What's the Perfect Medical Insurance Sum Assured for a Family Like Mine?

Ans: Hi, the coverage amount should be an estimate of the treatment you may be expecting in the near future in case you have any pre existing diseases. Else, due to the age being on higher end, you may have to pay higher premiums. Do not delay and purchase as soon as possible.

Ans: Hi Kumar, every insurance policy has its own benefits and one will have to pick according to their requirements. However, check for waiting period, any exclusions, network hospitals etc., while deciding.

Ans: For a family of three with ages 57, 51, and 20, the health insurance requirement depends on several factors like current health status, medical history, lifestyle, and location. Here's a general guideline:

Medical Inflation: Medical costs tend to rise with inflation. Consider the average annual medical inflation rate (around 10-15%) to estimate future medical expenses.
Healthcare Needs: Assess the healthcare needs based on family history, lifestyle, and any existing health conditions. Older individuals may require more frequent medical care and treatments.
Coverage Amount: A minimum coverage of Rs 5-10 lakhs for the younger member and Rs 10-15 lakhs for the older members is recommended.
Family Floater vs Individual Policies: A family floater policy can provide coverage for all family members under a single sum insured, whereas individual policies offer separate coverage for each member.
Considering the above factors, a health insurance coverage of Rs 15-25 lakhs for the family would be a reasonable starting point. However, it's essential to reassess your coverage needs periodically and adjust the coverage amount accordingly. Consulting with a Certified Financial Planner or insurance advisor can help determine the appropriate coverage amount based on your specific needs and circumstances.

Ans: Choosing a health insurance plan, especially a family floater with a high sum insured like Rs 1 crore, requires careful consideration of several factors. At 47 years old, you are at an age where health insurance becomes even more critical. Here's a detailed guide on selecting a suitable plan:

Key Considerations for Selecting Health Insurance
Comprehensive Coverage
Look for policies that offer extensive coverage, including:

In-patient Hospitalization: Covers room rent, ICU charges, doctor fees, and more.
Pre and Post Hospitalization: Expenses incurred before and after hospitalization.
Daycare Procedures: Treatments that don't require a 24-hour hospital stay.
Domiciliary Treatment: Home treatment in case of inability to get hospitalized.
Ambulance Charges: Coverage for emergency transportation.
Critical Illness Cover: Additional cover for life-threatening diseases.
Cashless Hospitalization
Ensure the insurer has a wide network of hospitals offering cashless treatment. This feature is crucial for hassle-free hospital admissions and treatments.

No-Claim Bonus
Choose a policy that offers a no-claim bonus. This feature increases the sum insured for every claim-free year, providing additional coverage at no extra cost.

Annual Health Check-ups
Look for policies that offer free annual health check-ups for all family members. This can help in early detection and management of potential health issues.

Factors to Compare
Premiums
Compare premiums for similar coverage across different insurers. Look for the most cost-effective option without compromising on coverage.

Waiting Periods
Check the waiting periods for pre-existing diseases and specific treatments. Opt for policies with shorter waiting periods.

Sub-Limits and Co-Payments
Be aware of any sub-limits on room rent or specific treatments, and co-payment clauses where you share the treatment costs. Prefer policies with minimal or no sub-limits and co-payments.

Customer Service and Claim Settlement
Research the insurer's reputation for customer service and claims settlement ratio. Insurers with high claim settlement ratios and positive customer feedback are preferable.

Selecting the right health insurance can feel overwhelming, especially with the wide range of options available. Your priority should be securing the best possible coverage for your family's health needs, ensuring peace of mind in medical emergencies.

Final Insights
A Rs 1 crore family floater plan is a wise choice, providing ample coverage for medical emergencies. Ensure you choose a policy that offers comprehensive benefits, a high claim settlement ratio, and a wide network of cashless hospitals. Regularly review and update your policy to match your changing health needs.

Best Regards,

K. Ramalingam, MBA, CFP,

Chief Financial Planner,

www.holisticinvestment.in