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Health Insurance Policy का पूरा सच – 2020 में Best Health Insurance & Mediclaim Policy कैसे खरीदें? - YouTube
Channel: Asset Yogi
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Namaskar, my name is Mukul, and welcome to Asset Yogi.
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Guys, we talk about different types of investments on this channel
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Like Stocks, Mutual Funds, Real Estate Gold, etc.
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But we never discussed that where should be our first investment.
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Its answer is there in another question that
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What is the biggest asset for us?
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For me, the most important asset is myself
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Because my earning potential is unlimited
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and that's why it is very important to take care of ourself.
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There is a famous saying 'If you have life, you have the world'.
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If we'll take care of ourself then only we can realize our earning potential.
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That's why it is very important to invest in your body and health and that's why
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The first investment we should do is to get Health insurance.
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But when we go to buy health insurance, many questions come to our mind
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Do I need health insurance according to my career stage or age?
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Or how much total cover should I take?
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Sometimes some companies provide health insurance to their employees so they think that they're done
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But is that cover sufficient?
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If you buy any health insurance policy then what is included and what is excluded
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On what you should focus more on?
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And if we're buying any policy then should we buy the cheapest one?
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Sometimes, even if you buy the policy, the claim gets rejected
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Some pre-existing diseases are not covered in that
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What are restoration benefits, top-up cover, and super top-up cover?
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We'll discuss all these so stay tuned with this video.
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Press the bell icon while subscribing
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So that you get the notification of the latest finance video.
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We'll cover this video in 4 parts.
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Firstly, we'll see the benefits of health insurance.
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Secondly, we'll talk about inclusions and exclusions that means about the features
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what all things are included and excluded in a standard policy and what all things to keep in mind.
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On third, we'll talk about how much total cover we should take
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Either as an individual or as a family
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And finally, we'll watch a live demo on how to buy health insurance
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and what all things to keep in mind.
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Let's discuss the benefits.
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The first benefit of health insurance is that your savings remain untouched at times of emergency
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Let's say any medical problem occurs in your family
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And as we know medical costs are very high nowadays
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Surgery or treatment cost for any critical illness is very high like 5-15 lakhs
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So in this case, your savings will not be affected much
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and you'll get total cover from health insurance.
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2nd huge benefit is Cashless treatment and we don't have to pay anything from your pocket.
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Most of the standard policies have a network of hospitals where you can get cashless treatment.
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3rd benefit is, there are Corporate Plans Top-up.
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Many companies provide 1.5-3 lakhs insurance cover.
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But it's not sufficient in most cases so you can Top-up that also.
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4th big benefit is, if you buy insurance at a young age,
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then your premium is less and most of your diseases are covered.
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Because there are fewer chances of diseases at young age
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But over a period of time, the chances of diseases or any illness increases
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Most of the policies have a waiting period for pre-existing diseases of around 3-4 years
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If that will be covered then any other disease will be covered in future
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5th benefit is, you get cover for all the lifestyle diseases
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Nowadays most of the jobs are desktop jobs
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because in this COVID time, most of the people are working from home
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So it becomes more important in these times
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And 6th benefit is, you get many other benefits other than hospitalization like
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Maternity benefit or daycare facilities.
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Many surgeries or treatments do not require hospitalization
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That is also covered in many policies.
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Many viral diseases are covered and there are special policies for COVID these days.
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7th benefit is, Tax benefits
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Under Section 80D, you get a tax deduction of Rs. 25,000 if you choose the old slab.
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However, it's not a big thing but it may be a big advantage for some people.
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Now let's talk about Inclusions and Exclusions.
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The first feature you have to check in any policy is
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In your nearby hospitals, check which policy is providing cashless treatment.
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Secondly, check that whether pre and post hospitalization charges are covered or not
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Pre and post hospitalization charges are the charges which include during treatment charges
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And along with that, 30-60 days of pre-hospitalization period
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which includes consultation of a doctor, diagnostic test, any physiotherapy, etc.
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And post-hospitalization may also include physiotherapy, diagnostic consultation.
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So many policies cover 30-60 days of pre hospitalization expenses
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And covers 60-180 days post-hospitalization expenses.
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So keep this in mind as well.
