Insurance Uncovered

My wife, 59, has a corporate mediclaim policy that covers her, my daughter who is 27 and myself, aged 61, for ₹5 lakh. We also have a health insurance cover for ₹5 lakh with Star Health. I read about health insurance porting in an article in BusinessLine.

I want to port from New India Assurance because the policy-related services are not satisfactory. Also, as my wife will be retiring next year, she will not be eligible to continue the corporate mediclaim policy.

Should I port out or buy a basic health insurance with another company, while retaining Star Health? Or, should I buy an entirely new policy by discontinuing both the health insurance policies? Kindly advice.

Prasad Gorur

Porting ensures that the policyholder does not lose any benefit while switching from one insurer to another. However, note that unlike in individual policies, where you have the freedom to choose any insurer while porting, when part of a group cover, you can move to a new policy with the same insurer only.

You will be allowed to switch to a new insurer only after a year. In your case, when porting out of New India Assurance’s group policy, you will have to go with the company’s retail health policy - New India Floater Mediclaim.

In this product, the waiting period for pre-existing diseases is four years. If you have already spent four years or more under your old group policy, you will be covered for pre-existing diseases under the new policy from Day 1.

However, note that the insurer may not accept you without underwriting. Every family member may be required to go through medical tests. Also, note that the New India Assurance’s retail health policy doesn’t cover children over 25 years.

While porting out of New India Assurance’s group policy is a wise move, given that your spouse is retiring next year, you may want to re-think about porting out of Star Health’s insurance plan. If you are happy with the service, you can continue that policy. But, make sure it is a regular health plan and covers hospitalisation expenses.

And, given your age, you could go for a total cover of ₹10 lakh. You can find out if Star Health is willing to offer you a higher sum insured. But that will come with a fresh waiting period.

If you don’t want to increase the SI in the base plan to ₹10 lakh, you can look at a super top-up cover.

This will save premium. A super top-up policy will cover all expenses over and above a threshold, in this case ₹5 lakh. You can look for a super top-up plan from Star Health itself or from any other player in the market. However, remember that the super top-up plan will come with a fresh waiting period.

For some reason, if you are not happy about the Star Health plan, you can consider porting to another insurer. Note that you will be eligible to port your health insurance policy only if you had renewed it without a break. Also, the porting request to the new insurer should be made at least 45 days before the expiry of the policy in the prescribed form.

If you are reasonably healthy, getting a new health policy is not too difficult, even at your age. The advantage of going with regular health insurance plans is that most of these policies may have no sub-limits or ‘co-pay’ requirements (where the policy holder has to share a portion of the hospital bill).

If you go looking for senior citizen plans specifically, the premium may be lower, but they will come with mandatory co-pay requirement of 10-30 per cent. For pre-existing illnesses, the co-pay may be as high as 50 per cent.

Among regular health plans, Royal Sundaram’s Lifeline Supreme, Max Bupa’s Health Companion and Apollo Munich’s Optima Restore, do not have ‘co-pay’ requirements, and are options you could consider.

It is suggested that your daughter looks for a separate health cover. Given her young age, she will be able to easily get a comprehensive health policy at an attractive price.

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