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| 1- Who offers OPD Coverage as a part of Health Insurance in India |
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| The maximum benefit allowable for 1 adult is Rs. 8,500 [350*3 + 500*1 + 1,000 + 2,000 + 1,000 + 1,000 + 2,000(estimated)] |
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| In addition, both the policies do not allow, an insured person to claim OPD cost within 90 days of commencement of the policy. |
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| If we go for a normal health insurance policy, the premium paid is much less compared to these policies, as a result we end up paying more than the benefits we may receive. |
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| Let us see the choice with examples: |
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| Example 1: |
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| Mr. X aged 30 years buys individual Health Advantage Plus plan from ICICI |
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| Sum Insured |
Rs. 3,00,000 |
| Premium paid |
Rs. 16,545 |
| Less: Tax saved |
Rs. 4,964 (30%) |
| Net premium |
Rs. 11,581 |
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| Now if he takes normal healthcare policy from New India |
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| Sum Insured |
Rs. 3,00,000 |
| Premium paid |
Rs. 3,871 |
| Less: Tax saved |
Rs. 1,161(30%) |
| Net premium |
Rs. 2,710 |
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| So, to avail OPD coverage of Rs. 8,800(which he will not be able to claim without unnecessary visits etc.) he pays a premium of Rs. 8,871extra. |
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| Example 2: |
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| Mr. X aged 30 years buys individual Maxima plan from Apollo: |
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| Sum Insured |
Rs. 3,00,000 |
| Premium paid |
Rs. 15,216 |
| Less: Tax saved |
Rs. 4,565 (30%) |
| Net premium |
Rs. 10,651 |
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| Now if he takes normal healthcare policy from New India: |
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| Sum Insured |
Rs. 3,00,000 |
| Premium paid |
Rs. 3,871 |
| Less: Tax saved |
Rs. 1,161 (30%) |
| Net premium |
Rs. 2,710 |
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| So, to avail OPD coverage of Rs. 8,500 (which he will not be able to claim without unnecessary visits etc.) he pays a premium of Rs. 7,941 extra. |
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| The conclusion drawn is by having these policies you are getting the benefit in the ratio of 1:1 only. |
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