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You should also check Day Care Facilities because
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Nowadays, many surgeries last just for 1 day
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That means you don't need night admission in hospitals
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Many policies do not cover Day care facilities
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So keep this in mind as well.
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Along with this, many policies cover Ambulance charges as well.
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You have to check the coverage and there should not be any cap on different diseases or treatments.
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For example, your policy may have a limit of Rs. 50,000 on maternity benefits
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And maybe your expenses come out Rs. 75,000-1,00,000.
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So keep this in mind.
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Besides this, some policies also contain a Co-pay option
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That means you also have to give some money
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So if treatment costs Rs. 1 lakh and 10 % is Co-pay clause
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Then you have to pay Rs. 10,000 so it's better not to have a Co-pay option.
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One more thing to keep in mind is how much Room Rent is available
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All these charges are linked to your room rent and let's say room rent is high under your policy
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So you have to Co-pay accordingly
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That's why it's important to see the room you would prefer according to your lifestyle.
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One more benefit which is available in some policies is the Restoration benefit.
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Let's say all your cover is exhausted in one year.
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Let's say Rs. 3,00,000 cover exhausted for a family member
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So that cover will be restored for another member. Hence, restoration benefits are also there.
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And in some policies, These restoration benefits are available during hospitalization.
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Similarly, there's one more benefit which is the Top-up benefit.
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If there is a company insurance going on
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and if someone wants to take Top-up insurance then that is a very good option
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Let's say you have a cover of Rs. 3 lakhs and you want it to be Rs. 6 lakhs
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Then you can buy an additional cover of Rs. 3 lakhs which is called Top-up cover.
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Top-up cover means if your Rs. 3 lakhs cover is exhausted
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then additional Rs. 3 lakhs cover will be available.
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And there is one more beneficial plan which is Super Top-up cover
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In which your multiple claims are also covered.
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And multiple claims means
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Let's say a family member fallen sick and it cost Rs. 1 lakh for the treatment
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Then the remaining Rs. 2 lakhs got spent on another family member and the total cover exhausted.
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Now you will get a Top-up of Rs. 3 lakhs again which is called super Top-up.
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And if you buy Top-up Or Super Top-up cover then your existing conditions are continued as it is
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That means the waiting period is continued as it is.
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This is the benefit of Top-up or Super Top-up.
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Now let's understand what is Pre-Existing Disease and Waiting Period
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Because most of the claims used to get rejected because of this earlier and today as well.
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So to tackle this, IRDA defined the Pre-existing diseases properly.
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So the disease diagnosed 48 months prior to the date of policy buying is called Pre-existing disease.
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And this is considered basically for your claim.
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So for example, if someone is suffering from diabetes
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and let's say he took the policy in July 2020 and he was already suffering from diabetes
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Hence, it is a Pre-existing disease.
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So he can claim the cost of its treatment from the 5th year onwards which means from July 2024.
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But definitely, if you have any existing conditions or illnesses, then your premium increases.
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And this waiting period can be different for different diseases
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It is generally 2-4 years of duration.
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Along with this, remember that you don't have to hide your existing condition.
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If you smoke, you're diabetic,
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or have any other type of heart condition then clearly mention it
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Because if you will not tell and later on it got detected, then your policy may get terminated.
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Besides this, you can check the No Claim Bonus in your policy.
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Because of that, conditions of decrease in premium maybe there or you get extra cover.
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So let's say you took policy for the current year without doing any claim
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and you were paying the premium regularly
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And let's say you continued that policy, then you may get 10% extra cover or a rebate of 10%.
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So No claim bonus may go up to 50-100%
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So check how much No Claim Bonus is available.
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Along with it, if you have No Claim for any year,
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then you get Preventive Health Check-up in many policies
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In which you can do your health check-up in a hospital and you get its refund.
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Let's say you didn't claimed for 2 years then you may get Rs. 2500 to Rs. 5000
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So it depends on how much is your total cover.
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Now let's come on our 3rd segment
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How much Health Insurance Cover should you take?
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It depends on many factors like your age, medical history of the family,
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existing conditions, nature of your job,
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is there any danger involved in that, income level, lifestyle, etc?
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But still, we'll talk about some thumb rules.
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If you're buying a policy as an individual,
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then you should take a minimum cover of Rs. 3 lakhs
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because there are fewer chances of existing diseases at young age
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And as your age increases, you can increase your cover with that.
