Suffering from cardiac ailment? Apply for a customized plan

 

Suffering from cardiac ailment? Apply for a customized plan

 

September 29, is World Heat Day. According to a report by the American College of Cardiology, non-communicable diseases accounted for 65 per cent of total deaths in India in 2019. More than 25 per cent could be attributed to cardio-vascular diseases and related risk factors. Reliance General Insurance recently conducted a study on coronary angiography (CAG) procedures performed on 19-35 and 36-45 age groups between 2018 and 2023. While the number of procedures increased by 160.9 per cent in the 19-35 age bands between 2018-19 and 2022-23, it rose by 102.9 per cent in the 36-45 age band over the same period.

Given the severe financial implications, having a health insurance cover becomes critical. However, people who have survived a cardiac event find it difficult to obtain coverage. They should consider applying for a cardiac-specific indemnity plan.

 

Cover for a higher-risk group

Cardiac patients whose proposals for a regular health insurance plan get turned down should apply for a cardiac-specific plan.

Their uniqueness is that they cover people who have already had a heart-related procedure.

Their features are similar to those of a regular hospitalization policy.

They cover hospitalization, pre-and post-hospitalization, ambulance expenses and also offer a comprehensive health check-up.

Waiting periods usually apply before pre-existing heart conditions get covered. The customer also gets covered for non-cardiac ailments. These plans may also offer benefits like outpatient department coverage, restoration, and no claim bonus.

 

Limited coverage, higher premiums

These plans usually have a limited sum insured and may also have a co-payment requirement. They are also costlier than regular hospitalization covers. They could be 30-40 per cent more expensive. The timing of the cardiac event matters. They are sold to people who had a heart attack two to seven years earlier. If it is a very recent case, or if seven years have elapsed since the event, the customer may get this policy but cardiac ailments may be permanently excluded.

 

Who should go for them?

People who have undergone a cardiac event should buy these plans. People with an existing heart condition should immediately buy this product if they do not have a cover already or if they feel their existing cover may not suffice to meet rising healthcare costs.

People with cardiac issues should also buy this plan if they only have group insurance coverage from their employers.

 

Checks to run

Customers should first check if their existing heart-related conditions will be covered or permanently excluded. Thereafter, they should verify the waiting period-two or four years – for heart – related conditions. They should also check for room rent, capping. Looking for clauses related to exclusion, sub-limit, and co-payment. These may not be mentioned in the one-page brochure, so refer to the customer information’s sheet or the policy wording.

Customers checking for a sub-limit on specific treatments, elaborates that one product offers a sum insured of Rs 10 lakh but has a sub-limit of Rs 3 lakh for cerebrovascular, renal, cancer, and related ailments. The co-payment requirement should preferably not exceed 10 per cent.

Checking if the insurer has imposed a “personal waiting period” on you specifically, assessing the strength of the insurer’s hospital network.

PROS AND CONS OF FIXED-BENEFIT PLANS  

• Besides indemnity-based plans (which compensate you for hospitalization bills), fixed-benefit plans covering cardiac ailments are also available 
• These may be single-disease covers (for cardiac ailments only) for critical illness plans (where a number of dreaded diseases, including cardiac ailments are covered)
• If the customer is diagnosed with a disease covered under these plans, they pay a predefined fixed amount
• Such policies are a great add-on to the regular hospitalization cover as they can be used to take care of many ancillary costs
• Understand the specific definition and the stage of the critical illness covered
• Once they make a payout, these covers end

 

For More Details: Pooja Manoj Gupta, visit www.giia26.com
Email: pmgiia26.com Mobile  9868944340