[Lobogris]

Originally Posted by SoumenD

Unlike term insurance, do the premium for health insurance keep increasing every year? In that case does it make any difference if I get the insurance while I am 30 or 35? As in if I start the insurance at the age of 30 & continue paying, will my premium at 35 be similar to someone who is starting the insurance at 35? Or do I get benefits of having started at younger age?

Your premium would depend upon your current age and the current premium each year. It makes no difference when you started the policy. If you are only 30 years old, save your money till you are at least 45 or 50 and then consider getting extra insurance. till then you should be fine with your work policy.

[Chetan_Rao]

Originally Posted by SoumenD

Can someone please clarify a couple of points regarding health insurance for me?

While lower entry age can also benefit you premium-wise in the long run, the largest benefit is the lower entry barriers while you're young(er).

There are exceptions, of course, but most young(er) people are less likely to have pre-existing conditions (esp. lifestyle afflictions) than someone middle-aged, so likely to get better coverage at lower premium with fewer policy exceptions (w.r.t. issues not covered, time limit before claims for certain illnesses/expenses etc.).

It's also not a good idea to be solely dependent on employer plans, esp. in a world with volatile job security. I have my parents covered through my employer since a few years now as outside insurance became ridiculously expensive once they became senior citizens, but the better half and I are covered by an independent external policy (on top of the default cover my employer provides).

Get one now, you'll thank yourself later on in life.

[SoumenD]

Originally Posted by Lobogris

Your premium would depend upon your current age and the current premium each year. It makes no difference when you started the policy. If you are only 30 years old, save your money till you are at least 45 or 50 and then consider getting extra insurance. till then you should be fine with your work policy.

So current premium would be lesser if I have a continuing plan from past few years right? Compared to a fresh plan where current premium is 0?

Originally Posted by Chetan_Rao

While lower entry age can also benefit you premium-wise in the long run, the largest benefit is the lower entry barriers while you're young(er).

There are exceptions, of course, but most young(er) people are less likely to have pre-existing conditions (esp. lifestyle afflictions) than someone middle-aged, so likely to get better coverage at lower premium with fewer policy exceptions (w.r.t. issues not covered, time limit before claims for certain illnesses/expenses etc.).

Thanks. Agree on the lower entry barriers part. But then do the premium keep increasing with age? I was hoping its somewhat like term insurance where the premium is fixed. Sorry am a total novice when it comes to health insurance nitty gritties

Originally Posted by Chetan_Rao

I have my parents covered through my employer since a few years now as outside insurance became ridiculously expensive once they became senior citizens

Exactly the reason I am not looking at external policies for them. They are senior citizens.

Any suggestion on policy providers which can be looked at? Like Max bupa, hdfc ergo? How are these?

[Chetan_Rao]

Originally Posted by SoumenD

...But then do the premium keep increasing with age?

Premiums increase for multiple reasons. e.g. my renewal premium went up a little bit this year due to govt. mandating COVID coverage on policies.

Usually, a few factors would influence your premium as years go by:

1. Your health situation as you age. Notice most policies are broken down by age brackets (usually 5 year segments), and your insurer may insist on periodic health check-ups to ascertain your health status and amend your policy accordingly.

2. Inflation in medical costs.

3. Your profession. Hazardous professions with known health impact will have higher coverage costs compared to saf(er) professions, both to begin with and the longer you stay in it.

All said, you'll get a far better policy at far better prices while younger/healthier when it's upto the provider to justify exclusions, than it is to get one when you're older and need to justify inclusions.

...Any suggestion on policy providers which can be looked at? Like Max bupa, hdfc ergo? How are these?

Haven't made a claim so can't comment on settlement efficacy first-hand, but I had an Apollo Munich policy (base + top-up) that has since transitioned to HDFC ERGO with a merger, and customer service has been good so far.

P.S. Whatever policy you get, don't fall for 'add-ons/riders'. A common one is the 'personal accident cover', which can be had far cheaper and higher value if bought separately. They say don't mix investment with insurance, I say don't mix your types of insurance either.