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Now let's talk about the Family cover.
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If we talk about a standard family with 2 adults and 2 kids then
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You should take Rs. 5-10 lakhs standard cover
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And there are some thumb rules here as well
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You can choose one among the 2 thumb rules
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Like 50% of annual salary or you can choose what's the cost of heart surgery in your city.
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If the cost of heart surgery in your city is 4 lakhs then you can choose the cover of Rs. 4 lakhs
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But if you are in a Tier 1 city,
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it may go around Rs. 7-8 lakhs so you can take cover according to that.
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But it also depends on your income and lifestyle.
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So a minimum cover for a family should be Rs. 5-10 lakhs.
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Besides this, if your parents are above the age of 50-60 years,
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You can keep them in a separate policy
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Otherwise, your premium will be very much high
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because the premium is decided according to the highest age.
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So let's come on to our final segment that, How should we buy health insurance?
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So firstly, understand that the cheapest is not the best.
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We saw in our last video that the brand value of a company is also very important when we buy insurance
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Because we are actually buying a promise
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So it becomes important that whether that company will pass our claim or not.
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So for this, we can check Incurred Claim Ratio and Claim Settlement Ratio.
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We'll talk about these in detail that what exactly these are and how to check them.
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But before that, let's talk about 1-2 more points.
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Many times an agent or a bank approaches us for the policy
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There we have this disadvantage that we cannot compare the insurance
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And maybe that person had his vested interest
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And maybe he's selling you that policy in which he has more commision
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That's why the best way is to purchase online insurance
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For example, Policy Bazaar is a good website from where you can purchase your insurance.
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I also purchased insurance many times from this website.
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So let me give you a quick demo.
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We're on the website of Policy Bazaar and this is the Health Insurance section
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Different types of health insurance are available here
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Normal health insurance, family, senior citizen insurance.
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And there is also special health insurance for Corona Virus.
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Now let's get into the Normal Health Insurance plan and fill in the details.
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After that, go to view plans and let me select an individual plan
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And the age I selected is 25 years. Click on continue
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Select the city.
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Do you take any daily medication or not?
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I am selecting No here and let's see what all plans we're getting.
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So the plans are starting from Rs. 206 per month and you're getting cover of Rs. 5 lakhs by Edelweiss.
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So we can compare all the plans here.
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After this, we'll go to features.
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So you can check all the features about which we discussed
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Here are all the highlights and features.
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Hospital room eligibiity. So we can check all these in details.
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What is the claim process and which are the cashless hospitals.
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You can also compare plans by yourself.
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I will give the link in the description and comment.
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Along with this, there are some more benefits of using these online platforms.
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Like executers will help you if you are not able to understand
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If you're facing a problem in claim settlement then the claim settlement team will help you.
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And nowadays, claim settlement teams are there in hospitals and they will help you.
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Besides this, because of this Covid situation,
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Medical test is usually Telemedical or Video medical.
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So we saw how to do the online comparison of health insurance.
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Along with this, we should also check the conditions of the company also
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We can check that by mainly 2 ratios
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1. Claim settlement ratio.
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This means the ratio of how many claims did company passed out of the total claims in a year.
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If this ratio is greater than 85%
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then we can say that it is a healthy ratio and you can consider that policy.
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2. Incurred claim ratio.
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That means how much money company pays for paying the claims out of the total premium they received.
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So if this Incurred claim ratio is too much, then that is also not good.
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Let's say if it's more than 90%
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then maybe the company cannot pay the claims due to lack of money.
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And if it's less than 50, then maybe the company is charging more premiums
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and they are more focused on profitability.
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So a healthy ratio is ideally between 70-90 but you can consider 55-60 on a lower side.
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And the flexibility of these ratios depends on the brand value of the company.
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I hope I solved most of your doubts related to health insurance.
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So if you liked this video then press the like button
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And share it with your friends and family members
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Maybe they're also searching for health insurance and they also have some doubts.
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If you have any suggestions related to this video or channel,
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Then you can tell us in the comment section.
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And if you haven't subscribed to this channel
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Then please subscribe to it and press the bell icon
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So that you can get the notification of the latest video.
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So we'll meet in another informative video
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Till then keep learning, keep earning, and as always stay happy.
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