20 lakh Health Insurance
20 lakh Health Insurance
What is a ₹20 lakh health insurance plan?
A health insurance that you can purchase for yourself and your loved ones and that has a sum insured of ₹20 lakhs, is a ₹20 lakh health insurance plan. Should there be a need to claim the policy, the maximum reimbursement, or cashless benefits that you can avail of will be limited to ₹20 lakhs. It is one of the most practical policies to buy since the coverage can be ideal for an individual as well as a family floater plan.
Considering the higher expenses related to medical treatments, ₹20 lakh health insurance policy will provide you ample financial cushion against most health emergencies. And even more importantly, it will enable you to seek the best treatment out there, without any concerns about its cost. The health insurance plan will safeguard you against accidents, diseases, and illnesses so that you can lead a healthy life.
Workings of Mediclaim policy for ₹20 lakh sum insured
A Mediclaim policy, with coverage up to ₹20 lakh, is designed to assist policyholders in managing their medical expenses. Various elements make the policy a complete package, such as coverage details, policy duration, premium payments, and claims processing.
When considering the purchase of a ₹20 lakh Mediclaim policy, you’ll be required to pay a specific premium amount to the insurance provider. This premium is typically applicable for a predetermined policy term. Upon reaching the end of this term, you can opt to renew the policy by paying the premium again. It is advisable to maintain your policy for an extended duration to ensure continued coverage for unexpected medical emergencies.
Mediclaim policies commonly encompass expenses associated with hospitalisation due to a range of circumstances, such as critical illnesses, accidents, and surgical procedures. To access these benefits, you must initiate the claim process.
You can select either a cashless claim or a reimbursement claim. In a cashless claim, the insurance provider directly settles the hospital bills, eliminating the need for you to make payments. Conversely, a reimbursement claim necessitates you to settle the hospital bill upon discharge and then provide all relevant bills and medical summaries to the insurance company. They will review the documentation and, upon approval, reimburse you accordingly.
Who should buy health insurance plans for ₹20 lakhs?
Acquiring a health insurance policy with ₹20 lakh coverage can be a prudent choice for a variety of individuals. The following groups can particularly benefit from investing in ₹20 lakh health insurance plan:
1. Unforeseen Medical Emergencies: Individuals who seek a financial safety net for unexpected medical emergencies can find value in this policy, as such situations often strike without warning.
2. People with a History of Health Issues: Those with a track record of medical conditions or a family history of such ailments may find this policy essential, given the increased likelihood of inheriting or developing medical issues.
3. Individuals Leading Sedentary Lifestyles: Individuals who lead sedentary lives are more susceptible to lifestyle-related diseases like hypertension, diabetes, and heart diseases, which can result in substantial treatment costs.
4. High-Risk and High-Pressure Work Environments: Those engaged in high-risk professions or high-pressure work environments should consider a higher coverage health insurance plan to ensure comprehensive protection.
5. Frequent Travelers: Individuals who frequently travel, regardless of their location, can benefit from the versatility and security offered by this policy, which provides coverage wherever they are.
6. Supplement to Employer-Based Plans: If you already have health insurance through your employer but find the coverage inadequate, opting for a ₹20 lakh health insurance plan can provide enhanced protection against the escalating expenses associated with medical treatments.
It is vital to carefully assess your coverage needs and align them with your budget. Additionally, reviewing your family’s medical history can help determine the appropriate coverage level. If you are uncertain about the features and advantages of a ₹20 lakh plan, comprehensive details are available to assist you in making an informed decision.
Premiums for ₹20 lakh health insurance plan
In recent years, the combination of a global pandemic and increased medical costs has placed significant financial strain on many families when it comes to covering medical expenses. Given these circumstances, selecting the right health insurance plan becomes paramount for safeguarding your financial well-being. Opting for a health insurance policy with a coverage of ₹20 lakh can be a prudent decision, as it not only provides comprehensive coverage but also boasts reasonable premiums.
The premium for a ₹20 lakh health insurance policy is dependent upon several factors, including the insured individuals’ ages, coverage, and current place of residence, among others. If you choose to pay the premium annually, you can obtain this coverage for less than ₹10,000. Fortunately, most insurance providers now allow the purchase of plans on small monthly payments. You can secure a ₹20 lakh health insurance plan for as low as ₹750 a month.
