Ramesh, 35, from Mumbai, needed ₹2.5 lakh for his father’s heart surgery. His health insurance covered most of it, but he had to pay ₹50,000 himself. To handle this, Ramesh took a personal loan. This loan made it easier for him to pay without worrying about money.
Stories like Ramesh’s are common in Mumbai, where healthcare is expensive. ICU charges can be ₹50,000 a day. That’s why good health insurance matters.
Here’s how to choose one.
1. Understand Your Healthcare Needs
Before buying health insurance, think about these questions:
- How old are you, and who do you want to cover: If you’re 25 and single, a basic health plan is enough. But if you’re 40 with a family, choose a plan that covers your spouse, kids, or parents too.
- Do you or your family have pre-existing health problems: Some plans cover conditions like diabetes or asthma, but there might be a waiting period.
- What is your lifestyle like: Mumbai’s fast-paced life can increase stress-related health risks, so consider plans that cover these conditions.
2. What Should the Insurance Cover?
A good health insurance plan will help you with:
- Hospitalisation Costs: Like room rent and ICU charges.
- Daycare Treatments: Short procedures like cataract surgeries.
- Pre- and Post-Hospitalisation Expenses: For tests, medicines, or follow-up doctor visits.
- Maternity Benefits: Helpful for young families.
- Critical Illnesses: Coverage for severe conditions like cancer or heart diseases.
3. Choose Insurance with Good Hospitals in the Network
If you need treatment at top hospitals like Kokilaben or Lilavati, ensure your insurance covers them. This way, you can get treatment without paying upfront, making the process easier. Some major insurances that cover most of the hospitals are Star Health, Niva Bupa, Care Health.
4. Compare Premiums and Sum Insured
Premium is the amount you pay for insurance, while the sum insured is the maximum amount the company will pay for your claims.
For example:
| Plan Type | Annual Premium (₹) | Sum Insured (₹) |
| Basic Individual Plan | 6,000–10,000 | 3 lakh – 5 lakh |
| Family Floater Plan | 12,000–25,000 | 10 lakh–15 lakh |
| Premium Plan with Add-ons | 30,000+ | 20 lakh and above |
In Mumbai, surgeries can cost over ₹1 lakh, so choose a plan with higher coverage. If the premium is high, you can consider a personal loan in Mumbai to help you manage the costs.
5. Watch Out for Waiting Periods and Sub-Limits
- Waiting Period: Some plans make you wait 2-4 years for illnesses like diabetes. Choose plans with shorter waiting times.
- Sub-Limits: Some policies limit room rents or specific treatments. For example, a policy might only allow ₹2,000 per day for a hospital room. Always read the fine print.
6. Add-ons and Riders: Are They Useful?
Sometimes, you can customise your policy with add-ons like:
- Accident Coverage: For injuries due to accidents.
- Critical Illness Riders: For severe diseases like kidney failure.
- Daily Hospital Cash: A small daily amount to cover other expenses.
Think about what’s most useful for your situation.
8. Be ready for unexpected expenses.
For Example: If your hospital bill is ₹2 lakh and your insurance covers ₹1.5 lakh, you’ll need ₹50,000 more. A personal loan can cover this amount quickly.
Even with good insurance, some costs may still be left for you to pay. Personal loans are easy and fast to help with such expenses.
Some Facts:
- A 2022 National Health Authority report states that hospital stays in India cost ₹2,000 to ₹10,000 per day, with surgeries and treatments in private hospitals often exceeding₹1 lakh.
- In 2023, over 18,000 hospitals in India will be part of health insurance networks offering cashless treatment. This includes top hospitals like Kokilaben and AIIMS, easing payment for insured individuals.
Conclusion: Secure Your Future Today
For Example, Ramesh’s father needed heart surgery that cost ₹2.5 lakh. His health insurance covered₹2 lakh, but he had to pay₹50,000. Ramesh took a personal loan to cover this ₹50,000, ensuring his father received the best care without financial stress.
Health emergencies are unpredictable, and medical costs in Mumbai can be high.
For example, surgeries can cost over ₹1 lakh. Having the right health insurance helps you manage most expenses, and a personal loan can cover the rest. Compare different plans, and make sure you’re financially ready for emergencies.
