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Why to Buy Health Insurance and Critical Illness Policy Separately?
Akshay recently got diagnosed with lung cancer. Severe pain, list of medicines and hours of waiting for the doctor were not enough to shatter him down until he got his reports. Health insurance seemed like a silver lining of this dark cloud. But, unfortunately, Akshay was taken aback when his health insurance advisor informed him that his policy did not cover any such critical diseases. That is when he realized that all the premiums he paid for being secure against any health issues would go down the drain when he would need that security the most as his health insurance could only cover his hospitalization expenses but not the treatment charges.
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- Why to Buy Health Insurance and Critical Illness Policy Separately
Had Akshay purchased a critical illness plan earlier, he would not have to deal with any financial and emotional worries. Like Akshay, many of us believe that a comprehensive health insurance plan is enough to deal with all health problems that might occur in our life, but we forget that critical illness and health insurance plans are two completely different policies that cater to separate purposes.
Let’s try to understand the specific needs of both the plans and find out why health insurance and critical illness plan are required separately.
Basic Feature
Health insurance reimburses your medical and OPD expenses during hospitalization. It might not cover all the diseases and generally have a longer waiting period.
Whereas, critical illness policy covers life-threatening diseases like cancer, multiple sclerosis, kidney failure, bypass surgery etc. The insured gets the cover amount as soon as he/she gets diagnosed with any of the listed critical illnesses. This policy has no association or concern with the hospitalization expenses.
Coverage
Both health insurance policy and critical illness plan have a different scope of coverage. The health insurance policy covers accidents and a gamut of ailments. After a defined period of time, it even covers the pre-existing diseases and maternity health. Whereas, critical illness policy covers a specified list of critical illnesses; the number of which might vary from 6 to 12 depending on the insurer. According to the policy documentation, if mentioned, it also covers circumstances like travel and boarding on a temporary basis, postoperative care and loss of pay.
| You may also like to Read: Section 80C Income Tax Deduction |
Benefits
Benefits of mediclaim or health insurance plan include the reimbursement of hospitalization expenses. When getting treated at a network hospital, the insured person can avail cashless facility where the bills are paid directly by the TPA/ insurance company to the hospital. After making a claim, your health insurance policy might continue till the time your entire sum insured is exhausted. Further, it can be renewed every year.
Critical illness plan has its own set of defined advantages. Here the insured receives a tax-free lump sum after diagnosis of a pre-specified critical illness. Insured is not required to present the original bills and can manage with photocopies. Since the entire amount is handed at once, the insured can spend it as he/she wishes. Further, the critical illness policy expires once the claim is made.
Sum Assured
Although the sum assured value varies from one insurer to the other, there are some limits defined for all. In case of health insurance policy, the cap is set at Rs. 5 Lakh (some companies might provide cover up to Rs. 10lakh) and the coverage of critical illness policy ranges from 5 Lakh to Rs. 50 Lakh.
| You may also like to Read: Section 80D |
Waiting Period
Both mediclaim and critical illness policy follow the concept of the waiting period. Apart from accident-related loss, health insurance policies have a waiting period for the first 30 days and the illness contracted during this duration from the commencement of the policy is excluded. In the case of pre-existing ailments, there is generally a waiting period of 1 to 4 years.
Whereas in case of critical illness policy, there are a 3 months general waiting period and the illness diagnosed in this period is not included in the cover.
Conclusion:
While mediclaim policies are bought to defray hospitalization expenses, critical illness policy compensates the financial expenses that arise from a serious illness. None of us would ever want to be in Akshay’s position wherein he could not fight with a life-threatening illness even after being covered with a comprehensive health insurance policy. Both the policies are designed to serve some particular purpose and supplement each other and hence, both the plans are necessary and should be purchased separately.
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Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. For complete list of insurers in India refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in
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*₹1748/month is the starting price for a 1 crore health insurance for an 18-year-old male, with no pre-existing diseases. Discount on renewal premium is subject to the number of wellness points earned in the health insurance policy. For more details about the plans, please read the sale brochure carefully to get upto 100% discount on renewal premium.
*₹400/month is the starting price for ₹ 5 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases
*₹541/month is the starting price for ₹ 10 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases
*₹762/month is the starting price for ₹ 1 Crore Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases
*₹243/month(₹ 8/day) is the starting price for a 5 lakh health insurance for a 20-year-old male, non-smoker, living in Bengaluru with no pre-existing diseases
*₹2020/month is the starting price for ₹ 1 Cr Health insurance for a 50 year old male & 50 years old female, living in Bangalore with no pre-existing diseases rounded off to nearest 10.
*₹390/month (₹13 per day) is starting price for 1 cr. Health insurance for 25 years old male, with pre-existing diseases, residing from tier 1 city rounded off to the nearest 10.
*No medical tests are required unless requested by the insurer’s underwriter. In-case of pre-existing diseases relevant medical proof would be required as per the terms and condition of the policy opted.
*The values taken for effective cost calculation are indicative values and may change as per the selected plan.
*Coverage upto double the amount of Sum Insured is available on certain covers for a minimum plan of Rs. 5 Lakh on the first claim only to an individual of upto 45 years of age with no pre-existing diseases. The benefit is available with or without extra cost depending on the plan chosen.
*Coverage of pre-existing diseases is provided by insurer as per their underwriting policy.
*The scope of coverage may vary from plan to plan.
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