Why to pay hospital bills out of own pocket! Health policy is the new cash for medical bills. Moreover, your annual health check up is free!
Times have changed. Man is living more and population is on the rise. Reality is people of any age are getting sick. Hospitals are full. Demand for beds and treatments is increasing. In hope, people migrate to metro cities or local hospitals refers to them. Demand for modern treatment is on the rise. Tall bills erase our savings. We need focus on treatment and let bills be settled between hospital and the insurance company.
Among hundreds of health insurance policies, ‘restore’ policies are the best.
We went inside out of the top 15 ‘restore’ policies available in the Indian market. We compare 23 unique features among them as below.
(Don’t forget to slide through pages in the table)
*varies with Sum Assured (SA)
Buy a Health Insurance with best features as follows :-
- Cashless Network
- Day Care Treatment
- Restore Benefit
- Multiplier Benefit
- Pre/Post Hospitalization coverage
- Waiting Period
- Co-Pay (Bill Share)
- Health Check Up
- Air Ambulance
- Sub-Limits (Treatment Limits)
- Global Coverage
- Compassionate Travel
1. Cashless Network: Hospital bill reimbursement? Go cashless! Insurance companies loves this. Hospital can’t inflate bills in this. They have agreed rate list for each item. You save too in your SA limits.
HDFC Ergo leads with 10,000+ cashless network. Star has 9,900+, Religare 8,100+, Aditya Birla 6,000+ etc.
2. Day Care Treatment: Be Limitless! Go for All Day Care coverage. Policy should be such that it works all times. It must cover any new treatment.
Only HDFC Ergo Optima Restore, Star Comprehensive, Max Bupa Health Companion, and Royal Sundaram Lifeline Supreme covers them all.
3. Restore Benefit: This restores the sum assured if it exhausts. Tall bills eats away both sum assured and bonus very fast. Here, Restore Benefit works wonders.
Many companies don’t offer pure restore. Their coverage has limitations. One limit is cover for same illness restore. This practically means no restore. Star Comprehensive has changed their policy. Others should fall in line too.
Only HDFC Ergo Optima Restore and Star Comprehensive is pure restore.
4. Multiplier Benefit/Cumulative Bonus: Company adds bonus on Sum Assured (SA) on every no-claim year up to SA. Always choose an optimal restore. Too high or too low both has downsides. Even, a small claim should not erode our entire bonus. Companies do offer add-ons to take care of small claims.
Multiplier – No Claim bonus 50% SA up to 100% SA. Claim reduction of 50% SA upto SA. HDFC Ergo Optima Restore, Edelweiss Platinum, TATA MediCare, Future Generalli Health Total offers optimal multiplier.
Multiplier – Too high – 100% addition and reduction is not good. Even small claim erodes entire bonus. Star Comprehensive has too high multiplier.
Multiplier – Too low – 5-20% addition and reduction is not good. Raheja QBE has lowest 5%. However, Magna TTK, Royal Sundaram Lifeline Supreme, Max Bupa policies with nil reduction are good.
5. Pre/Post Hospitalization coverage: Higher the better! Edelweiss Platinum Health offers 90/180 days and is best.
HDFC Ergo Optima Restore, Magna TTK and Aditya Birla Activ Health Platinum Enhanced offers 60/180 days which is good too.
This is most helpful in critical illnesses cases, such as cancer, kidney failure, organ transplant, by-pass surgery, or any disease with long term medication.
6. Waiting Period: –
a. Policy Inception waiting period – 30 days except accidental.
b. Specific Diseases like cataract, hernia, joints etc has some waiting period. Majority of the insurance firms has waiting period of 2 years. Liberty Health Connect policy offers around 1 year for some specific diseases.
c. Pre-Existing Diseases: Lower waiting periods are good. Liberty Health Connect Supreme, ICICI iHealth Plus, Edelweiss Platinum Health, TATA AIG MediCare offers 2 years.
HDFC Ergo Optima Restore, Star Comprehensive, Max Bupa Health Companion, Royal Sundaram offers 3 years. Anything above 3 years is not justified.
7. Co-Payment: Avoid this at all costs! Why to take burden of sharing the bill? This should not be optional too.
Star Comprehensive policy adds 10% cost on age above 60 years. Similar for Aditya Birla Activ, Religare, Edelweiss, Bajaj Allianz, Future Generalli.
8. Health Check: Health policy with Benefits! Medical check-ups cost a lot. This is preventive in nature. TATA AIG offers best at Rs. 10,000 per year. Next is Apollo Munich with Rs. 8,000 onwards. Magna TTK provides at ‘Actuals’ from 2nd Year onwards which is good.
Others offer check-up at own impaneled hospitals. It is difficult to manage if not in local city. The Company that promotes this are Max Bupa, Religare Care 5, Raheja QBE and Aditya Birla Activ Health.
9. Air Ambulance: No treatment available in the city, you are covered! Fly to nearby best hospital in emergency.
Here, TATA AIG MediCare Premier provides Rs. 5 Lakhs. Star Comprehensive has Rs. 5 Lakhs. HDFC Ergo offers Rs. 2.5 Lakhs. Anything above Rs. 2 Lakhs is good.
10. Sub-limits: This should be avoided! It limits the hospital bill payment by insurance company.
Among Restore policies, only ICICI iHealth Plus puts sub-limits. This policy should be avoided.
11. Global Coverage: Go GLOCAL! Local Insurance Global coverage. This is good for people who travel to stay abroad.
Religare Care 5, TATA AIG MediCare Premier and Magna TTK offers global coverage. Best is TATA AIG as it offers coverage up to Sum Assured and Bonus. Other two have coverage up to Sum Assured.
12. Compassionate Travel: It is being more practical! for Tier 2 and 3 patients.
One normally travels with at-least a companion to hospital. One person is needed for all paper work help.
TATA AIG MediCarePremier and Edelweiss Platinum provides cover for this. Round trip economy or First Class railway ticket is included. Only condition is 5-7 days continued treatment.
So now, you need nomoreviews !