[ruzbehxyz]

Originally Posted by csnanjappa

My Mother is 72 years with regular underlying conditions such has diabetes and BP. Do you suggest any kind of health insurance for her?

Go for Senior citizen Red carpet policy from Star Health. I have it for my dad who is above 70. Its quite a transparent policy and all charges are mentioned.
Before purchase, do some research online and satisfy yourself.

Link: https://www.starhealth.in/plans%20/%20Insuranceplans_2

[sunilch]

Originally Posted by pandey.jai

My spouse and I are in the IT industry and we have company provided insurance. Both our floater plans cover 5 and 6 lacs respectively.

We’re expecting a baby in a couple of months time. I checked the hospital that the OBGYN has a tie up with and it appears that the hospital is not in the networks hospital list of one of our insurance companies.

The one where we can get the cashless option has a paltry 30k upper limit for maternity, while the other insurance has 50k.

What are my options in this situation? Do I opt for cashless (Insurance 1, with 30k limit) or do I pay cash and try the reimbursement route (insurance 2, 50k maternity limit)? Or is there another better option?

Check the fine print again and try this - Take cashless of 30K first and for the balance, submit a claim with Insurance 2. You will have the bills in original with you for this claim as the first will be cashless.

[ranjitnair77]

Originally Posted by pandey.jai

What are my options in this situation? Do I opt for cashless (Insurance 1, with 30k limit) or do I pay cash and try the reimbursement route (insurance 2, 50k maternity limit)? Or is there another better option?

I went through this exact situation a few months back. First, you should pick the hospital that works for you. That's very important.

In my case, the hospital we liked did not have cashless with both our insurances but they had given me a very accurate estimate on delivery cost. I paid when we checked out. I also had a list of documents required by the insurance company along with the forms that the hospital needed to fill out and stamp.

I then applied to my insurance and got 50k reimbursed. My insurance was Bajaj Allianz and the process was completely digital. That got settled in a week and I received the settlement note. I used that settlement note to claim the balance amount from my wife's insurance which needed some documents couriered. It was pretty seamless and the whole process took roughly 10 days from start to end.

[csnanjappa]

Originally Posted by ruzbehxyz

Go for Senior citizen Red carpet policy from Star Health. I have it for my dad who is above 70. Its quite a transparent policy and all charges are mentioned.
Before purchase, do some research online and satisfy yourself.

Link: https://www.starhealth.in/plans%20/%20Insuranceplans_2

Thanks, Just went through the brochure and ailments mentioned in waiting period for 24 consecutive months is a very big list.

[Haste]

Originally Posted by Ram_BMWTravel

Thats a premium only for entry into the insurance. Year on year based on the claim and medical history it will vary. So in my view the premium table does not matter much for future years. Please choose a policy which covers your specific needs and also hospital coverage.

Check this post out

Originally Posted by laluks

I got a shocker today on receiving our Health insurance premium renewal notice. It was 38K last year, no claims at all so far. The renewal premium sent to me without any additional noteworthy benefits or increased coverage is 58K. That is at least a 50% hike in premium. I made a soft call to their customer care to know what is going on. I am being informed about some IRDAI changes and such things. I raised a dispute and asked some senior to contact me to talk and understand what is going on.

Did something happen at the IRDAI front? This is a health policy from Max Bupa, running since some 10 years, with every year a premium increase under 10% so far

It seems they increase the premium every year even without claims

Can anybody tell me if other health insurance providers also do that?

[sunilch]

Originally Posted by Haste

Check this post out



It seems they increase the premium every year even without claims

Can anybody tell me if other health insurance providers also do that?

They may not do that every-year but every 5 years they will for sure. Currently all companies place you in a 5 year band as per your age and then calculate the premium accordingly. So once you cross that band, your premium will rise.

Age of the oldest member will be taken into account here, in case of a family floater policy.

[pandey.jai]

Originally Posted by ranjitnair77

In my case, the hospital we liked did not have cashless with both our insurances but they had given me a very accurate estimate on delivery cost. I paid when we checked out. I also had a list of documents required by the insurance company along with the forms that the hospital needed to fill out and stamp.

I then applied to my insurance and got 50k reimbursed. My insurance was Bajaj Allianz and the process was completely digital. That got settled in a week and I received the settlement note. I used that settlement note to claim the balance amount from my wife's insurance which needed some documents couriered. It was pretty seamless and the whole process took roughly 10 days from start to end.

Thanks for the response. How does the part in bold work? I was always under the assumption that you cannot claim in multiple places for the same expense.

Edit..

Originally Posted by sunilch

Check the fine print again and try this - Take cashless of 30K first and for the balance, submit a claim with Insurance 2. You will have the bills in original with you for this claim as the first will be cashless.

Similar question to you too. Is it possible to claim in two insurance companies for the same treatment? Is it absolutely legal or is there a grey area?

[sunilch]

Originally Posted by pandey.jai

....
Is it possible to claim in two insurance companies for the same treatment? Is it absolutely legal or is there a grey area?

Yes it is possible and legal. You are the holder of those policies that are dutifully paid either by you or your employer on your behalf.

