Budget Homes

Here is a check lists before taking a Medical Insurance. What is a sub-limit and family floater coverage, temporarily excluded diseases, and permanently excluded diseases. Many private companies jumping into Medical Insurance business. There are few government agencies existing already. The premium amount and the benefits are highly competitive in private sector than government.


Probation or gestation period for full eligibility:
Please make sure how long is the full eligibility period. Normally it is 1 year, in some cases it is 2 year. You can not avail medical coverage for all the disease in this periods.


Diseases Permanently Excluded:
There are few disease which are permanently excluded from medical coverage. My relative has SLE illness. When we try to cover her medical expenses, we come to know, medical insurance is not applicable to SLE.

Moreover, make sure, whether medical insurance is covering mental illness. Stress, depression , anxiety are emerging problems today. If I am right, medical insurance does not cover mental illness. Clarify this with your insurance agent or direct representative from the insurance company.

Be aware that what are the diseases are permanently excluded from medical insurance. This will avoid getting upset later on.


TPA: Know who is your TPA. Third Party Administrator. It is the TPA who actually pay your bill. Later they claim it from the Insurance Company. TTK is my TPA though I have insured in New India Assurance.


Sub-limit and Family Floater:
What is sub limit in mediclaim policy? you must know the difference between sublimit and family floater coverage.

I take medical insurance for 2 lakhs rupees. This is for myself, my wife, and my kid. This 2 lakh is divived. I can get medical coverage upto 1 lakh if I get ill. My wife and kid can avail mecial coverage upto Rs.50000 respectively. This is sub limit.

Family floater coverage is either myself or my wife or my kid can avail medical coverage upto 2 lakhs. Two lakh can be spent for a single person or shared among the members of the family. If my kid get sick and she claimed 1 lakh and 10000, remaining Rs.90000 can be availed by any one of us in the same calender year. In sub-limit, this is not possible.

The premium for sub-limit and family floater coverage are different. Premium for family floater coverage is higher than the sub-limit.

Family floater is always the best choice though its premium is high.