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PROVIDING medical insurance cover for employees and their family members is a norm among many big companies now. But, considering how medical expenses have soared in the past few years and companies have also reduced the size of medical cover due to high claim levels, it just may not be enough.
It would be wiser to have a family health cover to prevent unforeseen medical expenses at unexpected times. What should one look out for before choosing a medical insurance cover.
If there is no medical cover from the employer:
For those who do not have a medical cover provided by the employer, taking a family health cover for all family members will be more economical than taking individual cover for each member.
For a family of four members, say a couple and two children, living in a metro, a medical cover for Rs 3,00,000 would be ideal.
If one were to include two senior citizens, then a Rs 5,00,000 cover would be advisable with a critical illness top-up.
If the employer provides medical cover:
Even if the employer provides a basic medical insurance, it may not be sufficient to cover the possible medical expenses. Instead of taking an additional health insurance cover, it would be wise to take a top-up cover. A top up cover would come into force only when the coverage limit of the basic health insurance policy has been used up. The premium paid on a top-up cover is also cheaper than a full-fledged family insurance cover.
Many insurers like United India and Bajaj Allianz have top-up family insurance covers.
Over 45 years? Consider a full-fledged cover:
Taking a full-fledged medical insurance cover for self and spouse after retirement, when the corporate medical coverage ceases to exist, will end up becoming very expensive. Instead, taking a comprehensive policy when one is around 45 years of age will not only provide adequate coverage when health conditions start kicking in, but will also result in lower premium outgo, compared with taking a fresh policy at 50 years of age.
Family individual plan or floater plan?
An individual plan is where each member will be covered up to a specific sum, say Rs 1,00,000 in a policy with Rs 4,00,000 coverage for a family of four members. In a family floater policy, the medical cover could be used by any member, to any extent up to the maximum coverage limit.
The premium is cheaper in a family floater policy compared with a family individual policy. The choice between taking a family floater or individual policy depends on the risk perception and the susceptibility to medical treatments as perceived by the person.
How to choose a cheaper family health policy?
Some insurance companies start with low premium rate and then after two years increase the rate dramatically. When evaluating health insurance policies, look at premium rates of the last five years of the insurance company to ensure that you are looking at pricing over a period of time.
Also, it is good to choose policies with a co-payment option (percentage of claim that you will have to bear) as it can bring down the premium rates significantly at a nominal cost.
Saving tax with family health insurance: Finally, a family health insurance cover also helps one save tax under Section 80D.
One can claim an annual deduction of Rs 15,000 from taxable income for health insurance premium for oneself and dependents, which includes spouse and children. For health insurance premium paid towards parents, an additional tax benefit of Rs 15,000 could be claimed, which would also increases to Rs 20,000 if the parents were senior citizens.
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Some of the best Tax Saving Mutual Funds available ( ELSS Mutual Funds )
- HDFC TaxSaver
- ICICI Prudential Tax Plan
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- Reliance Tax Saver (ELSS) Fund
- IDFC Tax Advantage (ELSS) Fund
- SBI Magnum Tax Gain Scheme 1993
- Sundaram Tax Saver
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