The number of scams in the insurance industry will hardly be there in any industry I’ve spent a lot of time doing deep research on this topic So that here i am to help you how to find the BEST Health Insurance Policy. We can make something and we can become more aware. Health insurance has become too complicated and companies also try to confuse you So how do we find the best insurance policy for us or for our family Because you have no idea when 50,000 options come in front of you And you go like crazy whether it is good or not for you So before buying any thing its very important for anyone to make A list that what do you want from the health insurance Do you think the cover of 5 lakhs is sufficient for you or not?
Do you think you’ll be ok with 5k-6k room of double-wing sharing or you want a single private room So why don’t you write all requirements so that comparison becomes easy for you If you go after want then you won’t buy anything But how do we make our list of requirements until we know That which features are available with which health insurance policy And what are the terms and conditions with these features Because many times we take policy after seeing features its but at the time of claim any condition comes out of nowhere Because of this, you don’t get the money so I’ll tell you all features and options Related to health insurance with their terms and conditions. After that, I’ll tell you how to make your requirements list and On the basis of that list how you can find your health insurance policy I’ll tell you the whole process in this video. But first thing Why do you need health insurance?
Who needs health insurance? Does this person need health insurance? hell no He has so much money that angioplasty can be done all over India What it means that neither you have extra money nor I’ve No, we’re not rich we don’t have money Disease won’t come after telling you it is possible that by tomorrow itself A medical bill of 10 lakh could be made in my family. By tomorrow itself So will give me Rs10 lakh?
Either I’ve to take a loan on high interest Or I’ve to withdrawal money from my long-term goals to pay my medical bills And you know this very well that if you stop the power of compounding then you’ll never be rich. Every person who wants to become rich in future and is also investing money with discipline today should always have health insurance Because this is such an unexpected liability which can disturb your goal But to think that, after taking policy whatever happens, you will get the money This thinking is also wrong because no company is made for social services And such long terms & conditions are made so that you sign it without even reading it By telling you any condition they always try to stop your claim or gives you half of the claim.
If the claim amount is 5 lakhs and you’re paying 2.5 lakhs then your policy is not meaningful I’ll help you and try that 99% of the time whenever your claim goes it will pass 100% but even God cannot give the guarantee But there is a way you can speak with 100% guarantee that in future whenever medical expenses will come then I’ll take care of them without disturbing my finances and that way is an investment I’ve given you Bill Gates example to prove one point that the person who has already made his wealth Does not worry that what will he do if medical bills of 10-20 lakhs comes, because he has excess cash So if you really want to get this tension out of your head then please take investing a little seriously and take action from today itself As time passes, a person gets married have children, his parents get old then chances of getting medical bills also become high And I’ll say one thing that if you are not rich in your 20s or 30s then maybe it is not your fault or maybe your background is not so privileged But if you could not become rich in your 40s, 50s or 60s then its all your fault because you didn’t take investing seriously So, I am giving you a link for mutual fund app and link for opening Demat account in the description And Upstox Demat account is opening for free of cost So you can save 300 Rupees Now let’s about how much health insurance cover do you need It depends on many factors for example your lifestyle Are you eating too much pizza these days,
if yes then you’ll need more cover or it will depend on your nature of work if you’re doing a hazardous job then you’ll need high cover than normal people You should also know the cost of average heart surgery in your city If I try to quantify then cover of 3 lakh is sufficient for fit children And for adults, there should be a minimum cover of 5 lakh per person Health insurance is of two types, one is Floater and the other is Individual Floater means combo, in which you got the whole family insured together And you have to pay only one premium for this. It has some pros and cons The advantage is that it is cheap You have to take only one plan for the whole family And you have to pay for only one premium.
