Categorized | Health Insurance

what determines the premium of mediclaim policy?

Health insurance or Mediclaim Policy as is widely known in India is a policy that covers the medical expenses of an individual or of a family in case of a medical emergency.  As you know, diseases and accidents come uninvited and can affect any person, at any time. Mediclaim policy gives us the necessary mental peace and critical finances in such emergency medical situations.  Also, certain diseases are extremely expensive to treat, in which case only a Mediclaim policy can come to the rescue for most of us. 

A Mediclaim policy covers more or less all Hospitalization expenses, medications and so on for a minimum period of 24 hours, including some day care procedures. Thus, mediclaim has become an essential requirement and investment in our lives these days. If you or your family member is between the age of 5 to 65 years, you can opt for this policy. Foreign nationals too are eligible for the policy if the treatment is within India and the Claim is paid in Indian Rupee.  

When you take a mediclaim policy, you need to pay a quarterly, monthly or annual installment to the insurance company. This amount is called the mediclaim premium. A good mediclaim policy should accommodate all or at least most of what you want. Also, different insurers charge different premiums, but there are various factors that decide the Premium when you take a Health Insurance policy. They are always based on certain criteria like the age of the insured, the present health condition and so on. The various types of mediclaim policies, the factors affecting the mediclaim premium and so on will be covered in detail here.

Types of Mediclaim Policies:

You have the option of buying two types of products under mediclaim. They are:

1.Individual health insurance plan
Under this plan, each Insured member has a separate insurance. This is an ideal one for families with aged family members where the health Risk is high. There is no Age Limit for renewing the policy, and you can include your aged parents, in-laws etc as they are also eligible for coverage.  However, due to these advantages the policy is a little expensive.

2.Family Floater plan
Under this plan, the insurance amount is shared by all the family members. Hence, it is less expensive when compared to individual policy. A good plan for younger families with low health risk, typically two adults and two children are included. Also, you may get a greater amount than an individual plan if there is only one claim in a year.

Factors Affecting Mediclaim Premium

The following are the common factors affecting the premium of any mediclaim policy:

1.Amount of Cover 
The premium of the insurance policy depends mainly on the amount of insurance cover that you ask for. Greater the cover higher will be the premium amount.

2.Type of Plan
There are different types of medical insurance plans available in the market. Apart from Individual health insurance and Family floater plans, there are some other policies that specifically cover life threatening critical illnesses. Also, along with some plans companies include benefits like cashless hospitalization. The premium is determined by all these features, and you must know if your Mediclaim policy includes them or not. 

3.Age of the policyholder
The premium of the insurance policy depends a lot on the age of the policyholder. This is because with age a person becomes more vulnerable to illnesses. The monthly premium often increases as the age of the policy holder increases.

4.Health of the policyholder
If you already have some medical issues, the insurance premium will increase too. In many cases, you are asked to declare the Pre-existing diseases. Sometimes, you need to go through a detailed medical checkup before a policy in your name is approved. 

5.Term of the Policy
A Mediclaim plans can be either for a short Term or for long term duration. In case of a short term policy, the monthly premium will be higher compared to a long term policy.