Features of ₹20 lakh medical insurance
Opting for a ₹20 lakh health insurance policy provides access to a range of features and benefits. Here are key features to prioritise when selecting a health plan:
1. Policy Premiums: While policy premiums are crucial, they shouldn’t be the sole criterion for selection. Look for a policy offering adequate coverage without excessively high premiums. Balancing cost with coverage is key to making an informed decision.
2. Network Hospitals: Insurance providers have partnerships with specific hospitals, offering policyholders better benefits. Treatment and discharge at these network hospitals often come with zero out-of-pocket expenses, as the insurer settles the bills directly. Therefore, it’s essential to review the list of network hospitals when choosing a policy.
3. Pre and Post-Hospitalisation: Medical expenses can take place beyond hospitalisation. Patients may require medications and therapies before and after hospitalisation. Health insurance typically covers these pre-hospitalisation (30 days) and post-hospitalisation (60 days) expenses, aiding in quicker recovery.
4. Pre-existing Diseases: Pre-existing conditions refer to medical conditions existing before a policy purchase. Insurance companies typically impose waiting periods for coverage of such conditions. Look for policies either covering pre-existing diseases or having minimal waiting periods to ensure comprehensive protection.
5. Co-payment: Some plans include a co-payment clause, requiring the policyholder to contribute a percentage of the claim amount. For instance, with a 10% co-payment clause, a ₹2 lakh claim would require a ₹20,000 out-of-pocket payment. It’s advisable to consider policies without co-payment clauses to avoid such expenses.
6. Room Rent: Many insurers impose limits or sub-limits on room rents. Given that room charges form a significant part of medical bills, policies without room rent caps are preferable.
7. No Claim Bonus (NCB): NCB rewards policyholders for claim-free years. Accumulated NCB can result in either premium discounts or an increase in the sum insured. This bonus typically ranges from 10% to 50% for each claim-free year.
Choosing a ₹20 lakh health insurance policy offers you access to various advantages. Prioritising these features ensures you select a policy that not only fits your budget but also provides comprehensive coverage for your healthcare needs.
Higher sum insured plans v/s low sum insured with Top-up plans
The presence of a range of health insurance plans and different sums insured can be a bit confusing at times. It is possible to get confused between buying a policy with a higher sum insured or using a top-up plan on a policy with a low sum insured. Here are the primary differences between both, to help you decide better.
| Considerations | Low sum insured + Top-up | High sum insured |
| Policy premium | This combination is a more affordable option due to the low sum insured by the base plan. | Has a higher policy premium due to a higher sum insured |
| Claim process | Easy to follow claim process but you might not always have access to cashless benefits | Easy to follow claim process and mostly cashless |
| Deductibles | Deductibles can be a bit high and the top-up will only come into effect, once the deductible is paid by the insured | Low deductibles |
Both plans have their pros and cons. If you already have a health insurance plan with a lower sum insured, adding top-ups would be a more efficient way. However, for individuals buying a new plan, opting for a higher sum insured plan is preferable, due to better coverage and increased medical costs.
Benefits of buying ₹20 lakh health insurance
A health insurance plan with a ₹20 lakh sum insured guarantees that you and your loved ones will have ample coverage to confront unforeseen medical contingencies. Here are some benefits of opting for such a plan:
1. Cashless Payments: One of the significant advantages of buying a ₹20 lakh health insurance plan is the convenience of cashless benefits. On treatment at a network hospital designated by the insurance provider, you won’t need to make payments. The insurance provider and the hospital will directly settle the bills on your behalf.
2. Comprehensive Coverage: A plan with a ₹20 lakh sum insured ensures that you and your family have substantial financial support to address unexpected medical challenges. Such a plan typically covers various expenses, including hospitalisation charges, consultation fees, surgical expenses, nursing fees, and more. This comprehensive coverage preserves your savings, as the policy caters to these expenses.
3. Critical Illness: ₹20 lakh health insurance plan provides robust protection against critical illnesses, such as heart attacks, paralysis, cancer, and others, which often require substantial treatment costs. Additionally, you can opt for a critical illness rider along with the plan. In the event of a critical illness diagnosis, the insurance provider pays a lump sum amount that can be utilised for treatment.
4. Tax Benefits: Premiums paid for a ₹20 lakh health insurance policy offer tax benefits. According to Section 80D of the Income Tax Act of 1961, the premiums you pay can be deducted from your total taxable income. For individuals under 60 years old, the maximum deduction limit is ₹25,000, while for those aged 60 and above, it is set at ₹50,000.
