Health Insurance - Policy Suggestion Please

[vsan]

I am looking at buying an insurance policy for a female who is 51 years in age and is already having diabetes since 5-7yrs.

1. Mediclaim - My basic hospital, doctor, surgery, ICU, OT bill etc
2. Hospital Cash - allowance towards my Private nurse etc.
3. Critical Illness - Lumpsum if i am detected with something.
4. Surgical Benefits - something new i think, maybe i may take it premium seems to be one time payable for 20 yrs in HDFC

i hope i have got my basics right as to what policy pays for what

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Mediclaim policy should cover higher category hospital rooms which are usually between 7,000 to 10,000 per day in good hospitals in Mumbai.
I have seen many mediclaim policy's that restrict the room charge to either 1% or the lowest single room.
So maybe a higher mediclaim policy of 7.5 to 10L is required.

Some policy says pre existing covered after 4 years some say 2 years, i am sure there will be conditions attached to this. can someone through light on this please.

Does one mediclaim policy have multiple TPA's thereby giving you maximum coverage of cashless claim hospitals.

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Hospital Cash

Again i am looking at allowance like 2500 to 5000 a day
Do you think i should take a separate one or does any mediclaim have it in built.

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Critical illness
which is the best, covering maximum common diseases, some cover a lot but mostly you dont get thoses diseases during a lifetime, so no point buy a policy which covers 100s but not the common one.

As diabetes is already pre existing, does this critical illness policy help,
are medicals necessary
Do you have to declare diabetes.

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Surgical benefits
something new i have not known till now, need to study it still.

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So forum can you help me derive at the best possible policys. I am sure this post will help others too.
Also what insurance company's are best at settling claims many a times i have heard they just don't pay and deduct etc.

Thanks
VSAN

[Harish Rawat]

I am looking at buying an insurance policy for a female who is 51 years in age and is already having diabetes since 5-7yrs.

Please check - ICICI Pru Diabetes Care Active.

[PolicyWala]

You can take Apollo Munich Health Insurance - Maxima Product. It will cover three of your four requirement - Mediclaim, Hospital Cash and Critical Illness

Why go for Apollo Munich?
1- 100% Lifelong Renewal.
2- 4500 Hospitals in over 800 cities.
3- Pre-existing illnesses under OPD Benefits, covered: If you need medicines or a Doctor consultation for any pre-existing illness, it’ll be covered without any waiting period.
More Info - http://www.apollomunichinsurance.com/Downloads/sidedeck/about-maxima.pdf


Mediclaim policy should cover higher category hospital rooms which are usually between 7,000 to 10,000 per day in good hospitals in Mumbai.
I have seen many mediclaim policy's that restrict the room charge to either 1% or the lowest single room.
So maybe a higher mediclaim policy of 7.5 to 10L is required.

Some policy says pre existing covered after 4 years some say 2 years, i am sure there will be conditions attached to this. can someone through light on this please.
In some companies there are multiple TPA, you can choose from. But It's the insurance company which pays the claim so the policy and coverage is the most that matters.

Do you think i should take a separate one or does any mediclaim have it in built. I think build in would be cheapest and also you need to contact one TPA/ insurer in case of claim.


Critical illness
which is the best, covering maximum common diseases, some cover a lot but mostly you don’t get those diseases during a lifetime, so no point buy a policy which covers 100s but not the common one.
As diabetes is already pre existing, does this critical illness policy help,

Almost all the health policies cover similar Critical illness disease. Diabetes is pre-existing, anyway diabetes is not part of Critical Illness disease.

are medicals necessary
Yes

Do you have to declare diabetes.
Yes. you need to declare

[PolicyWala]

Please check - ICICI Pru Diabetes Care Active.I personally avoid ICICI Pru Diabetes Care Active.

[vsan]

I wanted to clarify these 2 points in Apollo Munich Maxima.

1. The policy says they can apply loading of upto 150%
Does the loading have to be decided (if any) at the time of purchase?
Can they apply loading once the policy is started i mean maybe after 2yrs or 7yrs or 9yrs or something at their discretion ?
Can they change the premium once someone completes a particular age like 60?

2. They also say 10% increase in the SI every claim free year, Max 50%.
but they also say incase of a claim, the cumulative bonus will be reduced by 20% in the next year.
DOES this mean that my base policy of 300000 is always constant and changes are only in the bonuses or can the make changes to my base amount of Rs.300000 also.

Can you please help my clarify the 2 points above.

Regards
vsan

[vsan]

I just called Apollo Munich on 18001030555 and their representative Ms. Kanika informed me that they dont cover patients with pre existing DIABETES.

[PolicyWala]

I wanted to clarify these 2 points in Apollo Munich Maxima.

1. The policy says they can apply loading of upto 150%
Does the loading have to be decided (if any) at the time of purchase?
Can they apply loading once the policy is started i mean maybe after 2yrs or 7yrs or 9yrs or something at their discretion ?
Can they change the premium once someone completes a particular age like 60?
This all depends on the underwriting policy of the insurance company.


2. They also say 10% increase in the SI every claim free year, Max 50%.
but they also say incase of a claim, the cumulative bonus will be reduced by 20% in the next year.
DOES this mean that my base policy of 300000 is always constant and changes are only in the bonuses or can the make changes to my base amount of Rs.300000 also.

Can you please help my clarify the 2 points above.

Regards
vsan
Bonus means that your Sum Insured will increase without paying extra premium. And same way only the bonus premium will reduce on the basis of each claim.

I just called Apollo Munich on 18001030555 and their representative Ms. Kanika informed me that they dont cover patients with pre existing DIABETES.
I have said as per the info on there website. Which says, "Pre-existing illnesses under OPD Benefits, covered: If you need medicines or a Doctor consultation for any pre-existing illness, it’ll be covered without any waiting period."

[vsan]

No but the whole joke is that they are not ready to even ready to consider application form from diabetic patient. so no Apollo Maxima policy for diabetic patients. :-)