But the disadvantage is that, for example if you have taken the cover of 5 lakh For husband, wife and two children, so it means that The total cover is not Rs.20 lakh it is Rs.5 lakh only In a year, all four people together can make only a medical claim of Rs.5 lakh If one of them gets hospitalized and bill of 3 lakh comes So if someone else in the family falls ill in the same year Then he can get only medical claim of Rs.2 lakh In some plans restoration benefit is also available, means If you have only 2 lakh cover left then after adding Rs.3 lakh Then it will restore into 5 lakh cover in the same year But of course if this feature is extra then the premium will also to be paid a little extra and
the other disadvantage is that If there are elders in the family and they have any disease So because of their premium of the family will be high So the recommendation is that you take an Individual plan for elders And include the rest of the family in the Floated plan So this will reduce your premium. [Music] In my opinion one of the biggest sacm in health insurance It is my opinion, it is not a legit scam and that is Room Rent And many people don’t know that there is a limit on room rent charges Suppose you went to hospital and you liked an AC deluxe room And while sitting there you are getting your treatment They want to earn money and don’t want to open public welfare institutions There are various policies in the market in which there is a cap on room rent But there are some policies in which there is no cap on room rent You can get your treatment done in an expensive room without any problem But of course, if you are getting this facility then its premium will be high Let’s come back to the room rent policy because many people choose this policy Because it is cheaper than others, now you have to know If we have taken a cover Rs.5 lakh then the allowed room rent on it will not be a random number but it will be a percentage of 5 lakh which is 1% and 1% of Rs.5 lakh is Rs.5000 This means if you got into trouble like accident or have to undergo any surgery If you took 10k room in the hospital instead of 5k room Then the company will tell you that max. room rent allowed to you was 5k But you took the room which has rent of Rs.10 thousand This means that you can get a claim of only 50% of the room rent Then I’ll think that I had done surgery of Rs.2.5 lakh At least that’ll be paid by the company & I had to pay only Rs.5k for room rent But no because other charges are also linked to room rent If you are reimbursed with the 50% of the room rent Then you will be reimbursed with only 50% of the cost of your surgery Means for 2.5 lakh surgery you will get only Rs.1.75 lakh And all other expenses including PPE Kits, injections are linked with your room rent If you are getting a claim of 50% of the room rent then you will get 50% of the claim for rest of the expenses It will be less proportionally then what does it mean I had taken it with the thought that in times of trouble I would not have to burden my pocket and bear the medical expenses from the claim. Let’s assume for a while that we are compelled to take such a policy But my question to all companies and the sleeping IRDA that Even if my room rent was overpriced the insurance I have taken was not Taken to pay the room rent so how can you link major expenses with room rent And why am I being penalized Therefore paying my room rent Let’s consider one more scenario that I went to the company for Buying Rs.5 lakh insurance cover but change the room rent from 5k to 10k Because hospitals nearby me become bit expensive And I can get the claim in future so keeping future prices in mind I want a bit higher room rent cap then the company will tell you If you want high room rent so room rent is linked with the sum insured Which is 1% of it, so if you want room rent of 10k Then you have to take policy of Rs.10 lakh that means More premium out of your pocket now I’ll tell you some practical points When you have to go to the hospital if you have a planned surgery Or angioplasty, so you can go after two or three days It’s not like that you have to get it done today itself But if you have an accident then you will be taken to a nearby hospital And suppose their rooms below your room rent are occupied You will be put into the the room which is expensive Your bill will be higher just because you met with an accident You had taken health insurance for this purpose that if Such an opportunity comes then it will not burden my pocket So you may have to pay for your treatment expenses proportionately From your pocket because company will deny for it So first point in your list is a cap of room rent You have to find that policy in which there is no cap on room rent Or if there is a cap then no charges are linked with room rent We can pay 1k-2k for a room but our claim has to be settled The next point is Sub Limit so there is the possibility that Maybe you have got a cover of Rs.5 Lakhs but maybe for heart surgery Minimum 3 lakh is allowed and for another disease max. 2 lakh is allowed So we have to avoid any such policy in which cap is imposed on different diseases Later we will explore if premium is going out of budget The third point is Co-pay which means some money out of your claim Will be given by the company and you will have to pay the rest of the money And this defeats your purpose because you are taking health insurance Because whenever the medical bill comes in future then 100% of claims will pass So we have to find that policy in which there is no option of Co-pay 4th point is Zonal policies there are two types of health insurance policies One in which premium remains same PAN India means premium will not change in any