[AZT]

Originally Posted by SoumenD

For parents I want to continue with that as the premium for outside insurance is quite high. But as me and my spouse are younger is it better to have a separate health insurance from outside now as post retirement office cover wont last?

For parents, would suggest taking an additional outside insurance. As they cross 70, it becomes impossible to get new insurance and all policies have a 2 or 3 year lag where they can't claim for pre-existing conditions or some critical illnesses. Also, this is a tax deductible expense so if your parents file returns they can claim it or you can claim deduction in your return. Offices sometimes provide co-pay insurance which you don't find out till you actually have to use it, Co-pay means eg. 80% cost will be covered by insurance but 20% has to be borne by you which is huge if you have to go in for something like a heart surgery.

Would strongly recommend taking either a family floater for whole family or just a separate outside insurance for your parents, would say minimum of 5 lakhs and if you can stretch 10 lakhs considering cost of getting admitted and surgery these days.

https://economictimes.indiatimes.com...8.cms?from=mdr

[Lobogris]

Originally Posted by Chetan_Rao

While lower entry age can also benefit you premium-wise in the long run, the largest benefit is the lower entry barriers while you're young(er).

There are exceptions, of course, but most young(er) people are less likely to have pre-existing conditions (esp. lifestyle afflictions) than someone middle-aged, so likely to get better coverage at lower premium with fewer policy exceptions (w.r.t. issues not covered, time limit before claims for certain illnesses/expenses etc.

Insurance premiums are dependent on the age group. If a person gets health insurance when he is 20, he would pay a lesser price. However if he doesn’t need the coverage at 20 then there is no benefit in getting it for the future. When that same person reaches 25, 30, 35, 40, 45 or whatever way the brackets are designed by the company, his premium would keep increasing. So a person who got insurance from X provider at 20 would pay the same amount at 45 as someone who starts their policy at the age of 45. This is a common misconception that leads people to get unnecessary insurance at an early age. The whole hullabaloo about health insurance in India is ridiculous. In a place like the US where healthcare is very expensive, it makes sense. In India most hospitalisations cost around 1 to 3 lakhs. Something like a cardiac arrest followed by surgery is around 5 lakhs at the moment in a good hospital. So just to mitigate a possible cost of 2 to 3 lakhs, people want to pay 20 to 50k per year for decades. Once you cross 50 to 60 years, you would definitely need the insurance but guess what? It becomes prohibitively expensive by then. To the point that the premium of every couple of years would pay for one procedure. So the best alternative for a younger healthy person is to self insure unless they are very poor with no savings. Set aside a few lakh rupees and use them if you need it someday rather than needlessly paying 20 to 40k per year due to fear mongering.

Originally Posted by Chetan_Rao

Premiums increase for multiple reasons. e.g. my renewal premium went up a little bit this year due to govt. mandating COVID coverage. All said, you'll get a far better policy at far better prices while younger/healthier

The main reason and probably the only reason is age plus normal inflation related increase. That is applicable across the board regardless of when you got the policy. Yes, you would get a better policy while younger but when you reach 45, 50 or 60, you would have the same policy as anyone else and you would pay the same as those who join that year. So no need to waste money when you are young and unlikely to need health insurance.

Originally Posted by SoumenD

So current premium would be lesser if I have a continuing plan from past few years right? Compared to a fresh plan where current premium is 0?

Agree on the lower entry barriers part. But then do the premium keep increasing with age? I was hoping its somewhat like term insurance where the premium is fixed.

No, the premium paid each year would depend on the age at that time and would be the same regardless of when the policy was purchased. So a person who got a policy in 2005 would pay the same as someone of the same age getting it this year. Only benefit in getting insurance earlier on is that most policies come with 2 to 3 year exclusion on certain illnesses. However it is silly to start a policy at 30 just to avoid a 2 year exclusion if you anticipate needing it at the age of 50 plus. You could start it at 48 years of age in that case.

[Chetan_Rao]

Originally Posted by Lobogris

... no need to waste money when you are young and unlikely to need health insurance.

Let me tell you a little story.

A badminton mate of mine used to be a staunch advocate of 'I'm young and healthy, statistically unlikely to need insurance so I won't waste my money'.

