What are the components I ought to look into to decide on a medical health insurance coverage

I’m a 43-year-old with two children, at present posted in Mumbai. The age of my partner is 39. I need to purchase a medical health insurance coverage for my household with three dependents. Please counsel me appropriate medical health insurance coverage choices, how a lot insurance coverage cowl can be sufficient in Mumbai, and what are the components I ought to look into to decide on the suitable medical health insurance coverage.


One ought to have at the least 10 -15 lakh of base plan together with a low-cost tremendous top-up plan from the identical insurance coverage firm. We advocate the below-mentioned choices with premiums :

1. 10 lakh of Reassure Plan from Niva Bupa + 40 lakh of Recharge tremendous top-up from Niva Bupa – Rs. 24,788(Base)+ 2,079(Tremendous High-up)= 26.867

2. 10 lakh of Prohealth Shield Plan from Manipal Cigna + 30 lakh of Tremendous top-up plan – 28,524 (Base) + 2,490 (Tremendous High-up) = 31,014

3. 50 Lakh of Lifetime Well being Plan – Home from Manipal Cigna Medical health insurance Co. – 32.214

Elements to think about earlier than choosing the proper medical health insurance:

1. Choosing the suitable insurance coverage quantity/Sum insured: On the time of choosing a medical health insurance plan, one ought to choose the quantity properly because it covers the medical bills for a yr. One also needs to check out his or her earnings ranges to investigate the premium inexpensive. One ought to have a sum insured which is 1.5 occasions of your annual earnings (Self + Partner put collectively).

2. No Declare Bonus: NCB refers back to the incentive provided by the insurance coverage firm for all of the years that you haven’t filed a declare. Normally it varies from 5 to 50% pa relying on the insurance coverage firm and plan. Your protection quantity is elevated on the time of subsequent coverage renewals for all claim-free years. This issue ensures that the coverage is future-ready to get a large sum insured enhancement yearly. It’ll make sure that ever so rising medical inflation would not eat into your sum insured over a time period.

3. No illness clever capping: This refers to a capping placed on varied diseases regardless of the sum insured within the coverage. There should not be any capping of ailments.

4. Cappings on room & ICU costs in a hospital: This refers back to the restrict on Room lease and ICU costs on a per-day foundation. One should have a look at shopping for a coverage that covers rooms on a single occupancy foundation with precise costs coated for ICU admission.

5. Extra options: There are options like Refill/Annual Free well being check-up yearly/Wellness options /OPD and many others which makes a medical health insurance coverage a “New Age medical health insurance Plan.”

Question answered by Sanjiv Bajaj, joint chairman and MD of Bajaj Capital. Queries and views at [email protected]

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