When you submit the second policy claim, they will have fields asking about the amount that you hare already received as part of any other policy. Read the forms carefully and fill those with 100% precision. This will be a very important step.

Otherwise, why and how can people buy multiple policies in the first place? What will you do in case, say you get admitted due to a disease or accident and then the first (employer) policy is not enough to cover your expenses? This is where the second (usually self obtained, but can be a policy from your spouse's employer as well) comes handy to claim the rest of the amount.

What is not possible usually, is claiming full benefits from both the policies for the same treatment. This will be part of the fine print. Again this is not illegal but this is part of your contract with the insurance provider and hence invalid. Not illegal.

Also think about a life insurance policy. You can buy multiple policies from different or same insurance provider, right? In case of death, you family will be able to claim the SI from all of those (and they have the right to do so).

[ranjitnair77]

Originally Posted by pandey.jai

Thanks for the response. How does the part in bold work? I was always under the assumption that you cannot claim in multiple places for the same expense.

You can claim in two places and it is completely legal. There is a clear process for this which I followed.

Let's say your total maternity cost was Rs. 1 lakh. You have coverage for Rs. 30k (Insurance A) and your wife has coverage for 50k (Insurance B). This is what you should do, if you are not going the cashless way.

• Talk to your insurance company and they will tell you the list of documents that they need. They will also provide a form for the hospital to sign and stamp.
• In my case they needed the discharge summary, medical bills and the hospital registration document. Make a copy of this as you need to submit the documents in two places.
• Submit all of this to Insurance A. They will approve 30k with some deductibles and send you a claim approval letter.
• Submit the same set of documents to Insurance B along with the claim approval letter. They will approve the balance with some deductibles.
• Please note that the hospital will not sign and stamp the insurance form for Insurance B. That's perfectly fine.

In a nutshell, you can get Rs. 80k reimbursed across two insurances for the same procedure. There might be slight variances across insurance companies. Do talk to both to clarify any doubts.

[knp]

Friends, looking for an advice, though this has been discussed earlier on this post. But, i'm looking for any latest and better policy. My sister is looking for a family floater for herself, husband and 8 yr old daughter, probably for sum insured for 10L. appreciate your suggetions.

[diyguy]

Originally Posted by knp

My sister is looking for a family floater for herself, husband and 8 yr old daughter, probably for sum insured for 10L. appreciate your suggestions.

I have a family floater from Apollo Munich (now HDFC) for my wife and two kids. We pay 37k for 25L and it has a bonus 25L on it as we have not claimed in the past two years since we took it. Nett cover is 50L for them. Never claimed, so dont know the difficulties in the claim process but keeping my fingers crossed. Our premium is high since i started this only when my wife was 46 and kids were 18 and 14.

[vsrivatsa]

Originally Posted by varun.ppl

If someone already has a health cover and they end up buying Corona Kavach then in case that person tests positive for Covid, they can use only this policy to cover the expenses till sum insured (but maximum sum insured option right now is limited to 5 Lacs).

The Maximum Sum Insured is 5L with Max Bupa, Reliance and Oriental.
HDFC Ergo is offering higher values up to 50L. Is it a good option to go with HDFC Corona Kavach Policy? Thinking to take a Floater for 10L based on feedback here.

[Cessna182]

I have a policy from ICICI Lombard. The renewal date is in November and one of my relatives has taken up an insurance selling (Star health) recently. He recommended me to port to Star health. Is this advisable? My policy is 1 year old, I'm in the late 20s and this is an individual plan.
The reviews for both ICICI and Star health are mixed, hence it is becoming difficult to decide.

[Gansan]

A friend of mine (Male,63) is trying to take a health policy for his wife and himself. He has undergone CABG surgery three years ago. His wife (61) is hypertensive and diabetic. Apparently his attempts with Star Health have failed. They are prepared to give a policy to his wife but not him.

He is retired but health cover by his former employer covers him and his wife till he is 70. He used that cover for his surgery. He wants to take a policy now for continuation of cover after he turns 70. He knew there will be exclusions for the initial few years and was prepared for it.

Is there any health policy which will cover him now?

[sunilch]

Originally Posted by Gansan

A friend of mine (Male,63) is trying to take a health policy for his wife and himself. He has undergone CABG surgery three years ago. His wife (61) is hypertensive and diabetic. Apparently his attempts with Star Health have failed. They are prepared to give a policy to his wife but not him.

He is retired but health cover by his former employer covers him and his wife till he is 70. He used that cover for his surgery. He wants to take a policy now for continuation of cover after he turns 70. He knew there will be exclusions for the initial few years and was prepared for it.

Is there any health policy which will cover him now?

Given the age and existing issues, his premium will be very high and there will be many exclusions. Most likely his existing conditions will not be covered at all and there may be an initial pay but no benefit period too. Star has a high co-pay (50%) policy that he can check again with them. But other than Star, I guess Raligare has some policies for seniors.

Ask him to get it before he turns 65 for sure. As after that companies may refuse it flat-out.

Once he gets a policy, after 1-2 years of no claim he can have it ported after negotiation with another provider.