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I want to buy a Health Insurance Plan for my family and have zeroed in on 3 plans

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16 Jan, 2021 by  Manju Jain

I want to buy a Health Insurance Plan for my family and have zeroed in on 3 plans Max Bupa Reassure, HDFC Ergo Optima Restore and Aditya Birla Activ Health Platinum - Enhanced after going through various plans and their brochures.


My Family (Myself - Age (Mid-Thirties) , Spouse - Age (Mid-Thirties) and 2 kids)


But Challenge i'm facing currently is to decide whether i should go for Base plan of SI (Rs 25 Lakhs) alone or Go for [Base Plan (Rs 10 L) + Super Top-up (Rs 25 Lakhs)] with the same insurer , Are there any critical points to take into consideration before finalizing the option ? Also any advice on which plan out of these 3 would be best will be highly appreciated and Vital. Thanks in advance.


Note: I've arrived at SI amount of Rs 25 Lakhs after going through various posts on Beshak forum and advice given by experts that today SI of Rs 10 Lacs may be sufficient but after 20 to 25 years it may not be sufficient considering health inflation of 5% P.A. So its better to have sufficient coverage at the earliest as in old-age it may not be possible to upgrade plan due to higher chances of rejection by Insurance Companies due to various factors. Please suggest if the thought process is appropriate or not.

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16 Jan, 2021
Co-founder, SureClaim

Hey Manju,

If you notice, all benefits in policies max out by 10 lakh. Beyond that sum insured, you're only buying extra SI, nothing else.

You can add Max Bupa Health Companion also in your consideration. It's a bit cheaper than ReAssure.

Of the lot you are considering, ReAssure is the most premium product (it gets sexier if you add Safeguard addon to your basket). Health Companion and Optima Restore are neck to neck competing products, and HC may be a little bit cheaper than OR in the very long term.

15-25L top-up is a better strategy with base of 10L. But check out their configurations. The top-ups should offer somewhat similar room limits as base plan, else you will face problem in deciding how to select room category at time of admission. I'm not very conversant about the top-up plans of these companies. But buy base and topup from same insurer.


I have come to believe that insurers don't want us when we're old. They artificially pitch premium very high at the time of renewal. You'd be shocked to hear insurers demanding 80k renewal premium for 3 lakh cover to 70-odd year old customers and they voluntarily drop out from renewal. You might be thinking to get loyal to insurers, but never expect them to get loyal to you. So don't throw a lot of money in the hope that your retirement is sorted. It may not be.


I hope I have not confused you :)


Wish you well. Happy to answer any follow-up questions.


Anuj Jindal

Co-founder

SureClaim

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17 Jan, 2021
Manju Jain
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19 Jan, 2021
Co-founder, SureClaim

Hi Manju, go for Option 1.

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21 Jan, 2021
Manju Jain
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02 Feb, 2021
Founder, Beshak

Hello Manju,


This is about your comment on this article: Health Insurance for people with Pre-existing Diseases | Top FAQs on pre-existing disease cover (beshak.org), where you asked for my views.


Base Plan Vs. Combo of Base + Super Topup from the Same Insurer:

One base plan will always be better; however, the excellent price benefits of Super Topup will outweigh the inconvenience of having two plans instead of one. If you ensure that the core benefits concerning room rent, financial limitations are similar, there shouldn't be an issue with Super Topup from the same insurer.


Reassure plan with Safeguard Add-on Vs. ReAssure Plan + SUPER TOP-UP:

You can opt for the Safeguard option to inflation-proof your cover in the long run.

  • Safeguard gives you a bonus sum insured on the inflation calculated based on the average CPI of the previous two years. The CPI inflation is usually around (give or take) 5%. Expecting 5% flat inflation on healthcare expenses over a longer period of 20 years is not unreasonable.

However note,

  • The Safeguard option does not protect the cumulative bonus or booster well - it protects only when claims are less than 50K in the previous year.
  • Reassure's reinstatement benefit is also excellent - since it refills the sum insured exhausted due to multiple claims - for related and unrelated ailments. Note, however, that the maximum amount payable for one claim is the sum insured - so in case your one claim is above the sum insured, then the policy won't pay for the entire amount. Hence do not cover the Reassure benefit as a double sum insured.
  • Based on the above considerations, we recommend that you have a base cover of at least 15L and then opt for Safeguard add-in. It looks like this should take care of your lifetime of hospitalization expenses. You won't need to take a Super Topup then, as Anuj mentioned.



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