Do health insurance plans cover maternity expenses?

Maternity health insurance

“Maternity Plans” are not really separate plans. It is a feature which may be covered under normal health plans. However, only a few health plans offer maternity cover as part of their normal health plans.

Key features of maternity cover are as follows:

  • There is usually a separate waiting period for maternity coverage – This means that any claims with respect to maternity will be catered to only after the maternity specific waiting period is over
  • Almost all plans have an upper cap on the amount of expenses that will be covered – Usually the coverage ranges from INR 25000 – 50000 per delivery. The reason most policies have an upper cap is because the number of claims for maternity is likely to be very high. The purpose of Health Insurance is to protect you from any sudden outflow of funds due to a medical emergency. The occurrence of maternity is almost certain and hence a limit on the same is warranted
  • Pre – maternity costs are generally not covered – Most plans which offer maternity coverage generally do not cover any expenses that are incurred towards consultancies and tests
  • New born coverage – Generally, the new born baby is covered till the end of policy year

Should you buy a health plan only because it provides maternity coverage?

Maternity should ideally be treated as a bonus option. The overall decision behind buying a health plan should ideally be the key features which are relevant for any kind of hospitalization. Imagine a plan providing good maternity coverage but having a claim settlement ratio of 70%. Therefore, choosing a plan just because it provides maternity coverage may not be the best decision to take.

However, in case you have a choice between two equally good plans with one of them providing maternity coverage with or without some extra premium, then it might make sense to take the plan with the maternity clause. Especially, if you are planning a kid in next few years.

Want to discuss more on maternity plans? Write to us on contact@cagrfunds.com.

Have you read about our Cancer Plans?

Cancer Health Plans may be useful to consider!

Cancer Health plans

A slew of niche healthcare plans have been launched recently. These plans cater to specific diseases only. Cancer Plans are one such category.

Key features which are common across various Cancer Plans are as follows:

  • Objective is to cover the expenses that arise out of diagnosis of any type of Cancer
  • Benefits are generally payable in parts basis the different stages of Cancer

Why should you buy these plans?

Well, there is no good answer to this. As we know, occurrence of Cancer is random and anyone could be a victim of the same. Some of the facts are worth being aware of:

  • India is the world’s largest contributor to Cancer deaths
  • 22 lakh Cancer deaths are reported every year
  • 71% of the Cancer deaths occur in the age group of 30 – 69 years
  • 15% of Cancer patients are children and young adults (as compared to the global average of 0.5%)

The geographic spread of Cancer in India is largely driven by the environmental practices prevailing in respective regions:

States Common types of Cancer Reasons
UP, Bihar, WB Gall Bladder, Neck and Head Polluted water, diet rich in animal protein or fish
MP, Bihar, Gujarat, Rajasthan Oral High Tobacco and Pan Masala consumption
Punjab, Haryana, Delhi All Cancers are higher than average, especially, kidney, lungs, urinary, breast Pollution, pesticide, toxins in food
Goa Colon Cancer Red Meat, Alcohol, Tobacco
WB Lung, Urinary Bladder Air and Water Pollution
North East Highest Cancer Rate, especially of Oesophagus Tobacco, Household burning of Firewood
South & Coastal India Stomach Diet rich in spice, salt

Is Cancer not covered in regular Health Insurance Plans?

Regular health plans do cover hospitalization for Cancer. However, Cancer treatment costs often cost anywhere between 10 – 25 lacs and only go upwards for advanced treatments. Health Plans with such high sum insured can turn out to be very expensive.

Moreover, Cancer treatments tend to continue for years and the costs have only been rising.

What about Critical Illness covers?

Cancer is also covered under Critical Illness Plans, but only at advanced stages where a lump sum is payable. Generally, most Cancer specific plans tend to pay lumpsum at multiple stages of diagnosis, thereby protecting the continuous flow of expenses.

What is the alternative?

A decent size of Base Insured Plan + A large Top Up Plan + Critical Illness may be a good alternative. However, for those who have had a first – hand experience of Cancer treatments among friends and family, might want to insure themselves against the deadly possibility. The decision depends on affordability of every individual.

Read more on Top Up Plans here

To know more about the best Cancer Plans, write to us on contact@cagrfunds.com

 

Everything about Top Up Health Insurance Plans

Top Up Health Plans

What are Top Up Plans?

Also known as Deductible Plans, Top Up Health Plans provide a cover over and above a certain base cover. This base cover in most cases come from existing policies. Some Top Up Plans allow deductible options even without an existing insurance policy.

In cases where there is an existing insurance policy, reimbursement against any claim that arises will first be made out of the existing policy. The liability of the Top Up Plan arises only after the set threshold of the existing plan has been exhausted.

In cases where there is no existing policy and the Top Up Plan permits such a situation, expenses up to the threshold level has to be borne by the insured out of his or her own pocket. The liability of the Top – Up Plan arises only after the set threshold has been exhausted.

Example 1:

Ajay has a health insurance cover from his employer of 8 lacs. He purchases a top up plan for 10 lacs with a deductible of 3 lacs. An unfortunate event of hospitalization generates a claim of 9 lacs. Ajay can use either of the following options:

Option 1: Raise a claim of 8 lacs against the employer health plan and balance 1 lac against the top up plan

Option 2: Raise a claim of 3 lacs against the employer health plan and balance 6 lacs against the top up plan

So basically, the top up plan gets activated only when the deductible threshold is crossed.

