[hothatchaway]

Not aware if any policy covers consumables or so called non medical expenses. Some insurers have agreed to cover the cost of PPEs because that's what worrying consumers. You can check for those

[sunilch]

Originally Posted by black12rr

I think I didn't explain properly , when there is a bill , customer have to pay consumables , it can be 10 % , 20% or any amount of bill , any insurance that even pays these.

Consumables are typically not part of the coverage for most of the plans. Consumables are high in cost only recently due to the ongoing pandemic.

However, there are plans that do cover consumables as well. But everything is simply directly proportional to premium you will pay. Higher coverage with low co-pay or coverage for consumables will simply jack up the premium you will need to pay.

Apart from consumables, there are limits on co-pay and room rent which also behave the same way.

However, there are plans that cover everything that you may ask for but those are expensive

[JayKis]

A a quick question on health insurance. Heard there is something called the GIPSA package between certain insurance companies and hospitals. Would you know who can provide these package amounts across hospitals for a certain insurer like national insurance for a specific treatment like Maternity for example?

1) Is it the Insurer per se?
2) Is it the Third party administrator?
3) Is it the individual hospital?

Thanks in Advance

[raksrules]

Can anyone suggest me a plan for a family of 4 with ages 37, 35, 6, 1.5?
I asked policy bazaar about the aditya birla 1Cr plan and it is mentioned, it is 5L + 95L topup as some people said.
They said NCB would be 25K only and max will go upto 2.5L. Does this mean that in the lifetime of this plan, I can never have base sum insured more than 7.5L (which will take few years of NCB I suppose?
They did mention COVID is covered along with consumables and premium is around 24K for our family.

Any other plans out there anyone can suggest for my scenario? I can go and verify accordingly.

PS: I have mediclaim through my work but it is only 3L. I cannot do any topup now as it is allowed only at year start or so. I may check next year what is topup amount my company asks but for now I need to get a health insurance plan myself.

[diyguy]

Originally Posted by raksrules

Can anyone suggest me a plan for a family of 4 with ages 37, 35, 6, 1.5?

Sharing my information. I have an employment policy of 9L plus a top up of 21L for me and my family (Wife, 2 kids and Mom). I took a personal policy in 2017 for my wife and kids alone so it would cover them post my demise. This was from Apollo Munich (now taken over by HDFC) and is called Health On floater insurance policy. It has a base coverage of 25L with a multiplier benefit of an additional 25L. I pay about 37K premium each year for this coverage.

[raksrules]

Originally Posted by diyguy

Sharing my information. I have an employment policy of 9L plus a top up of 21L for me and my family (Wife, 2 kids and Mom). I took a personal policy in 2017 for my wife and kids alone so it would cover them post my demise. This was from Apollo Munich (now taken over by HDFC) and is called Health On floater insurance policy. It has a base coverage of 25L with a multiplier benefit of an additional 25L. I pay about 37K premium each year for this coverage.

The 37K premium is for the 21L topup through work and additionally your personal policy both right?

[diyguy]

Originally Posted by raksrules

The 37K premium is for the 21L topup through work and additionally your personal policy both right?

No this is just for the personal 25L base policy for my wife and two kids.

[nitinkbhaskar]

Originally Posted by raksrules

Can anyone suggest me a plan for a family of 4 with ages 37, 35, 6, 1.5?

I have opted for Max Bupa 5+95 plan. Went through policybazaar as they were offering no cost EMI option for 3 years combined cost. Total amount ~18.5k / year for a family of 3 (31,32,4).

[raksrules]

Originally Posted by nitinkbhaskar

I have opted for Max Bupa 5+95 plan. Went through policybazaar as they were offering no cost EMI option for 3 years combined cost. Total amount ~18.5k / year for a family of 3 (31,32,4).

We have family friend who does sell Max Bupa policy and I have asked her quotes. She also was suggesting to go for greater base than 5+95 but she said 5+95 is also good policy.

[nitinkbhaskar]

Originally Posted by raksrules

We have family friend who does sell Max Bupa policy and I have asked her quotes. She also was suggesting to go for greater base than 5+95 but she said 5+95 is also good policy.

The greater base will help you in 2 ways:
1. Refill of Sum Insured is on base amount. Hence, in this case the refill will be 5 lakhs (or 7.5 if the refill is 150% of sum insured)
2. No Claim Bonus (NCB) is calculated on base amount. Hence, NCB in this case would be 10% on 5 lakhs.

In my opinion the total coverage (1 Cr) is good enough for at least a decade and hence the trade off for refill and NCB is quite fine.

[Ram_BMWTravel]

I have a Max Bupa group policy for similar family profile - 37,34,5,1 . I have a base policy of 5 Lakhs and a super top-up of 95 Lakhs. I bought this directly from Max Bupa for a total price of INR 22000.

I suggest to purchase this directly from Max Bupa website.
The base policy is Health Companion.
The Super Top-Up is called Health Recharge.

Ram

[raksrules]

Originally Posted by Ram_BMWTravel

I have a Max Bupa group policy for similar family profile - 37,34,5,1 . I have a base policy of 5 Lakhs and a super top-up of 95 Lakhs. I bought this directly from Max Bupa for a total price of INR 22000.

I suggest to purchase this directly from Max Bupa website.
The base policy is Health Companion.
The Super Top-Up is called Health Recharge.

Ram

I am confused as how to even go and buy this policy on max bupa website. I did find one 1Cr Money Saver Policy but I believe the one you are telling is different. I did find the "Health Companion" which shows me 3 variants but I don't see the super top up health recharge option anywhere.
Can you guide on this? I want to see how much premium is coming for us.

Edit: Using google and such, I did this..

1. Went to Click here and selected "Variant 3" with 5 Lakh Coverage. I got premium as 18432 for me.
2. Went to Click here and select 95 Lakh with 5 Lakh deductible and got quote of 6728.

This makes my total as 18432 + 6728 = 25160.


I am confused about the 5 Lakh deductible. Does this mean if someone is hospitalized and expense is 10 Lakh, then the base health companion wll pay 5 Lakh + additional 5 Lakh should come from my super top recharge but the 5 Lakh deductible means I will have to pay the 5 Lakh.
Does this mean, I will end up spending 5 Lakh when my total expense is 10 Lakh and with insurance covering initial 5 Lakh?

[Ram_BMWTravel]

Scenario 1

If your expense is 10 Lakhs then 5 Lakhs will come from base policy and then the next 5 Lakhs come from Top-Up.

Scenario 2

Hospitalisation Expense 1 --> 4 Lakhs --> Paid by base policy
Hospitalisation Expense 2 --> 2 Lakhs --> 1 Lakh paid by base policy and 1 lakh paid by Top-Up

The idea is that Top-Up policy has a deductible of 5 Lakhs and that deductible is covered by Base policy

[Deep Blue]

A noob question. Why such complicated terms of base & top up etc? Why cant the health insurance companies offer a straight forward policy of 1 crore instead of 5 lakhs base + 95 lakhs top up etc? And then there are so many riders. Why can't a single comprehensive policy cover everything?

[saket77]

Originally Posted by Deep Blue

A noob question. Why such complicated terms of base & top up etc? Why cant the health insurance companies offer a straight forward policy of 1 crore instead of 5 lakhs base + 95 lakhs top up etc? And then there are so many riders. Why can't a single comprehensive policy cover everything?

Because many of us will not be able to afford a ‘straight’ one crore policy.

In a top up concept, the base policy pays first- which is more probable for all cases. If the base policy is exhausted, then only the top up policy is enforced thus reducing your premium on it.

Regards.