Patients with heart conditions can get special mediclaim

Published in Mint on 30th Sept 2014, Written by Abhishek Bondia

I am 30 years old and have a year-old daughter. My wife is a homemaker. What will be the right amount of health cover for my family?
—S. Karuna

At this young age, you have several options. Here is an approach to choose the right cover. First, shortlist plans that have no disease sub-limits, no co-pay and no room rent restrictions. These conditions significantly affect your admissible claim amount. Second, if either of you have a pre-existing condition, then filter plans with least waiting period for pre-existing diseases. Finally, compare costs. Additionally, you can use the Mint Mediclaim ratings for a specific detailed comparison across products.
When buying health cover, do not compromise on the sum assured. A rule of thumb is to take a cover that is at least 50% of your annual income.

I plan to buy a health insurance for my parents, which will be in their name. But since I am buying the policy, will I get tax deduction on the premium?
—Piyush Jha

You will get tax deduction under section 80D up to Rs.15,000. The deduction for parents’ policy premium is over and above the deduction allowed for self, spouse and kids. If your parents are more than 60 years old, the eligible deduction limit increases to Rs.20,000.

I have a health insurance policy of my own and one from my company. I want to make a claim. Can I claim on both?
—Alex

As per recent health insurance regulations, you can hold two health insurance policies and can distribute a claim between the policies in any proportion you want. You can file the entire claim in one policy as well. I recommend that you first claim on the company policy. After that is used up, utilize your individual insurance. This will help protect your no-claim bonus in the individual policy. Also, claim settlement in corporate group insurance tends to be faster and more streamlined.

I suffered a heart attack two years ago. Will this in any way affect my getting a health insurance policy?
—Saqib

Yes, it will. Insurers hesitate to issue a cover when there is a major pre-existing condition, such as a heart attack or epilepsy. Some insurers might issue a policy either with premium loading or make cardiovascular diseases a permanent exclusion. You need to identify an insurer with slightly liberal underwriting—that’s typically insurers with a large health insurance portfolio. The good news is that there are some special plans designed exclusively for heart patients. These plans are expensive and with a few restrictions but will provide you at least a basic cover.

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