Example 2:

Vijay does not have any existing health plan except a top up cover of 10 lacs with a deductible of 1 lac. He gets hospitalized and has to raise a claim of 3 lacs. In this case, Ajay will have to pay the initial 1 lacs from his own pocket and the Top – Up Plan will consider only balance amount of 2 lacs for claim settlement.

Why are Top Up plans useful?

These plans are useful for two simple reasons:

  1. A high coverage is available at a significantly low premium
  2. In an event of a medical emergency where the amount of expenses tend to spiral beyond the usual ranges, these plans come to rescue

Who should buy Top Up Plans?

  1. Salaried people who have a basic corporate cover – Smaller hospitalization claims can be covered by the corporate cover and in case of larger expenses, Top Up Plans can be utilized. This also means that post retirement, claims up to the deductible amount will have to be either self – funded or funded through a Base Insurance Plan. However, since deductibles are pre-decided, the same can be set aside as an emergency fund.
  2. Salaried people who plan to change jobs or start on their own – Top Up Plans are an excellent option in this case. The cover and the low cost premium continues irrespective of whether you are salaried or get into entrepreneurship.
  3. People who have sufficient resources for covering up small ticket emergencies – These people can leverage the low premium Top Up Plans to cover themselves for any eventualities
  4. People who have a Base Insurance Plan with a basic cover amount of 5-10 lacs – In cases of severe medical emergencies such as complicated surgeries, the amount of expense usually shoots beyond the normal cover that we usually have. Especially if the treatment is being carried out in one of the plush city hospitals! A Top Up Plan is the umbrella for such unannounced rainy days.

Which are the best Top Up Plans?

Most Insurance Companies now offer top Up Plans. However, one has to select the plan which has the most suitable features and has a low premium. Email us on contact@cagrfunds.com to ask us for the best Top Up Plans.

Why should people with Corporate Insurance cover still have a separate health plan?

How does CAGRfunds charge zero to its customers?

At CAGRfunds, we help you to invest in “Regular Plans” of Mutual Funds. As such, we earn commissions from the AMCs (Asset Management Companies) based on the value of investments that we facilitate.  The commissions that we get are just one of the many components of the “Expense Ratios” of the funds. Since we get our revenues through commissions, we do not charge our clients anything.

Why we deserve what we earn?

First things first. There are no free lunches. So next time someone gives you free advice (for no consideration whatsoever) be extremely careful about betting your money on advice that has no ownership.

Expense ratios are essentially a part of earnings that are deployed towards fund expenses. Since our commissions are a part of it, we feel extremely responsible to add enough value to justify our revenues. Following is how we consistently add value to our clients:

Behavioural education – We believe that investing is more about your inherent behaviour and less about identifying the “best funds”. As normal people who are not rational at all points in time, we tend to take misguided decisions when it comes to money. Most investors often wonder when is the right time to sell as soon as markets start getting volatile. Therefore, we spend a huge amount of time educating our clients about various aspects of investing, inherent biases that they should be avoiding, the correct approach and the ideal way to plan. Throughout your investment journey, there will be times when you will need expert guidance about what action or decision they should take (A lot of our existing clients call us to ask if they should purchase XYZ policy that their bank RM has been pushing them for). And that is where we step in. So while, our very simple platform takes care of executing your transactions, we proactively take care of every small action that remains to be a humanised and personalized service. We strive to be the financial partners of our clients throughout their investment journey. We believe in being approachable and responsive to their requirements. Indeed, a human voice and a face to talk to always helps.

Customized fund recommendation – We understand that each person has different needs, objectives and preferences. Since we do not offer any standardized algorithms, our fund recommendation is purely customized to your suitability. With us, you, therefore, do not run the risk of being misguided by fund rankings and recent returns. This is extremely crucial as your objective is to meet your financial goals by investing in the most suitable funds.

Asset Allocation and rebalancing: At the start of any investment, we put down the target asset allocation of the investor. This target allocation depends on the age, investment objectives and risk profile of the investor. At the end of every year, we compare the target allocation with the current asset allocation and recommend a suitable action. The investor can either choose to follow the recommendation or set a new asset allocation target. In addition, we also proactively suggest any changes that may be required in your portfolio due to fundamental changes in fund attributes (For example, a change in fund manager may have a considerable impact on the future performance of the fund). We, therefore, spend a lot of time reviewing each portfolio in the utmost details. We, therefore, ensure that your money is optimally invested at all times.

Tax Planning: We help our investors with tax planning in multiple ways

  1. Recommend the most suitable tax saving mutual funds under section 80C
  2. Comprehensive Tax Reports which inform the investor what proportion of his corpus has become tax-free and what proportion is liable to taxation. This comes extremely handy at the time of filing returns as investors prefer a ready reckoner of what is their tax liability
  3. Notification of tax liability on redemption (Coming Soon): Often times, investors tend to redeem funds oblivious to the tax liability it creates. We have therefore started intimating our investors on whether their redemption amount is subject to taxation or not. This is extremely helpful when there are tax-free avenues for redemption which can be utilized first
  4. NPS Account opening and investment