city And the second type of policy is Zonal policy if you are taking It is in tier-3 city, then premium will be less and If you are taking it in tier-2 city then premium will be more And if you are taking in tier-1 city then premium will be highest Many people in order to save premium put the address of their village But they live in city so their premium will be less But if they had to take emergency treatment in a city hospital Then they will not get 100% claim settlement and 20% 0f Co-pay will be applied and can get only 80% from the company And you have to pay 20% in order to save premium Please do not take policies on the address of the tier-3 city If you are taking for your parents then why are you taking it in Mumbai Why not you taking in place where your parents are living People forget some basic things, if you are in the city you put the Mumbai address for all then premium will be more You have to see that your parents are over there Then you should also take policy from there Anyway there are two types of policies if you are not comfortable with zonal Then you should take such a policy whose premium is the same over PAN India Then you can get the whole claim in any hospital in India. Many times your claim got rejected on which basis Suppose you are living in Bandra or any other place I am in Mumbai so I am giving an example of it And there are 4 or 5 hospitals in that area And you went to one of them in which cost of surgery is 1.5 lakh And you claimed for 1.5 lakh your insurance company can Give you the claim of 1 lakh instead of 1.5 lakh They will not give because after checking other hospitals They find that the cost of same surgery is Rs.1 lakh According to the rate in that area there is a term for that which is Reasonable and Customary clause they use it and is written in a policy So you have to see these things whether they are mentioned or not Because it does not happens in many policies and happens in many ones also These are written in very small form in the documents So we have to look for all these things This question is very interesting and I ask the question to policy bazaar executive By the way, this video is not sponsored by any brand I am telling you about my experience so that guy said that You will get to see this clause in group policies For example, you are covered in your company’s plan So there are chances that there you can see reasonable and customary clause But this is not in the individual policies Still, you don’t have to make it final if you are taking from an agent Then ask the same question to the agent or if you’re taking it from policy bazaar Then also you have to ask the same question even I’ve already asked it I am remembering one more thing from a group insurance policy If already there is your ongoing group insurance so don’t let it close Many times we left the job and the ongoing group insurance also gets cancelled Without cancelling it you can convert it into an individual plan And the advantage of getting this done is because if you allowed An existing policy to be closed and after that, if you are taking New health insurance then you have to do your medical again The new premium will be set according to it which may be an expensive one And for taking new policy you have to cross the waiting period duration After then only you can get a claim so if you have any ongoing Group insurance policy and if you are willing to leave the job Then at the right time convert it into an individual plan So that all your benefits will continue Next is Top-up and Super Top-up this is slightly complicated to understand People who want answer in one line can take super top-up not top-up People who want to understand that why I am saying this then listen It is understood from the name Top-up and super top-up that This insurance will be over and above your base policy So that if your claim crosses the base policy for example your base policy is Rs.5 lakh and your claim comes of Rs.8 lakh And you have top-up or super top-up of Rs.5 lakh Then your total insurance is Rs.10 lakh out of which claim is Rs.8 lakh Then 5 lakh will deduct from the base policy and 3 lakh from the top-up And you don’t have to pay a single rupee from your pocket So top-up and super top-up are very useful you will ask question That is why you have taken the top-up instead of taking a bigger base cover It’s a simple thing that top-up is cheaper and it is on an aggregate basis it’s not on the basis of individual claim and many people don’t know That top-up and super top-up both are individual stand-alone policies It is not an additional rider which is compulsory to take with the policy You can take base policy and top-up from different health insurance companies But don’t do that because if you do that then the claim up to The base policy will be provided to you cashless but for top-up You have to deposit money and produce bill then that amount will reimburse If you want to avoid this hassle then I recommend that super top-up And base policy should be taken from the same company Now I’ll tell you the difference between top-up and super top-up And I have already told you that these two are stand-alone policies You can also take it separately so think of it like that When will I need to get top-up? when I already have an insurance My base cover is Rs.5 lakh but I’m afraid of getting Rs.10 lakh claim So I should have a top-up or super top-up, so automatically I am taking such a policy in which I can’t get the claim until It will cross a certain amount because the meaning of taking top-up is that To some extent, we’ll handle it with base cover but if it goes above it Then only the top-up will be activated and this limit is called the deductible Deductible and