Congratulations on taking the step towards each other with a promise to be together in good as well as bad times. With marriage comes responsibilities, and this is a good opportunity to review your financial plan with your spouse. Given the high cost of healthcare in India with more than 7% medical inflation [1] and the advent of the pandemic, there is no denying the importance of health insurance for you as a couple and its correlation with financial planning!
The biggest dilemma while buying health insurance is deciding which one to buy. This is because there are about 25 general insurance companies and 7 stand-alone health insurance companies offering a variety of health insurance plans with varied benefits for you to choose from. So, today we will try to make it simple for you to choose the best health insurance plan for yourself and your newly wedded spouse!
Which type of health insurance plan should a newly married couple choose?
A family floater policy that covers both you and your spouse together, would be the best choice as a young newly married couple. This would give you umbrella coverage at reduced costs. You can also choose to add others, like your parents or in-laws, to your plan as well. Also, there would be a provision to include children at a later point in time.
However, if you or your spouse already have individual health insurance policies, you may choose to continue with them as well. Or add the other one in it and convert it to a family floater option, if the plan allows the same. Only check if it meets your requirements with an increase in responsibilities and whether it covers maternity benefits or not. If not, you can choose to port it to another insurer/plan which offers adequate coverage.
If you do not have any health plans as of now, it is not late to opt for one. Check the must-have benefits of a health insurance plan for a newly married couple and then choose wisely.
Must-have benefits of a health insurance plan as a newly married couple:
- Maternity coverage
Pregnancy and the cost of childbirth have become quite expensive in today’s age running into lakhs. An approximate cost of normal delivery would range from about Rs 40,000 to Rs 1 lakh and that of C-Section could go up to Rs 1.5 lakhs [2] as well. However, this does not include the cost of scans and necessary check-ups during pregnancy, nor the expenses for postnatal complications.
Thankfully, in today’s age, there are many health insurance plans in the market that cover the cost of pregnancy and childbirth along with any postnatal expenses for the child. Some health insurance plans offer maternity benefits along with comprehensive coverage for both of you. The would cover the cost of pre and post-natal expenses as well as the expenses related to childbirth, both normal and C-Section delivery.
There are maternity-specific health insurance plans as well. Some group insurance plans also might provide maternity coverage, but it usually is capped with an upper limit of an average of Rs 50,000 per delivery, along with room rent capping. However, for specific details, you need to check your own health plan documents.
Pro Tip: Maternity coverage involves a waiting period, i.e. you need to wait for a specific period after which the coverage is allowed. The waiting period usually ranges from 9 to 48 months. Thus, opt for the coverage at your earliest. Also, check the coverage limit and opt for a high sum insured so that your health care is not compromised. - Newborn cover
Most health plans with maternity coverage, also provide coverage for the newborn too. The child could either be automatically covered for the initial timeframe which ranges from 90 days after birth to the date of policy renewal. Then you would be provided with an option to include the child in your existing health plan by paying the incremental premium. Some health insurance plans allow the newborn to be covered as an inbuilt benefit while some allow the cover as a rider.
Pro Tip: Opt for the newborn cover so that your baby is covered against medical contingencies right from birth. - Room rent without sub-limits
Under some health insurance plans, there are sub-limits on room rent. For example, you might find coverage for room rent as 1% of the sum insured. These sub-limits should ideally be avoided if the premium isn’t the constraint.
If the plan has sub-limits, your coverage gets restricted, i.e. if the actual room rent exceeds the limit allowed by the policy, your inpatient hospitalization claim would be reduced proportionately and you would incur out-of-pocket expenses. This could lead to a compromise on your or your spouse’s healthcare facilities as well, which as millennials, might not be a suitable option! Incidentally, out-of-pocket expenses result in about 70% [3] of India’s healthcare expenses.
So, check if your health plan has any room rent limits and if it does, preferably port to plans that don’t.
Pro tip: Room rent limit is usually applicable if the sum insured is low, i.e. Rs.5 lakhs or less. So, if you enhance the sum insured of your existing policy or opt for a higher sum insured, the sub-limit could be removed and you would be able to stay in a single private AC room as well. - No Claim Bonus
Millennials are usually more into fitness and healthy living than the baby boomers or Gen X. So, if you and your spouse are also into fitness, you could get a discount on your health insurance plan as well. As is, every health insurance plan rewards you for each claim-free year. This reward is allowed in the form of a no-claim bonus where you can either enjoy an increase in the sum insured or a fitness voucher or some wellness benefit.
Pro Tip: Being a young couple, chances of claim in the initial years of the policy would typically be less and thus you can accumulate the no claim bonus to increase coverage for the future! So, look for plans that allow the sum insured to be increased so that you can enjoy higher coverage without any additional premium and also avail wellness benefits!
Benefits of opting for a health insurance plan when you are young:
- Exhausting the waiting period while you both are still young and healthy
- Availing tax benefit of Rs 25,000 for paying your health insurance premium for yourself and your spouse U/S 80D of the ITA
- A hectic, stressful yet sedentary lifestyle can cause illnesses like postural back pain, strain injury, osteoporosis, computer vision syndrome, along with any stress-induced medical conditions from a young age. So, adequate coverage could come in handy!
Some health plans offer additional benefits like sum insured restoration, free health check-ups, second opinion and doctor consultations, telemedicine and alternative treatment facilities, health assessment, etc.
These are some of the most important coverage benefits for newly wedded couples. You need to review your health cover on these benefits. If your existing plan is falling short on any parameter, you could port to another, comprehensive coverage for all-round protection. If you do not have any health insurance plan yet, here is a list of some plans that you can surely consider.
Top four health insurance plans for a married couple
If you are looking for the best health plans, here are three health insurance recommendations to get you started–
| Care Joy | ICICI Lombard iHealth Elite | ICICI Lombard iHealth Elite Plus | Star Comprehensive | |
| Maternity coverage | Rs.35,000 or Rs.50,000 depending on the sum insured Pre and post-natal expenses included | Normal delivery – Rs.15,000 to Rs.25,000 Caesarean delivery – Rs.25,000 to Rs.50,000 Pre and post-natal expenses – Rs.2000 | Normal delivery – Rs.25,000 Caesarean delivery – Rs.50,000 Pre and post-natal expenses – Rs.2000 | Normal delivery – Rs.15,000 to Rs.50,000 Caesarean delivery – Rs.20,000 to Rs.1 lakh Pre and post-natal expenses – Rs.2000 |
| Maternity waiting period | Joy Today – 9 months Joy Tomorrow – 24 months | 3 years | 3 years | 2 years |
| Newborn baby coverage | Covered up to 90 days from birth.Coverage amount – Rs.30,000 or Rs.50,000 depending on the sum insured Newborn defects coverage up to Rs.50,000 under Joy Tomorrow | Covered up to 91 days from birth Coverage amount – Rs.10,000 or Rs.1 lakh | Covered up to 91 days from birth Coverage amount –Rs.1 lakh | Up to Rs.2 lakhs |
| Room rent Type | Single Private AC Room | Covered as per actuals | Covered as per actuals | Single Private Standard AC Room |
| No claim bonus | 100% increase in the sum insured after the first claim-free year. This is, however, an add-on benefit | 10% increase in sum insured up to 50% | 10% increase in sum insured up to 50% | 50% or 100% increase in the sum insured |
What you should do?
If you are looking for maternity coverage with a low waiting period, Care Joy can be a good choice. Alternatively, you can choose any of the other above-mentioned plans with maternity benefit. Remember to review your coverage and ensure that your health plan is equipped with all the necessary coverage benefits. Also, opt for a high sum insured so that you are optimally insured.
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