be claimed in the personal policy. Recently I was made to know that any planned hospitalisation exceeding the corporate claim limit, cannot be done using the second policy. I also know that there is a product called as top up policy which can be used in such cases. I have 8 years of remaining service where there is a medical insurance cover during the period. After retirement, the employer provides a basic policy of 1.5 lakh for the family. The same feels to be insufficient in today’s times. What would be your advice with regards to the existing medical insurance policies and their amounts? Should I need to undertake any tweaking of the policy amounts or switch to a top up policy?

Ans: Hi Pradeep, yours is a legit concern. It would be best if you take advice from a professional person or company – having the necessary qualifications -- after discussing your issue with them.

Insurance is each to its own. Depending on your concerns and requirements a professional service provider will be able to give you the best advice, whether to tweak policy amount or switch to top up.

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