base cover are similar but they differ in some cases For example, you have a base cover of Rs.5 lakh And you have also taken a top-up of Rs.5 lakh In which deductible is also of Rs.5 lakh, so here your Base cover and deductible are the same and if the claim comes up to Rs.5 lakh Then will deduct from your base cover or let’s say The claim comes of Rs.7 lakh then 5 lakh will deduct from the base cover And rest of the Rs.2 lakh will deduct from your top-up In the same year if your claim of Rs.2 lakh comes again Then you will think that you still have Rs.3 lakh in your top-up My claim of Rs 2 lakh will pass, but this is not true This time you have to pay Rs.2 lakh from your pocket Because I’ve told you that top-up will activate only When a deductible limit is crossed and deductable in your top-up was Rs.5 lakh So the top-up policy knows that you will take care of expenses up to 5 lakh Either from your base cover or even from your pocket I’ll give money only when the claim is more than Rs.5 lakh So the biggest problem in top-up is that whenever you want to claim from there Then your medical bill should be more than deductible but If such a bill is made for the second time in the same year Then your base cover is already exhausted, so let’s say Your claim comes of Rs.7 lakh then you can get Rs.2 lakh from top-up But you have to pay first Rs.5 lakh from your pocket because You have already exhausted your base cover in the same year Obviously in next year again your base cover will be Rs.5 lakh And top-up will also be Rs.5 lakh but in the same year If you did it a second time then there is no 100% guarantee That you will get money from your top-up now Now there is super top-up in which activation condition is the same Means your bill should be more than the deductible, if you have Base policy of Rs.5 lakh and super top-up of Rs.5 lakh So bill made above Rs.5 lakh will be settle from super top-up Let’s take the same example you have the base cover of Rs.5 lakh But this time instead of top-up you have a super top-up of Rs.5 lakh Let’s say your bill is Rs.7 lakh then 5 lakh will deduct from Your base cover and Rs.2 lakh will deduct from super top-up But next time if your claim is made only Rs.2 lakh Then also it will settle from Rs.3 lakh of super top-up And at that time you don’t have to pay from your pocket Means super top-up is a little kind and says that even once in a year If you have crossed your deductible then if you go to the hospital Second time or third time, I’ll give you the claim as long as Your claim has to come within the top-up which means If you have a super top-up of Rs.5 lakh then you can get Claim up to Rs.5 lakh and condition like top-up will not be imposed on you That’s why I said to take super top-up instead of top-up If you want that every time your claim will pass Next is Pre & Post hospitalization that means it is not compulsory That we have to admit today itself what if I have any planned surgery One month from now but doctor gives me instructions to take therapy daily And to take medicines daily. So my health policy will reimburse the cost of therapy and medicines or not You have to check that and in today’s date most policies cover your expenses But you have to pay attention to that how many days you are getting pre-hospitalization and how many days till you get post-hospitalization expenses Most of the companies give you pre-hospitalization of 60 days And post-hospitalization expenses for 180 days so this is a good thing And you have to check it and as I just told you It is not necessary that I have to be admitted to the hospital today With that same logic, it is also not necessary that for treatment I have to admit in the hospital it is possible that I came home after a day’s treatment & I don’t have to stay at night So in that case will my health insurance policy give me claim? You also have to check this and this term is called daycare coverage The next point is extended coverage do you need Aayush treatments If yes then you should check whether your policy will provide it or not The next point is the waiting period this is not possible that You got a policy issue today and a medical emergency comes after 5 days And you are expecting that your claim will pass Because in most of the policies there is a waiting period of 30 days If you are taking policy for covid like corona Rakshak or corona Kawach So the waiting period in that is 15 days and after that waiting period You can apply for any claim and you have to keep this in mind The next point is the waiting period for pre-existing diseases If you already have any disease on day of taking health insurance Then if you are hospitalized related to that disease then You will not get your claim in the first 3 or 4 years It will depend on which company’s policy you are taking it Some companies have a waiting period of 3 years while some have 4 years However, if you are going to the hospital for some other reason like an accident Or any disease which comes after taking policy then in that case There will be no waiting period and only in case of Pre-existing diseases you will have to wait for 3 to 4 years Next is the waiting period for slow-growing diseases I also feel a little bit frustrated, but listen IRDA asked to make the waiting period same and you’ll not change it You to fill that document in which names of 15-20 diseases are written Which tells you the waiting period of 2,3 or 4 years If any comes because of that disease before 2,3 or 4 years Then you will not get the claim they are not a pre-existing disease I don’t have this disease but this is such type of disease In which we have to find cover immediately IRDA has clearly asked to make it standard that every policy Should