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Planning for health cover: Why mediclaim alone is not enough

When Amit, 37, an advertising executive in Delhi, underwent an emergency heart surgery, his family battled the headwinds, both emotionally and economically. Amit’s family, which was already grappling with the financial burden of EMIs for two loans and saving for their daughter’s education, had to spend their entire lifesavings on hospital bills. A health cover, in this situation, would have saved them the distress.

Amit is one of the many young urban Indians who are falling prey to lifestyle diseases, with alarming frequency today. Unfortunately, the emotional battle that comes with it for the families is aggravated by the massive economic burden. This is where a health insurance comes to the rescue.

But worryingly, less than 15% people in India have health cover, and of those who do, are gravely underinsured. Usually, most organizations provide a mediclaim cover, up to a certain limit, for its employees. However, individuals must take into account that a mediclaim policy has several exclusions, and in many cases, is not enough.

Mediclaim is helpful in cases of hospitalization due to regular ailments, minor surgeries or one-time treatment. In such cases, all costs, including tests, treatment, room rent etc. is taken care by the mediclaim policy. But, what happens if one is diagnosed with a critical illness, such as cancer or a heart attack, which requires continuous medical treatment over a significant period of time? Also, how will a family meet its present and future expenses, if the earning member of the family is diagnosed with a critical illness, and his income stops? 

Hence, for an adequate health care, it is imperative that along with a mediclaim policy, individuals must also invest in personal health policies, like critical illness plans and specific plans for high incidence critical illnesses. 

In such plans, the insured can claim the entire sum assured for the treatment of a critical illness, specified in the policy.  This sum assured paid to the insured, will not only cover his medical treatment, but the additional funds from the lumpsum amount paid by the insurer, can be used for household expenses and meeting future needs like child’s education or retirement.

However, it is crucial that factors like illnesses covered by the plan, the sum assured, the policy term and the premium should be considered carefully before choosing a critical illness plan. 

Remember, the right decision to invest in the right health plan at the right time, can not only help our family ride over uncertainty and emerge strong if an illness strikes, but also secure their future. 

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