Medical Insurance Plans That Cover Critical Illnesses: All You Need To Know

Today, insurers offer a variety of medical insurance plans to cater to different customer needs. Insurance companies provide several types of benefits to the customer in different medical insurance plans. Typically, in a regular medical insurance plan, expenses related to a heath condition that requires hospitalisation, and even the subsequent follow-ups, are covered but not those related to life threatening diseases, known as critical illnesses. This is where a special type of medical insurance comes to the customer's rescue.

Unlike a regular insurance policy, wherein expenses related to hospitalisation of eligible individuals are covered, the insurer provides cover in the form of a lump sum in case the subscriber is diagnosed with a pre-defined disease in a critical illness plan.

Here are five things you need to know about critical illness medical insurance plans:

1. Which types of health conditions are covered under a critical illness plan?

Critical illness usually includes illness, sickness, disease or corrective measure related to cancer, kidney failure, coronary artery (bypass) surgery, heart attack, heart valve surgery, major organ transplantation, multiple sclerosis, primary pulmonary arterial hypertension, aorta graft surgery, paralysis, coma, total blindness and stroke.

In other words, insurers provide cover against health conditions that require long-term medication and monitoring, and can occur or even reoccur indefinitely.

2. How do critical illness medical insurance plans differ from regular medical insurance plans?

Other than the kind of cover provided by the insurer, a critical illness plan typically does not require the patient to be hospitalised to be eligible for cover. Unlike a regular medi-claim plan, the individual is required to only be diagnosed with any of the conditions to be eligible for cover under a critical illness insurance plan. Therefore, the coverage offered under critical illness medical insurance plans is restrictive in nature, with respect to these pre-defined health conditions, and not extensive. Also, a critical illness plan is usually offered for a period of time longer than one year, unlike a regular medi-claim policy which is renewed on an annual basis.

3. Which important aspects does one need to consider while comparing different critical illness medical insurance plans?

Other than a general comparison of insurers on the basis of loan disbursement, market share and reputation, experts suggest studying the policy documents carefully for details on various features such as waiting period. It is always advisable to study the policy document, for details on the conditions applicable to the covered critical illnesses.

Here are three things one may take into account:

Waiting period

A critical illness insurance plan may have a waiting period spanning multiple years, which means that even after buying a policy, any claim by the policyholder is not deemed admissible by the insurer for that period. A potential medical insurance customer should compare thoroughly the waiting periods associated with different policies, especially if one wants protection against the said critical illnesses to come into effect soon, say experts.

Inclusion and exclusion

Besides, there are several inclusions and exclusions associated with critical illness medical insurance plans. This information is there in the policy document and can be demanded from the insurance agent too. Having a thorough understanding of various conditions applicable to a critical illness insurance coverage helps the customer in many ways.

Not only the customer becomes equipped to make most of the insurance plan by knowing the constraints and limitations applicable to it, but also avoids falling prey to difficult financial circumstances emerging out of a health condition.

Term vis-a-vis premium

Subscription to only a well-studied and suitable plan ensures protection in case a major health problem occurs.

Needless to say, one also needs to consider the term and premium associated with medical insurance policy keeping in mind his or her budget, requirement and family history, say experts.

4. Are there any options to purchase protection against critical illness?

Protection against critical illness can be taken up in two ways: as a standalone policy, or as a rider with a medical/life insurance plan. Insurance providers today offer cover against critical illnesses in a variety of products. Generally, when it comes to protection against critical illness, standalone medical insurance policies provide a higher cover compared to policies with critical illness riders. Also, the number of diseases covered in standalone critical illness medical insurance plans is higher than in case of life or medical insurance policies with critical illness riders.

5. How to compare different providers of medical insurance plans?

Any decision on investment in an insurance policy must be backed with a fair amount of due diligence, say experts. Comparing different insurance companies is as important as comparing different insurance products. A diligently selected medical insurance policy can go a long way, in supporting the insured in case of a medical emergency. Insurance regulator IRDAI or Insurance Regulatory and Development Authority releases data on performance of insurers periodically, with an aim to protect the interest of policyholders. This information - such as premium income, compliance, claim settlement and incurred claims ratio - can be used by the potential customer to make a choice.

Having subscription to multiple medical insurance plans where on one hand offers more protection to the customer, it also leaves a larger scope for error when it comes to selection of policy. A poor selection can render a medical insurance policyholder helpless at the actual time of requirement should the need arise. And this is why experts emphasise on a thorough understanding of different medical insurance plans to reap the maximum benefits of one's time and money.

IFFCO Tokio is a general insurance company that provides a range of medical insurance products, such as Critical Illness Insurance Policy and Family Health Protector Policy.