Three years ago, an on-court incident aggravated a couple of previously untreated/improperly treated niggles badly enough that he needed reconstructive surgery for one and long-term therapy for another.

He paid a rather significant chunk of the bills out of pocket. Dual income, no kids couple so could afford it but cleaned them out. Still didn't bother buying insurance on top of the relatively meager coverage his employee benefits provided.

While he was still recuperating himself, his pregnant wife (a bit younger than him) developed unforeeseen and severe pregnancy-related complications, causing further large bills and her having to quit her job (both for own health and childcare reasons). He had to change jobs (to one with lower pay) to accomodate his own restricted mobility, and hire a nurse for his bedridden wife as he couldn't manage to care for both of them (and later the baby) himself.

A reasonably well-earning, healthy and young (late 20s) middle class couple reduced to a one-income family now significantly in debt, and their finances screwed for at least a decade, if not more, all unexpectedly and within a a relatively short span of time.

Didn't end there either. His retired (and guess what, under-insured) father recently needed surgery for a heart ailment, necessitating personal loans at the usual predatory lending rates, while he's worried about his job (hospitality sector) and inability to pay his debts.

I've not had the misfortune of using any of my insurance yet; health, automotive or life (obviously), and I could in theory look at all my premiums paid so far as money wasted. Sure.

Playing the percentages admittedly seems very lucrative, esp. to those with a statistical advantage, until one unexpectedly finds themselves on the wrong side of the numbers. Falling prey to a one-in-a-million possibility is no solace to the poor sod who is the unfortunate one in the million.

The insurance business also works on the base assumption that pay-ins will exceed pay-outs. If everyone bought it when they actually need it, it would be far more restrictive, both financially and other entry criteria, than it is today, and some people would just be refused outright or unable to afford it, as already happens to older and/or at risk people, but orders of magnitude worse.

One buys insurance hoping to NEVER need it, and I'm not saying for a moment that health insurance would've solved all my friend's troubles, but it's rather obvious that it would've mitigated the situation spiralling so wildly out of control in such a short time. No prizes for guessing whether he can get a reasonably-priced policy now, without a tonne of riders attached, even though the couple is still theoretically 'young and statistically low-risk'.

Being uninsured/underinsured is playing the percentages, and dependent entirely on one's risk appetite, but it's absurd to assume nothing will happen just because it's statistically unlikely, as my friend (who owes me a rather significant 6 figure sum that I don't intend to collect on anytime soon) learnt in potentially life-destroying fashion.

In an ideal world, everyone will be financially prudent, have significant liquid savings to cover emergencies and be blessed with great health and fortune to not have an emergency at all. The real world looks like the story above.

Still, to each their own, of course.

[SoumenD]

Thanks everyone for your inputs around health insurance. Clears a lot of doubts for someone like me who hasn’t looked much into this aspect and has been primarily dependent on office insurance all this while.

Oh and I have used it twice. Once in 2010 for myself (50k) and very recently for my senior citizen dad(1.5L in hospital bills). My current office insurance is topped up to 10L ( I pay a small amount out of pocket). It can be further increased to 12.5L IIRC. This primarily covers my parents, spouse and I. Spouse already has another insurance from her office(no payment required) as well just incase I end up exhausting quota for parents god forbid.

Guess will stick with these for a couple of years

[Fx14]

Originally Posted by Lobogris

Insurance premiums are dependent on the age group. If a person gets health insurance when he is 20, he would pay a lesser price. However if he doesn’t need the coverage at 20 then there is no benefit in getting it for the future. When that same person reaches 25, 30, 35, 40, 45 or whatever way the brackets are designed by the company, his premium would keep increasing. So a person who got insurance from X provider at 20 would pay the same amount at 45 as someone who starts their policy at the age of 45. This is a common misconception that leads people to get unnecessary insurance at an early age.

........ Yes, you would get a better policy while younger but when you reach 45, 50 or 60, you would have the same policy as anyone else and you would pay the same as those who join that year. So no need to waste money when you are young and unlikely to need health insurance.

