Why does India rely on insurance based healthcare schemes like ayushman Bharat instead of providing completely free healthcare like Cuba or Sri Lanka?

Ans: Hi Bhupesh, there is no ‘one size fits all’ concept with health insurance. Health insurance is based on preferences of the customer and then the premium quotes are generated based on those factors. You can use insurance broking websites to compare the offerings on the mentioned 5 factors and the premiums for various policies that will help you to compare their benefits and make an informed choice. Depending on your priorities, weigh out the factors and decide accordingly.

Since you have mentioned about your family, you can opt for Family Health Insurance policies with an appropriate sum insured to cover your entire family. Like I have mentioned before, premiums are unique to individuals depending on their preferences, the sum insured they deem suitable, the riders they choose, their medical history etc.

What you can do to ensure you buy the correct policy for yourself is to evaluate policies carefully, keeping in mind the 5 important parameters.

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Ans: Hi Ashok, it is great to know that you are maintaining a healthy lifestyle and living your life to the fullest. The concern raised by you is legit but the solution to it is simple – Buy the right kind of health insurance policies at an early age. When one purchases health insurance at an early age, the premiums they pay will be lower because their pre-existing diseases will be lesser and will not be considered a high-risk profile.

As our age increases, the chances of health deterioration increase which makes the premiums higher and in some cases a lot of diseases and ailments come with a longer waiting period and PED exclusion lists. During the time of issuance, each insurer analysis the risk via proposal form, medical reports and take decisions accordingly.

Age is an important factor in risk determination by the insurers and considers old age applicants as very high-risk profiles and hence doesn’t provide health policy. Few of the heart policies as said will provide coverage but will exclude the PEDs (pre-existing diseases).

This is why the Govt. of India, IRDAI, Insurers and broking companies like Coverfox Insurance are trying to educate the masses to purchase health insurance policies at a younger age and are constantly trying to inform people of the benefits of Health Insurance and how to choose the correct plan for oneself.

Ans: I can guide you towards finding the best plan for your family based on your needs and medical history (thyroid). Here are some key factors to consider:

Family Needs:

Age: Consider your family's age and potential health risks associated with each age group.
Medical History: Disclose your thyroid condition to ensure the plan covers pre-existing conditions or offers add-on riders for specific illnesses.
Coverage Requirements: Think about the type of hospital you prefer (network vs. non-network), room type (single, double), and preferred treatments (Ayurvedic, homeopathy).
Policy Features:

Sum Insured: Choose a sufficient sum insured to cover hospitalization costs for everyone in your family. Consider factors like city tier (medical costs are higher in metros) and inflation.
Coverage Type: Consider a comprehensive plan that covers hospitalization expenses, pre and post-hospitalization costs, ambulance charges, and day care procedures.
Network Hospitals: Opt for a plan with a wide network of hospitals in your city to ensure easy access to quality healthcare.
Co-pay/Deductible: A co-pay or deductible involves sharing a portion of the hospitalization cost. This lowers premiums but increases your out-of-pocket expense.
Exclusions: Carefully review policy exclusions to understand what treatments or conditions are not covered.
Here's a roadmap to finding the best policy:

Compare Online: Use online insurance comparison platforms to get quotes from different insurers.
Shortlist Based on Needs: Shortlist plans that meet your family's coverage requirements and budget.
Read Policy Wording: Carefully read the policy wording (wording can differ between insurers) to understand inclusions, exclusions, claim settlement process, and renewal terms.
Customer Service Reviews: Research customer reviews to get an idea about claim settlement experiences with different insurers.
Agent vs. Direct Purchase: You can buy directly from the insurer's website or consult an insurance agent who can guide you through the process and recommend plans based on your needs.
Here are some additional tips:

Pre-existing Conditions: Disclose your thyroid condition clearly during the application process.
Some plans might have a waiting period for pre-existing conditions before coverage applies.
Some might offer coverage with exclusions or higher premiums.
Renewability: Choose a plan with guaranteed lifetime renewability to ensure coverage throughout your life.
Claim Settlement Ratio: Consider the insurer's claim settlement ratio to understand their record of settling claims efficiently.
Remember: The best health insurance policy is the one that caters to your specific needs and offers comprehensive coverage at an affordable premium.

Ans: Hello;

You may evaluate the following before finalizing:
1. HDFC Ergo Optima Secure
2. ICICI Lombard Health AdvantEdge plus 2.0
3. Tata AIG Medicare premier

The premiums may range from 50 K to 80K presuming no pre-existing diseases.

Best wishes;