I am a 63-year-old retired banker. In 2016, Indian Banks’ Association entered in an agreement with a general insurance company to provide a mediclaim of ₹ 4 lakh at a premium of ₹ 16,000 so I discontinued my long running policy and bought this one. Next year with a top-up, they raised the premium to ₹ 23,000 and this year from 1 November, they are asking for ₹ 40,000, which is a lot. My wife and I require a cataract surgery within the next 2-3 months. Now if I change the insurance company, they will not pay till the next two years. What should we do? Changing the insurer means no support for two years or paying a hefty premium which is equal to 45 days of our pension.
—Name withheld on request
This is a substantial increase. However, you have mentioned that the sum assured has been increased via a top-up last year. In an individual health insurance policy, you should be able to get a sum assured between ₹ 5 lakh and ₹ 7 lakh for an annual premium of ₹ 40,000. If you opt for a plan with co-pay, you could get a slightly higher sum assured. If the aggregate sum assured you have through the association is in the range of ₹ 5-7 lakh, then I suggest you continue with the plan.
Cataract surgery for both of you will cost around ₹ 50,000-75,000. So if you want to switch to another plan, do that after the surgery. One way to optimise the premium would be to opt for lower sum assured in the association plan and buy an individual top-up plan. This would ensure continuity in coverage for small claims during the waiting period in the top-up plan.
Annual health insurance premiums increase with age. This is true even for existing users of retail health insurance plans. In some plans, the increase is steeper than others. I would not, however, recommend reducing your overall coverage, as your health needs will increase with age.
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Abhishek Bondia is principal officer and managing director, SecureNow.in. Queries and views at email@example.com