contain these 18 diseases or there will be a waiting period for them only So you can’t show it differently in every policy which confuses a lot The waiting period is slightly depressing so let me tell you some good point Next is no claim bonus means you paid the policy’s premium for the whole year But you didn’t even need to go to hospital for a whole year So in that case company will reward you either your base cover increases Or your premium reduces, so after searching a lot I came to know that Most policies cover increases but they don’t reduce the premium But still this a very good option and I want this in my policy The next point is ambulance charges and you can also check that while taking a policy that my ambulance charges will reimburse or not Next point and probably one of the most important point You have to check whichever company’s policy you are interested in taking That it has tie-up with how many hospitals in your city So that in 99% case you always have a cashless claim And you don’t have to pay money upfront, it is very important Because in emergency cases for example on accident You went to a hospital where you can get the claim but not a cashless claim So first you have to deposit money then only treatment will start So a large network of cashless hospitals must be in your policy The next point is a free health checkup and many people don’t know that Most health insurance policies offer you free health check-up once in a year And you can schedule it according to your convenience You can get a full-body checkup absolutely free of cost And I explained a very good thing in the term life insurance video also So many people are afraid that is how they will prove that A disease which we have suffered has happened after taking the policy And our claim should not be rejected and you will prove in the same way That every year get a free medical checkup and keep its reports in the files whether softcopy or hardcopy, this will prove that At the time of taking policy you were absolutely fit and fine And whatever disease you have now, it has come only after Taking the policy and your claim should not be rejected [Music] I have explained all the points to you, now I’ll tell you How to make your requirements list, so the first item on the list will be You have to decide whether to take floater plan or individual plan Next point is to decide whether to take your policy from a private company Or government company and some people have confidence that if they take it From government company then their claim will always pass But I’ll tell you that, policies of the most government companies Have a limit on room rent and then even if your claim is passed But there is no guarantee that it will pass 100% On the other hand private companies are also not so bad If you are taking health insurance policy after seeing everything Then you have avoided many reasons for rejecting the claim But still, this call will be yours People smoke cigarettes and drink alcohol and don’t write in health insurance That they drink, since these things are easy to find out for company Because it will increase the premium you can’t blame the company everywhere In its business, it has a guarantee that if you had to take it from a company then what will happen if that company will close tomorrow Partners keep changing in health insurance, two companies merge A new partner comes, but normally the partner does the complete takeover People should not fear about that what will happen if it will close After all, it’s a private company At least IRDA can do this much work Basically, I want an established brand to which I can trust Let’s take HDFC, my trust is associated with the name of HDFC Same with ICICI, I know that ICICI is a bank also In about us of the company details are mentioned like Whose partnership is there and whose money is invested in it So when you know these things you get to know about the company So I always prefer going with the the company has a solid background And a solid support system. Whether it will give a claim or not I don’t know but the company is going to be there in the longer run Because if I want it with HDFC then like 10,15 or 20 years I want to take a long term commitment so I want to associate With a single brand for a long term as compared to Changing brand in every 2 years or to port from here and there So I think the brand name or familiarity with the brand is very important for me Next, you have to decide that how much base cover do you need And the majority of your premium will only depend on this Because if the base cover is taken too much then the premium will out of budget So you have to take a super top-up so that it’ll come within the budget And I have already told you that super top-up will ensure That your claim will always pass. After that, you have to decide That if you can’t afford more premium So do you want to take such a policy In which there is a limit on room rent and there are also some policies In which there is a limit on room rent but all other expenses Are not linked with room rent which means if your room rent cap is Rs.5k And you have taken a room for Rs.7k then you have to Pay only Rs.2k from your pocket but your all other expenses Worth lakhs of rupees not to be paid from your pocket So you can check that in which policy even after having room rent The remaining expenses are not linked with it and that is very important. After that Sub limit on diseases will come on your list As I told you that you may get base cover of Rs.5 lakh But the max. cover for heart surgery is Rs.3 lakh so you have to decide What do I want such a policy in which sub-limit is there or not The next point is Copay, I have told you Copay that Some % of