5. Family Floater: A health plan with a ₹20 lakh sum insured is ideal for a family floater plan. It ensures that every family member can benefit from a higher sum insured, using it to address health-related issues throughout the year. This increased coverage removes financial stress during most medical emergencies, providing peace of mind for you and your family.
Who needs a ₹20 lakh health insurance plan?
Eligibility & documents required to buy a ₹20 lakh health insurance
You must meet the following eligibility criteria to be able to buy ₹20 lakh health insurance policy.
1. Age limits
A policyholder must be at least 18 years old and up to 65 years old. For children, the age limits are set between 90 days and 18 years.
2. Pre-medical tests
Some insurance providers require the policyholders to undergo medical tests. The tests are usually diagnostic ones like urine tests, blood tests, tests for major organs, etc.
Apart from the above criteria, you will need to submit certain documents to be able to purchase a plan.
◦ Proof of address such as utility bill, driver’s license, Voter’s ID, passport, Aadhar card
◦ Proof of age such as birth certificate, PAN card, Aadhar card, passport, mark sheets
◦ Proof of identity such as Aadhar card, passport, driving license, PAN card
◦ Passport size photograph
◦ Any other existing medical records
What’s covered under ₹20 lakh health insurance?
A health insurance plan with ₹20 lakh coverage provides extensive protection for you and your family. Here are some of the typical coverages offered by a ₹20 lakh health insurance plan:
1. Expenses related to diagnostic tests
2. Cost of pre-hospitalisation
3. Cost of post-hospitalisation
4. Cost of organ donation
5. Cost of daycare treatments
6. Cost of ambulance
7. Ayush treatment
8. Cost of inpatient treatment such as room rent, nursing charges, medications, etc.
9. Cost of doctor consultations
What’s not covered under ₹20 lakh health insurance?
Though a ₹20 lakh health insurance plan covers a lot of grounds, there are a few elements that it does not cover. The following are some of the exclusions of a ₹20 lakh health insurance plan.
1. Dental treatments
2. Congenital diseases
3. Self-inflicted injuries or attempt to suicide
4. Alternative treatment costs for acupuncture and acupressure
5. Cosmetic treatment
6. Medical conditions due to abuse of alcohol, intoxicating substances, drugs, etc.
It is highly advisable that you review the policy documents and go through the inclusions and exclusions of a policy before buying one. Being aware of them will ensure that you can claim the policy without any worries of rejection.
How to buy a ₹20 lakh health insurance policy?
It is much easier to buy a ₹20 lakh health insurance policy these days without you even having to visit the local insurance provider office. Here is all that you need to do.
1. Visit the website or smartphone app of your preferred insurance provider or insurance aggregator.
2. Select the health insurance option on the website or app.
3. Look for a health insurance plan with the sum insured of ₹20 lakh.
4. Proceed with the purchase of the health insurance plan.
5. Provide your details such as name, contact information, age, etc.
6. View the list of add-ons to find an add-on that would add value or coverage to the policy.
7. Once you are happy with the coverage and premiums, proceed to complete the payment.
8. After completing the payment, your insurance provider will send you a copy of the policy to your registered email address.
Calculation behind purchasing a ₹20 lakh health insurance plan
Before the purchase of a ₹20 lakh health insurance policy, there are a few calculations that you must keep in mind. The following are some of the major ones.
1. Tax deductions
Section 80D of the Income Tax Act of 1961 allows individuals to claim tax deductions on premiums paid for health insurance policies. As per the section, you can claim a maximum deduction of ₹25,000 for a policy for yourself, your children, and your spouse, provided everyone is below 60 years old. Additionally, you can claim a deduction for your dependent parents and the same limits apply to them as well. For individuals and parents above 60 years, the limit is set at ₹50,000. Thus, the maximum deduction stands at ₹1 lakh.
2. Premium
It should not come as a surprise that insurance providers consider a lot of factors when they issue a health insurance policy. They look at the medical history of the applicant, family health history, age, location, lifestyle, etc. Also, factors such as individual plans and family floater plans play a crucial role in the policy premium. Lastly, the sum insured also sways the policy premiums. A policy with ₹20 lakh coverage will be a bit more expensive as compared to a policy with a lower sum insured.
3. Co-payment
Insurance providers can have a clause of co-payment while issuing health insurance policies. If your policy has a co-payment clause, you will end up paying a certain percentage of the total claim amount. For example, a 10% co-payment clause would result in ₹50,000 out-of-pocket expenses on a claim of ₹5 lakhs. It is better to avoid plans that have co-payment clauses.
