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: It's understandable that you're concerned about the increasing premiums and the perceived lack of benefits in your current insurance policy. Here are some steps you can consider:

• Review Your Policy Documents: Make sure to thoroughly review your insurance policy documents. Understand the terms and conditions, coverage details, and any clauses related to premium increases. It's essential to be aware of the specifics of your current policy before making any decisions.
• Compare Policies: Compare the benefits and premiums of your current policy with those offered by other insurance providers in the market. Look for policies that provide similar or better coverage at a more reasonable cost. Take into account the coverage for both term insurance and health insurance.
• Contact Your Current Provider: Reach out to HDFC Life and ERGO to discuss your concerns. Inquire about the reasons for the premium increase and whether there are any options to customise your policy to better suit your needs without compromising coverage. Sometimes, providers may have different plans or options that could better fit your requirements.
• Explore Portability Again: Since you mentioned that Star Health denied portability, consider reaching out to other insurance providers to explore portability options. Different providers may have different policies on porting combined policies, and it's worth checking with multiple companies.
• Seek Professional Advice: Consult with a financial advisor or insurance expert to get personalised advice based on your specific situation. They can help you understand the nuances of your policy, assess your needs, and guide you on the best course of action.
• Consider Separate Policies: If portability remains challenging, you may explore the option of having separate term insurance and health insurance policies from different providers. This way, you can tailor each policy to your specific needs and potentially save on costs.
• Stay Informed About Regulatory Changes: Keep yourself informed about any regulatory changes in the insurance industry that may impact your policy. Sometimes, regulatory changes can affect premium calculations or portability options.

Remember that making changes to insurance policies requires careful consideration, and it's crucial to ensure that you maintain adequate coverage for your family's needs. Always read the terms and conditions of any new policy thoroughly before making a decision. If needed, seek legal or financial advice to make an informed decision.

Ans: Taking the right health insurance coverage is crucial, especially given the rising medical costs. With your current family floater policy of Rs. 22.5 lakhs and considering your wife's family history, it’s essential to evaluate your needs. Here’s a comprehensive guide to help you decide on additional coverage and whether a critical illness or cancer policy is necessary.

Current Health Insurance Coverage
Your existing policy has served you well, accumulating a bonus of Rs. 7.5 lakhs, increasing your coverage to Rs. 22.5 lakhs. This is a good base, especially since you’ve prioritized a public sector insurer due to concerns over private insurers.

Public sector insurers have a reputation for reliability and fewer complaints. Your choice is wise, given your specific concerns.

Assessing Your Coverage Needs
Health insurance needs can vary based on several factors, including age, family medical history, and lifestyle. Considering these factors, let's analyze your situation:

Age: At 49 and 44, you and your wife are approaching an age where medical issues become more common. Your daughter, at 16, still has a relatively low risk.

Medical History: Your wife’s family history of heart problems and cancer is a significant factor. This history increases the likelihood of needing substantial medical care in the future.

Rising Medical Costs: Medical inflation in India is high. Treatments for severe illnesses can easily exceed Rs. 20 lakhs, especially in metropolitan areas.

Given these points, it might be wise to consider additional coverage. A coverage of Rs. 30-50 lakhs could be more appropriate.

Evaluating the Need for Additional Coverage
To determine if you need more coverage, consider these aspects:

Hospitalization Costs: Major treatments and surgeries can be very expensive. Even with Rs. 22.5 lakhs coverage, a few hospitalizations could exhaust your policy limits quickly.

Treatment Advances: Medical technology is advancing, leading to higher costs for newer treatments and procedures.

Geographical Location: If you live in a metro city, medical costs are generally higher compared to smaller towns.

A top-up or super top-up policy could be a cost-effective way to increase your coverage without significantly increasing premiums. These policies kick in after a certain threshold is met, offering higher coverage at a lower cost.

Critical Illness and Cancer Policies
Given your wife's family history, a critical illness policy or a specific cancer policy could be beneficial. These policies provide a lump-sum payment on diagnosis of specific illnesses, which can be used for treatment, recovery, or even daily expenses.

Critical Illness Policy: Covers a range of severe illnesses like heart attack, stroke, kidney failure, and more. It provides financial support at a crucial time, helping to cover costs that may not be included in a regular health policy.

Cancer Policy: Specifically designed for cancer treatment. Cancer treatment can be prolonged and expensive. This policy ensures that financial constraints do not hinder the treatment process.

Benefits of Critical Illness Policies
Lump-Sum Payment: On diagnosis, you receive a lump-sum amount which can be used for any purpose, giving you flexibility.

Wide Coverage: Covers several major illnesses which can be financially draining if not insured.

Peace of Mind: Knowing you have coverage for major illnesses can reduce stress and allow you to focus on recovery.

Benefits of Cancer Policies
Specialized Coverage: Tailored specifically for cancer, ensuring comprehensive coverage for all stages of the disease.

Enhanced Support: Provides financial support for expensive treatments, ensuring quality care without worrying about costs.

Flexibility: The payout can be used for treatment or other related expenses, providing financial flexibility during tough times.

Premium Considerations
Health insurance premiums do rise with age and medical inflation. To manage premium costs while ensuring adequate coverage, consider the following strategies:

Top-Up Plans: As mentioned, these can provide high coverage at lower premiums compared to base policies.

Family Floater Plans: These can sometimes be more economical than individual plans, especially when covering multiple family members.

Regular Review: Periodically review and adjust your coverage to match your current needs and financial situation.

Practical Steps to Enhance Coverage
Assess Your Needs Regularly: Health needs change over time. Regularly assess your insurance coverage to ensure it aligns with your current and future needs.

Consider Top-Up Policies: If you find your current coverage inadequate, a top-up policy can provide additional coverage at a reasonable cost.

Evaluate Critical Illness and Cancer Policies: Given your wife's family history, these policies can provide financial security in case of serious illnesses.

Consult a Certified Financial Planner: They can provide personalized advice, ensuring your insurance strategy fits within your broader financial plan.


You’ve taken commendable steps to ensure your family's health and financial security. Your proactive approach to health insurance is admirable. It’s evident that you care deeply about your family's well-being, and you're making informed decisions to protect them.

Final Insights
Ensuring adequate health insurance coverage is crucial, especially with rising medical costs and potential health risks. Your current coverage of Rs. 22.5 lakhs is a good start, but considering additional coverage could provide more security.

A top-up policy could enhance your coverage cost-effectively. Given your wife's family history, a critical illness or cancer policy could offer additional peace of mind and financial support.

Health insurance is not just about covering hospital bills; it's about securing your financial future against unforeseen medical expenses. By carefully evaluating your needs and considering additional coverage options, you can ensure comprehensive protection for your family.

Best Regards,

K. Ramalingam, MBA, CFP

Chief Financial Planner

www.holisticinvestment.in

Ans: You have done a good research job. If the features are same, then I suggest Star health policy of 1 Cr should be good for your family.

Here are few healthcare policies tailor-made for senior citizens:

1.Star senior citizen red carpet
2.Niva Bupa Senior First
3.Manipal Cigna Prime Senior
4.Care Senior Plan

You can select any one among these for your parents. Feel free to consult an insurance advisor if needed.