Well your assumption of the misconception is due to the fact that you have ignored the benefit of NCB.

While the premium is dependent on the age bracket of the policyholder, in the case of some one who has been renewing the policy without any claim, the NCB could add upto 100% of the base sum insured depending on the type of policy taken. So in effect the premium paid per Lakh of actual coverage is way different for a fresh applicant compared to an extant policyholder with NCB.

Besides this, the other beneficial arguments listed in the past few posts above of pre-existing ailment coverage, the basic concept of insurance to protect against the unforeseen etc. also hold true for an extant policyholder.

As an aside, the return for money spent argument is probably the worst approach where insurance is concerned, resulting in many people preferring even ULIP as against Term insurance. But yes, to each one his own perspective.

[Lobogris]

Originally Posted by Chetan_Rao

Let me tell you a little story.

A badminton mate of mine used to be a staunch advocate of 'I'm young and healthy, statistically unlikely to need insurance so I won't waste my money'.

Three years ago, an on-court incident aggravated a couple of previously untreated/improperly treated niggles badly enough that he needed reconstructive surgery for one and long-term therapy for another.

He paid a rather significant chunk of the bills out of pocket. Dual income, no kids couple so could afford it but cleaned them out. Still didn't bother buying insurance on top of the relatively meager coverage his employee benefits provided.

While he was still recuperating himself, his pregnant wife (a bit younger than him) developed unforeeseen and severe pregnancy-related complications, causing further large bills and her having to quit her job (both for own health and childcare reasons). He had to change jobs (to one with lower pay) to accomodate his own restricted mobility, and hire a nurse for his bedridden wife as he couldn't manage to care for both of them (and later the baby) himself.

A reasonably well-earning, healthy and young (late 20s) middle class couple reduced to a one-income family now significantly in debt, and their finances screwed for at least a decade, if not more, all unexpectedly and within a a relatively short span of time.

Playing the percentages admittedly seems very lucrative, esp. to those with a statistical advantage, until one unexpectedly finds themselves on the wrong side of the numbers. Falling prey to a one-in-a-million possibility is no solace to the poor sod who is the unfortunate one in the million.

These are exactly the kind of stories that are used to scare people into buying insurance. If the friend in question had purchased an insurance cover of 5 lakhs as most people did till recently, all that would have changed would have been that he was around 4 lakhs better off. That is the extent of benefit you can derive. I already made it clear that if one has no savings or is poor then it might make sense to look for insurance. If the amount of 5 or 10 lakhs is life changing for a person or is a sizable chunk of their savings or assets then by all means purchase insurance. Otherwise, I can tell you all kinds of stories as to why you need home insurance, renters insurance and even an umbrella policy in case you incur a lawsuit for damages.

Originally Posted by SoumenD

Oh and I have used it twice. Once in 2010 for myself (50k) and very recently for my senior citizen dad(1.5L in hospital bills). My current office insurance is topped up to 10L

Underscores my point. In the past 10 years the benefit has been just 50k for a young individual.

Originally Posted by Fx14

Well your assumption of the misconception is due to the fact that you have ignored the benefit of NCB.

While the premium is dependent on the age bracket of the policyholder, in the case of some one who has been renewing the policy without any claim, the NCB could add upto 100% of the base sum insured depending on the type of policy taken. So in effect the premium paid per Lakh of actual coverage is way different for a fresh applicant compared to an extant policyholder with NCB.

Besides this, the other beneficial arguments listed in the past few posts above of pre-existing ailment coverage, the basic concept of insurance to protect against the unforeseen etc. also hold true for an extant policyholder.

As an aside, the return for money spent argument is probably the worst approach where insurance is concerned, resulting in many people preferring even ULIP as against Term insurance. But yes, to each one his own perspective.

Yes, it is a personal choice. You do get higher sum insured after a few years of no claims but I would not pay needless premiums for many years just for that. My remark was for a person who is say 20 or 30 years old and is unlikely to need coverage till around 50 years of age. In my view it is unwise to needlessly pay premiums for decades for the marginal factors outlined by you. Again, as I said above, if you don’t have the capacity to pay a few lakhs out of pocket or a few lakhs would make a sizable dent in your finances then by all means purchase insurance.