4. Deductible
A deductible is a mandatory voluntary payment that you agree to pay on each policy claim. While buying a new health insurance policy, you can decide on the deductible amount that you are willing to pay. Though it is not mandatory to opt for deductibles, they can help you reduce the policy premiums by a considerable margin.
Reasons to go for ₹20 lakh health insurance in India
If you are still on the edge, thinking whether you should or should not buy a ₹20 lakh health insurance policy, here are some compelling reasons to do so.
Health insurance policies provided by employers might not be enough considering the exponential rise in the cost of healthcare over the past few years.
There has been an uptick in the number of diseases that can be directly related to sedentary lifestyles. Diseases such as high blood pressure, diabetes, heart disease etc. are on the rise.
If you are still in your 20s or 30s, buying a ₹20 lakh health insurance plan will turn out to be more affordable. Thus, allowing you better coverage in the future years.
Medical inflation is usually higher than the average inflation. In other words, a procedure would cost more a couple of years down the line than it does today. A ₹20 lakh health insurance policy will have you better prepared.
How does the 20 lakh health insurance plan work?
Once a policyholder is hospitalised, the ₹20 lakh health insurance plan takes effect. It provides coverage for the insured’s medical expenses, up to a maximum limit of ₹20 lakhs. In cases where the insured informs the provider about a planned medical procedure or treatment, the policy allows for cashless payments. Thereby making the medical ordeal seamless and letting the insured focus on recovery rather than expenses.
Alternatively, if the insured receives treatment at a non-network hospital, they can submit all the relevant bills. The insurance provider will then review and approve eligible expenses. It’s important to understand that only medical conditions specified as covered by the policy are eligible for a claim, as conditions listed in the exclusion section will not be covered by the provider.
Factors influencing the 20 lakh health insurance premium
Insurance providers take into consideration quite a few factors to decide on the policy premium. The following are some of them.
1. Coverage
It is a primary factor in deciding on the policy premium. Opting for a policy with a higher sum insured will result in a higher premium as well.
2. Age
A health insurance policy is no different than other insurance policies. Buying a plan during your early years will result in significant savings. Since the risk associated with younger age is less. Conversely, buying the same policy at an older age will set you back by a fair bit.
3. Deductibles
You can opt for deductibles if you want to bring down the policy premiums. However, one must be careful with the deductible amount. Setting a value too high will result in out-of-pocket payment every time you file for a claim.
4. Lifestyle choices
People who consume alcohol and smoke will end up paying a slightly higher policy premium than people who do not.
5. Medical history
If you have any pre-existing conditions, the chances are high that you will end up paying a higher policy premium.
How to pick the perfect 20 lakh health insurance plan?
It is important to choose the right health insurance plan since it can be a differentiating factor in the future. To help you choose the perfect ₹20 lakh health insurance, we have curated a simple list of factors to consider.
1. Coverage
Apart from a considerable sum insured, it is important to go through the coverage on offer of a health insurance policy. Look for any sub-limits or caps when it comes to inpatient treatment and other types of coverage as well such as daycare procedures, domiciliary treatment, etc.
2. Exclusions
You must not skip this step. Make sure to traverse the exclusion list of a policy. It will help you file a claim more accurately and prevent you from unwanted claim rejections.
3. Network hospitals
Visiting a network hospital or an insurance provider makes the entire ordeal much simpler. You can opt for cashless service and in some cases, even pay lower prices for expenses as well. A quick look at the network hospital list would help you identify if your preferred hospital(s) is on the list.
4. Copayment
Some insurance policies would require you to pay a copayment on the policy claims. It is advisable that you look at the copayment clause and avoid opting for such policies if you can.
5. Pre-existing conditions
If you already have a pre-existing medical condition, make sure to verify if the same is covered as a part of the policy. Look at the waiting period for the condition before it can be covered by the policy. a lower waiting period is preferable.
To Sum Up!
A ₹20 lakh health insurance policy can be a differentiating factor when it comes to hospitalisation, considering the skyrocketing medical expenses. It will prepare you better for any future medical contingencies.
Frequently Asked Questions
Buying a ₹20 lakh health insurance policy will help you prepare better for any unforeseen medical contingencies in the future.
While it is not mandatory, opting for add-ons can enhance the policy coverage considerably.
Yes. Most insurance providers offer multiple payment options and frequency of payments to facilitate easier buying.
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