Personal Medical Insurance

Medical Insurance, most of us working class feel this is the duty of our employer to provide and some lucky people also get medical Insurance cover of their parents provided by their employer and some people have to pay to the employer to cover their parents. But that's about it, that's all what we think is sufficient to cover all our needs related to Medical Insurance. 


How much does your employer cover under Medical Insurance? 
If you are in the government services, quiet a significant amount is covered but all those in the private sector have limitation imposed on them which is mostly floater policies covering the family for anywhere between 2 to 10 Lakhs depending on your position and the employer.

Is it Enough?
A normal procedure in an good reputed hospital can cost you anywhere between 50000 to an unlimited amount and god forbid if any member of your family meets with an emergency and you have to bear the expense for the remaining amount, will you be able to bear the need over and above your normal cover, in case you have it.

Are all Hospitals in your area covered by the insurer provided by your Employer?
Do i need say more, have you even scanned through the list of all the Cashless Claim Hospitals in your area, do you think the important ones are covered or are their some Gaps, what about the list of hospitals in your hometown in case you need it there. 

What if you change the Employer, are you sure he will have the same coverage as the one provided currently by your existing employer?
Do you plan to change your employer in the near or far future, what if the employer is a good paymaster or is closer to your home but does not have any insurance coverage or very low insurance coverage, do you think you can still live with this.

I have a suggestion, do look carefully in whats covered and whats not and don't treat Medical Insurance as just another tax saving vehicle, assess your needs and coverage requirements carefully.

I would suggest apart from the insurance of the Employer, each person should also buy atleast one additional Policy or at a minimum a Top-Up plan for the medical Coverage on your own. 

Just to give you some of the benefits of an additional Mediclaim Insurance Policy - 
  1. You can Choose a provider and cover your family for any additional Risks.
  2. In case you are admitted to an hospital and you have an employer provided policy of 2 Lakh Rupees and your bill is 2.5 Lakh Rupees, you can always claim the remaining amount from your personal policy, this is possible in India and hence reduce the burden on your self.
  3. Your Personal Policy can last beyond your Employer i.e - 
    1. What if your employer changes policy and ceases to provide Medical Coverage?
    2. What if your New Employer does not provide any medical Insurance?
    3. What if the Employer Insurance does not cover the specific Hospital recommended by your doctor?
    4. There is a less likely chance of you getting medical insurance in the later year that earlier, the earlier you take the better?
What is Top Up Plan i mentioned Above - 
Unlike mediclaim policies, top-up plans have a limit only above which you can claim also know as the Threshold Limit or Deductible amount. When you buy such a plan, you have to choose what deductible amount or threshold limit you want to apply, which is usually the amount your existing policy can cover. For example - 
If the mediclaim policy provided by your employer is for 2 lakh INR and you get admitted in a hospital for a procedure and your bill is for 4 lakh INR, you would normally have to pay from your pocket but in case you had a topup cover of say 5 lakh INR, than you would have 2 lakh INR as a threshold or deductible limit that would be paid by your Employers or your Mediclaim Policy and and the remaining 2 Lakh INR would be paid by the top-up Policy. In case, you did not have a base policy, you would have to bear the 2 lakh INR bill and top-up policy would cover the amount beyond that.

So to Sum it up, please do seriously think about the Medical Insurance needs, which is in today's world a more likely Risk.


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Medical insurance is a very important and responsible side of life. Unfortunately not in all countries this system works correctly. There are many pitfalls that make it impossible to take advantage of all the benefits of health insurance.

Riya Tiwari said...

Nice blog and content