[Chetan_Rao]

Originally Posted by Lobogris

... if one has no savings or is poor then it might make sense to look for insurance. If the amount of 5 or 10 lakhs is life changing for a person or is a sizable chunk of their savings or assets then by all means purchase insurance...

At average Indian payscales, how many young people do you think would NOT consider 5-10 lakhs a significant chunk of their savings? Tier-1 urban payscales (IT etc.) are the exception, not the norm.

You seem to be:

1. Assuming only older people need insurance
2. Discounting the impact of large incidental expenses on earning and asset creation potential (lack of money compounds too)
3. Missing the whole premise of insurance altogether

Even if we assume for a moment #1 & 2 don't matter, #3 is the kicker. Insurance exists on the basic premise that at any point in time, premiums paid-in exceed claims paid-out. If you flip that, as would happen if most people get insured closer to when they're likely to make a claim), the insurer will find themselves paying out more than they're getting paid in premiums. Which insurer would want to operate in that model (assuming their shortfall is not subsidized by other means)?

The only options left to the insurer then would be to either hike premiums to a level necessary to keep pay-outs lower than pay-ins (making it unaffordable to a large chunk of people), or to deny insurance to at-risk people altogether. The statistically larger younger and/or lower-risk group paying into insurance covers the claims of the statistically smaller group of older and/or higher-risk claimants. Remove the former from the pool, and the latter would need to to pay significantly higher to get coverage, unless you think the insurer will pay out of the goodness of their hearts while making a loss.

The approach you suggest (buying insurance closer to needing it) only works if a majority of people DON'T adopt it. If they do, a significant chunk of them won't be able to afford insurance when they actually need it. The insurance you'd buy when you're older and need it (assuming you could afford it), would still have its claims paid for from the premiums of others younger and lower-risk than you who 'wasted their money' in your opinion.

Obviously none of it matters if one just stops being 'poor' and can cover any incidental expenses out-of-pocket, but that's a small minority of people.

[Carpainter]

I have a query related to cashless claim. I have a policy from Universal Sompo that now stands at 7.80L after NCB. I have a planned hospitalization next month for which the hospital has given an estimate of 1.10 lakh but the insurance company has given a cashless authorisation of 50k only which is less than even 50% of actual estimate given. Is there any way I can increase the insurance claim or reduce my out of pocket expense in this case.

PS. There is no upper cap of room rent as per my policy.

[sugam]

Hi All,

Looking for advice related to buying top-up insurance for my parents who are now 67 and 62. They already have an ICICI Lombard policy that covers them for up to 5 lacs each (originally 3L, but benefits have accrued over time making it 5L).

Given that they have had some health scares 5-7 years ago, I've been told that insurers such as Max Bupa and Aditya Birla would not be willing to insure them and reject the proposal straight away.

I was suggested to consider Star Health's Senior Citizen red carpet by a policybazaar executive, who seemed to know his stuff well. I understand that it comes with a 1 year PED exclusion and a 30% co-pay thereafter - but does this sound like a reasonable option?

Does anybody else have any past experience on similar lines?

Also, considering Max Bupa 5+95 for myself and my wife - does this sound sensible?

Thanks in advance and stay healthy

[dsnaveen21]

Hi,

Anyone has tried ACKO for Health insurance? Their premium is less than Religare.
Religare health insurance is getting expired, premium is 15K, Acko is 9K
Any comments much appreciated.

Thanks,

[ManasN95]

Hello everyone, I'm 25 years old, and as per my existing mediclaim policy (Religare Care) I am in a floater with my father and I'll be seperating this year.

A brief search on policybazaar and on the internet regarding claim settlement ratios of different insurers, Religare still comes out on top as per various sites.

Now that I'm researching and buying my own health insurance, may I know what you all feel to be a good insurer for me and my Dad seperately?

I'm currently looking at Religare Care Advantage cover of 25L lakhs for me, maybe switch to 1cr in a year or two.

I don't have any previous medical issues but I'm obese.

I'd love some guidance from you all.

TIA.

- Manas.