Question 1

How much health insurance coverage do I need?

Accepted Answer

The ideal health insurance coverage depends on your city, age, and family size. For metro cities, experts recommend at least Rs 10-15 lakhs for a family of 4. For smaller cities, Rs 5-10 lakhs may suffice. Consider medical inflation (10-15% annually), pre-existing conditions, and hospitalization costs in your area. A family floater plan often provides better coverage at lower cost than individual policies.

Question 2

What is the difference between family floater and individual health insurance?

Accepted Answer

Family floater covers multiple family members under one sum insured (e.g., Rs 5 lakhs for 4 members). Individual policies provide dedicated coverage per person (e.g., Rs 5 lakhs each). Family floaters are cost-effective for young families with healthy members. Individual policies are better when family members have pre-existing conditions or different health needs, as claims on family floater reduce available coverage for other members.

Question 3

What are pre-existing conditions and how do they affect health insurance?

Accepted Answer

Pre-existing conditions are illnesses diagnosed or treated before buying insurance (diabetes, hypertension, thyroid, heart disease). Most policies have a 2-4 year waiting period before covering these conditions. During this period, you cannot claim for treatment related to pre-existing ailments. Some insurers offer shorter waiting periods or immediate coverage at higher premiums. Always disclose pre-existing conditions honestly to avoid claim rejection.

Question 4

Can I claim tax benefits on health insurance premiums?

Accepted Answer

Yes, health insurance premiums qualify for tax deduction under Section 80D. You can claim up to Rs 25,000 for self, spouse, and children. An additional Rs 25,000 (Rs 50,000 if parents are senior citizens) can be claimed for parents' health insurance. This means maximum deduction of Rs 1,00,000 per year if both you and your parents are senior citizens. Preventive health check-up expenses up to Rs 5,000 are also covered within these limits.

Question 5

What is a deductible in health insurance and should I choose one?

Accepted Answer

A deductible is the amount you pay out-of-pocket before insurance coverage begins. For example, with Rs 50,000 deductible on a Rs 2 lakh claim, you pay Rs 50,000 and insurer pays Rs 1.5 lakhs. Choosing a deductible reduces your premium by 15-30%. It's suitable if you can afford medical expenses up to the deductible amount and want to save on premiums. Good for healthy individuals who rarely need hospitalization.

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