Hemant Mishra/Mint
Hemant Mishra/Mint

Best health insurance plans for you

Any ailment that you contract after you buy the policy is not a pre-existing disease

How do you buy a health insurance plan? If you just settle with the plan your agent sells or are happy knowing you have bought the cheapest plan, there is a bit of unlearning and a lot of learning in store for you. A health insurance policy packs in several features and caveats. To give you a ready comparison, we designed Mint Mediclaim Ratings (MMR), which was developed by SecureNow Insurance Broker Pvt. Ltd. The full ratings along with the methodology can be seen here:http://www.livemint.com/mintmediratings.

In the ratings, for family floater plans, we have considered two sum insured amounts ( 10 lakh and 20 lakh) and three age categories in each—eldest insured member is 35, 45 or 65 years old. For individual plans, the age categories are the same but the sum assured is 5 lakh. The newest edition of the ratings (July 2015) also includes individual plans of 5 lakh, 10 lakh and 20 lakh for a person aged 70 years.

This week, we spotlight individual policies with sum assured 5 lakh, where the person is 45 years old.

We also explain some of the important aspects that one should look at while choosing a policy.

Let’s look at pre-existing diseases.

The rule book defines pre-existing disease as any condition, ailment, injury or related conditions for which the insured person had signs or symptoms, and/or was diagnosed and/or received medical treatment within 48 months before buying the policy. Such pre-existing ailments are covered after a waiting period of four years. If you have or had any ailment in the past four years before you bought a health plan for the first time and were aware of it, it will be considered a pre-existing disease. Further, the disease or other related conditions will not be covered for the next four years. Any ailment that you contract after you buy the policy is not a pre-existing disease. In fact, the waiting period on pre-existing ailments is one of the primary reasons why claims get rejected. But experts feel the definition is not watertight as the policyholder may have symptoms of a pre-existing disease but may not be aware of it, or the symptoms may be silent. Some insurers have started reducing the waiting period. So, shorter waiting period on pre-existing ailments have been given higher scores.

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