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HEALTH INSURANCE

Health Plans for Heart Ailments

Rohit Sapra Rohit Sapra 12 November 2019

Heart ailments are a quick, merciless killers. Understand the various types of health plans available in the market today that cover heart ailments.

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Healthcare costs have increased drastically in the last few decades. Today, even a simple medical treatment can cause a huge dent in a person’s savings, and hence, there’s no saying how much a heart ailment treatment may cost. A health insurance policy that covers all kinds of heart ailments is the only thing that can help save money while providing extensive coverage and proper treatment.

Health insurance plans for heart ailments are especially necessary for senior citizens and individuals who are prone to or are at risk of heart problems. These plans provide an extra cushion and can prove to be a great aide in bad times.

Why Choose a Cardiac Health Care Insurance?

There was a time when heart problems were considered to be specific to older age groups. It wasn’t common for younger people to experience heart health issues. But with a huge change in lifestyle and an extra dose of stress, we have arrived at a time where heart issues are commonly found in the younger generations as well.

According to a report by the University of Florida, Indians have the highest rate of coronary artery disease as compared to other races. This is despite the fact that almost 50 percent of Indians are vegetarians. Today, 25 percent of all heart attacks in India occur to individuals under the age of 40.

These numbers are quite worrying and make it important to invest in a good heart care insurance plan. Without that, the treatment expenses can take a toll on the savings as well as future plans of the patients and their families.

Most general health care plans fail to provide sufficient coverage for heart ailments. A specific heart insurance plan can come in handy in saving bank balances and providing crucial finances during such unfortunate times.

Health Insurance Policy for Heart Ailments

It is not very difficult to get a general health insurance policy with a pre-defined critical illness like heart problems, kidney issues and stroke. Almost all the companies have come up with specific health insurance plans that cover critical illnesses. These plans have special features and specific terms and conditions.

What to Look for When Buying a Cardiac Insurance Plan?

Sum Insured: The sum insured is the most important aspect of an insurance plan. This is the amount you receive for treatment when something unfortunate comes up. So, it is important to clearly understand the sum insured for a cardiac insurance policy and also pay attention to all the clauses attached to it.

Illness Coverage: A plan that provides coverage even after the diagnosis of a single disease is an ideal plan for individuals with heart issues. This means, before buying a plan, you should confirm that the plan pays for cardiac issues and also covers other ailments that may show up simultaneously.

Exclusions: Health insurance policies come with a lot of exclusions, which mean that there are a number of situations when the company need not provide coverage to the patient. It is important to read through all the disclosures mentioned in the insurance document. This is where all the exclusions are mentioned.

What is Covered?

Room Rent: Most of the cardiac care plans cover room rent which has a limit of 2% of the insured. Some plans have a fixed maximum amount like Rs. 5000 per day.

Co-Payment: A co-pay of 10% of claimable expenses is commonly offered. In the case of packaged treatments, a co-pay of 20% is also applicable.

No Claim Benefits: A no-claim benefit is the discount offered by an insurance company when no claim is made during the term of an insurance policy. This is not awarded by all insurance providers.

Pre/Post Hospitalization Expenses: This coverage begins almost 30 days before hospitalization and goes up to 60 days post-hospitalization. The number of days and other key features may vary according to the insurance company.

Ambulance Charges: Ambulance charges come with almost all health insurance policies. The amount can be Rs. 750 per hospitalization or Rs. 1500 per policy period.

What Is Not Covered?

  1. Dental treatments are not covered in health insurance policies. They may be covered if they are prescribed as a part of the treatment plan.

  2. Procedures like birth control, AIDS and related health issues are not covered under heart insurance.

  3. Treatment of mental illnesses is not covered in this type of insurance.

Cardiac Care Waiting Period

Most of the insurance providers do not entertain individuals who have had a heart-related issue or surgery in the past six months or three years after the procedure. Most of the cardiac care policies in the market have a short waiting period before the policy becomes valid. This period is mostly of 91 days after which the insured can take benefit of the policy.

The wait period clause applies to individuals who have had cardiac procedures like angioplasty or bypass surgery in the past few years.

The waiting period for coverage of other health ailments like knee replacement, hernia, cataracts, piles and sinus is approximately two years or more.

Key Features of Heart Health Insurance Policy

Health plans for heart ailments are created for individuals. Following are the key features of cardiac insurance plans provided by almost all the insurance companies.

  1. Comprehensive coverage for all the cardiac conditions and procedures related to them.
  2. Fixed lump sum payout for expenses incurred in diagnosis and treatment. This amount may be different from the expense incurred in the treatment.
  3. Multiple claims for heart related or different conditions can be covered. This is subject to exhaustion of Sum Insured in the Policy.
  4. Indexation benefit to help stay ahead of medical inflation.
  5. Optional hospitalization benefit for lump sum payout in case of hospitalization.
  6. Tax benefits under Section 80D of the Income Tax Act ,1961.

How to Choose a Cardiac Insurance Plan?

There are certain factors that need to be checked before choosing a heart health insurance policy. Some of the pointers to be considered are:

  1. Cover options available: Some insurance providers offer multiple cardiac insurance plans. So, individuals should check each one out in detail and then take a call based on their needs.

  2. Illnesses Covered: It is vital to check the illnesses covered by an insurance policy. There is no point in buying insurance that doesn’t provide cover when needed.

  3. Premium Price: The premium price has to be an affordable amount while providing the needed cover. It has to be considered while investing in a cardiac insurance policy.

  4. Add-on Benefits: Some insurance companies offer add-on benefits to its customers. It will be smart to consider these benefits while making the decision.

Life, as we know it, can change in a matter of seconds. Good health is a blessing which may not last a lifetime. A good cardiac health insurance can help avoid a big financial mess. There are several insurance companies that offer cardiac insurance, but only a few are good. So, a choice has to be made smartly according to the need and the benefits offered. A heart health insurance policy is definitely worth the money (premium amount) spent on it.

Recommended Link:ICICI Pru Heart/Cancer Protect

Rohit Sapra
Written by Rohit Sapra
Rohit Sapra, a licentiate, and currently an SME, is a seasoned insurance professional with previous work experience from Kotak and Birla Sun Life Insurance.
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