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Buying a Fixed-Benefit Health Plan? Think of it as a Supplement
As a result, taking care of a medical emergency or being afflicted with a serious aliment can not only take a toll on one’s general well-being but also their financial stability. This is why it is important to not only have a health insurance plan but additional back-up as well, in this case, in the form of a fixed benefit plan.
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- Buying a Fixed-Benefit Health Plan? Think of it as a Supplement
It is important to remember that while a fixed benefit health insurance plan covers a specific insured event, it does not cover aspects like pre-hospitalization and post-hospitalization expenses, and day-care expenditures.
With a growing increase in lifestyle-related diseases, the risk of having hospitalization is increasing.To make matters more complicated, the cost of healthcare is rising even faster than the general level of inflation.
This is why you should always ensure that you have a basic indemnity policy in place, over and above which, you can opt for a fixed benefit plan. To put it simply, a fixed benefit plan is for those individuals who want to enhance their existing health cover.
How does a fixed benefit plan work?
A fixed benefit plan pays a certain stipulated sum on a pre-defined event that has been insured. In a sense, it works like an income supplement. It could be in the form of a hospital cash policy, personal accident cover or a standalone critical illness cover.
For example, a critical illness policy will pay the policyholder the sum assured if the individuals covered under the plan contract any of the critical illnesses listed in the plan. Thereafter, the plan will terminate. To ensure that the plan chosen covers a range of likely diseases, you should pick a plan that covers at least some of the commonly known critical illnesses. The payout from the insurance provider has no relation to the actual expenses incurred, in a fixed benefit plan.
Often, policyholders are not able to claim medical insurance and expenses that are not related to hospitalization, which is where a fixed benefit plan comes in handy. It also compensates individuals for income lost due to hospitalization. This is particularly beneficial for self-employed professionals or those who do not get this benefit from their employer.
Why you should have a regular health insurance plan
A regular health plan provides a wider coverage, as a fixed benefit plan only covers specific illnesses. Thus, if you are to be hospitalized for a minor surgery, or because of accidental injuries, your health insurance plan will come into play.
Also, when it comes to a fixed benefit plan, once the claim is paid, the plan ceases to exist. However in the case of a regular health insurance policy, you can claim the amount up to the sum insured within the policy year and also renew the policy for life if you like.
So for example, if the sum insured is INR 3,00,000 and the bill amount is INR 70,000, the balance INR 2,30,000 will remain unutilized but the policyholder will be able to use this amount to claim any other hospitalization costs that might crop up during the coverage period. Additionally, fixed benefit plans are more expensive than a regular indemnity-based policy.
Supplement your health insurance plan with a fixed benefit plan
Your health insurance plan, which can be in the form of a family floater or mediclaim policy, should thus be the main cornerstone of your health insurance investments. Over and above that, you can consider opting for additional security by purchasing a critical illness plan to protect yourself against lifestyle-based diseases and a hospital cash policy to meet incidental costs while you are hospitalized.
Key factors to keep in mind
- Insufficient coverage—the policy will pay a lump sum only in case of surgery
- The payout from the insurance provider has no relation to the actual expenses incurred
- Some fixed benefit plans have a broad coverage, but not all
- Ideal for people who want to enhance their existing health cover
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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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*Product information is authentic and solely based on the information received from the Insurer. Policybazaar is acting only as a facilitator and claims settlement shall be at the sole discretion of the Insurer. Policybazaar does not provide any medical or surgical advice or diagnosis and is not responsible for your interactions / treatment by a medical practitioner/hospital. Please consult a registered medical practitioner for any medical or surgical advice. The Information that you obtain or receive from Policybazaar, and its employees, or otherwise on the Website is for informational purposes only. As per the Insurance guidelines, you are allowed to cancel the policy with-in 30 days from the date of Issuance of policy.This option is available incase of policies with a term of one year or more.
*All the health insurance plans cover hospitalization expenses including COVID-19 treatment cover up to the specified limits. You can also buy specific COVID-19 health insurance policies such as Corona Kavach Policy and Corona Rakshak policy.
**All savings and online discounts are provided by insurers as per IRDAI approved insurance plans. #Tax Benefits are subject to changes in tax laws. GST Exemptions depend on fulfilment of qualification criteria and submission of relevant documents.
*₹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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