So, this is It? Checklist to Choose your Best Health Insurance Policy

1. Hospital Room Rent Eligibility

2. Co Payment and Sub Limits for diseases (if any)

3. Waiting Period for Pre Existing Disease

4. Waiting period for few specific diseases like Cataract, Hernia etc

5. Cover Amount and Premium charged as compared to other players with same features

6. Pre Hospitalisation and Post Hospitalisation Coverage

7. Free Preventive Health Checkup Facility

8. Coverage for Critical Illness – Basis:- family history, option for top ups

9. Restoration Benefits – Whether with or without extra premium

10. Ambulance charges – whether covered

11. Eye Care, Dental Care, AIDS/HIV and Suicide Attempts – Generally are not covered

12. Alternate Treatments – Whether Allowed like Ayurveda?

13. Daily Hospital Cash Benefit, Organ Donor Expenses, convalescence benefit (i.e. time spent recovering from an illness or medical treatment) – Generally covered by way of Add on Cover

14. Outpatient Benefits like Consultancy Fee, Pharmacy Fee – Generally covered upto Rs. 5000 p.a. as add on cover

15. Maternity Benefit – Normal, C Section coverage, pre and post natal coverage, new born baby vaccination coverage, waiting period (Generally waiting period of 3-4 years, high premium and coverage upto Rs. 30,000 to Rs. 40000/- only)

16. Network Hospitals and Claim Process including timelines (Cashless as well as reimbursement)

Selection of Health Insurance Company:

  • Incurred Claim Ratio
  • Claim Settlement Ratio
  • Network Hospital Coverage
  • Claim Process and timelines

The above ratios are available on IRDAI website (Annual Report). Also if you are not happy with the services or Policy of any company, IRDAI has mandatorily given option of free look up period for cancellation within 15 days of taking policy as well as Portability option is available near to renewal time of policy. Policy can be ported to another company without losing waiting period/NCB benefits , provided prior to 45 days of the date of renewal, a written request is sent to existing insurance company.

Tax Benefits:

You can claim tax deductions under Section 80(D)…………., provided you are paying the premium on a mediclaim policy which is in the name of

  • Yourself (and / or)
  • Your Spouse (and / or)
  • Your Parents ( Parents need not be dependent on you)(and / or)
  • Dependent Children

Health insurance premium paid for Self, Spouse or dependent children, is allowed as deduction upto Rs 25,000 p.a. (Rs. 30,000/- if any family member is senior citizen). Health Insurance premium paid for parents (whether dependent or not) is allowable upto Rs 25,000 p.a. If your parents are senior citizens (60 years and above) then the maximum allowable deduction is Rs 30,000. That means total deduction can go as high as Rs. 60,000/- p.a. However, point to remember is that mode of payment of premium should be other than cash.

Also the amount incurred on preventive health check-up of individual, spouse, dependent children and parents will be allowed upto Rs. 5,000/- p.a. in aggregate. However, this limit is within mediclaim limit as mentioned above. Kindly remember medical allowance/reimbursement by employer is exempt upto Rs. 15000/- in a separate section and has no linkage with above mentioned Section 80D (i.e. Mediclaim)

Hope this article will help you in choosing best Health Insurance policy keeping several factors in mind.

Author of this article can be reached at ithinkfunds@gmail.com.

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Qualification: CA in Practice
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Location: Faridabad, Haryana, IN
Member Since: 29 Aug 2017 | Total Posts: 2

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Tags : Mediclaim (24) Section 80D (62)

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