the medical bill you have to pay from your pocket And only some % will pass from your claim and according to me You should not take this. next is very important Zonal policies vs PAN India policies if you are taking zonal policy Then in order to save premium if you had to take it to a small city address And taking treatment in a big city then a copay of 20% will be applicable You have to keep this in mind and if you don’t want to get in this Then you can decide to go for PAN India policy Next requirement is pre and post hospitalization Some policies have 30 days pre-period while some have 60 days pre-period Some policies have only 60 days post-period while Some policies give you 180 days post hospitalization expenses So you have to find out how many days of expenses you will need Next is daycare which is important and should be in your policy Because it is not necessary that we have to admit Only then we will get the claim, there are many costly treatments In which there is no need to admit so have daycare coverage with you. Next is a personal preference if you have any cosmetic treatment or Ayush treatment requirement then you have to see policy according to it After that, there are three types of the waiting period Mostly you will get 30 days in every policy and you can’t claim before that And you have to wait 3 or 4 years if you have any pre-existing disease We can see which policy comes with a minimum waiting period You can consider if someone is offering 3 years instead of 4 years There is also No Claim Bonus in my next requirement Because I am fit and fine for the next 5 years I may not need to go to the hospital so if I do not claim for 5 years Then my cover will increase significantly, I want No Claim Bonus You have to decide whether you want it or not The last three points are cashless hospitals, ambulance charges and free health checkup You also have to check that which policies are giving them. [Music] Now problem is that we had have written our requirements But how do we find policies? on every company’s website Information is presented in different types and you will confuse If you are finding a policy on these parameters, then Its solution which I am using and it’s not a sponsored video Policy Bazaar, I’ll tell you my real experience Before finding plans on Policy Bazaar you have to mention your name, Email id and phone number, as soon as you enter your phone number Within 5 minutes you will get a call from their executive And many times I got irritated because of too many calls But once I picked up the call and asked all my requirements And within 15 minutes they told me 3 policies that fulfil my requirements I found it very good that I do not need to go to Policy Bazar market just enter your phone no. and wait for the call And I can ask them all requirements and I had some other concerns too Because this is not term insurance, this is a health insurance policy This means I will go to the hospital in a medical emergency I don’t even know how my mental balance will be there At that time I should be with family or go to the counter for the claim process. And insurance agents also help here they came to your hospital and Get your claim passed, so in that case you don’t have to bother I don’t have any idea about that and they told me that Now Policy Bazar is in Delhi, Mumbai, Pune and Bangalore Means their agents will directly come to you in hospitals of these cities And will get your claim fulfilled and their expansion is ongoing And will cover the rest of the cities and R.M will also allot to you Means you don’t have to call company’s customer care number You can make calls on R.M mobile number and like an agent He will get your claim process done and along with this It happens many times in case of an emergency that We rush to the hospital in a hurry and showed our cashless card But we forget to inform the company that we want to claim But in the case of Policy Bazar as soon as you show your card Policy Bazar will know that you need a claim and without asking you They will initiate your claim so that it does not take much time And the personal and health information which you’ll give them On the basis of the profile, they keep some amount of claim pre-approved So that in case of emergency you can get that amount of claim instantly And the most important thing, if you’ve ever been to a hospital Or ever made a claim then you would know that Even if there is cashless treatment, after discharge, the hospital will Not let you go home until your claim get passed Many people wait for hours till their claim is passed Policy Bazar gives you a guarantee that if the claim is taking time to approve Then you can go home, Policy Bazar will take care of it. You don’t have to wait there so the decision is yours That if you’re comfortable with agent then take it from the agent Because peace of mind is a must but my experience with Policy Bazar I am just telling you that and the best thing is that They also give you the claim guarantee certificate So that if Policy Bazar fails to fulfil its promises then You will a written proof that they promised you all these things. If they are that transparent and confident so I thought to tell you The rest is your decision and I am giving you a link below If you are willing to take it from Policy Bazar, then you can use the link Or if you want to take it from an agent then it is your decision I’m taking it from Policy Bazar not because I’m not against agents In fact, agents play a major role in a health insurance policy But I am taking it from Policy Bazar because the satisfaction that I got from an agent, I’m also getting it from Policy Bazar It is available online means it is cheaper too. But I leave it up to you.
