How much health cover is adequate for you?

We are talking about a health cover that should suffice ‘your’ needs and must continue to do so throughout your life. This means that it will need up-gradation from time to time. This also means that while your company health cover can suffice today, as your family and needs grow, you will have to look at an additional health cover. Look at it this way, does your company email id stop you from having a personal one? No, right? You have it because you know the job may be temporary after all and there may be certain needs that your company email id may not help you with. Similar is the case with your company health cover. It is great while it lasts, but at some point, you have to take charge of your own medical needs and look beyond it. For ‘your’ healthcare needs, it is better to be self-reliant, even after your retirement.

More reasons to look at additional health insurance beyond your company health insurance-

Now, how do you decide how much cover do you need? There is no thumb rule to it, and it can differ depending on your age, liabilities, medical history and so on. The most important thing to bear in mind is that whatever health cover looks appropriate now, may not in the future due to medical inflation. So, if a heart surgery costs Rs 5 Lakh today, it may cost more than Rs 40 Lakh, 20 years later. You should look for policies that tend to increase your health cover for every claim-free year (no-claim bonus).

Here’s a rough estimate of the health cover you can target-

Age: 25-30 years

Assumed life-stage:

Single, healthy, employed

This is the age when your need for health insurance is the minimum. But ironically, this is also the age where your insurance decisions matter the most. This is because the premium you pay for health insurance at this age is amongst the lowest owing to your health and low health risk. Consider this- if you buy a Rs 10 Lakh health cover at 25 years, the premium you pay is approximately Rs 500 per month. It is cheaper than your mobile insurance, cheaper than a coffee date. Hence, what you buy at this age will go a long way. You can buy a base health insurance cover of Rs 3-5 Lakh, which can be later converted to a family floater plan. Or you can buy two health covers totalling to Rs 5-10 Lakh, one for self and the other for your parents.

Products/Benefits you should look at-

Citizen health insurance for parents, base health insurance for self

Age- 30-40 years

Assumed life-stage:

Married, have kids or a possibility of having kids at a later stage, struggling to maintain a healthy lifestyle

Basically, your cover will need to drastically increase at this stage and include newer benefits like OPD, accidental and maternity. You will have to re-look at your existing policy to ensure that you have covered your spouse and kids enough after upgrading to a family floater plan. Since you’d have kids now, you may want to look at products like OPD cover, accidental disability insurance etc. At this age, you should consider buying a critical illness/cancer care insurance, especially women. This is a good stage to consider buying a super top-up insurance plan over and above your existing health cover. Super top-up offers you additional coverage at a much cheaper premium because it comes with a deductible condition. The condition states that for every claim of say Rs 10 Lakh, you shall pay a certain amount on your own, say, Rs 5 Lakh. You can pay this amount from your savings or via another health insurance plan (read company health insurance). You can read more about it here. At this age, you must look at a Rs 15-20 Lakh cover, either through a combination of super top and base policy or through a single large base health cover.

Products/Benefits you should look at-

Super top-up insurance, OPD benefit, maternity benefit, accidental disability insurance, family floater insurance, critical illness insurance

Age 40-50 years

Assumed life-stage:

Older kids, High stress levels, susceptibility to lifestyle diseases

This is not the age to buy new health insurance plans. This is the age to perhaps get more add-ons or increase your cover on the basis of your health and your family’s. And also, the age to plan for your retirement years. Bear in mind that buying new health insurance after 60 is very difficult because you are at a higher medical risk. You should plan your insurance such that you don’t rely on anyone for your medical costs and should look at a Rs 20-25 Lakh cover. Check the sub-limits of the insurance plans you have. For example, what is the permissible room rent, or how much per knee in a knee replacement surgery is claimable etc.

By the time you reach 60, and you retire, your children may have their own health covers and the members in your health insurance plan may reduce, thereby reducing the premium. Nevertheless, just like you plan your investments and make tweaks to them on the basis of different life-stages, similar treatment is deserved by your insurance plan too. If you need details on any of the above-mentioned plans or benefits, feel free to call us at +91 8879960000