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Beyond Mediclaim: Why a Fixed Benefit Plan Is a Good Idea

  By posted Aug 6th 2012



As anyone who has faced high medical costs will tell you, medical eventualities go beyond the actual costs of diagnosis and treatment. From loss of pay due to recovery to traveling costs for further treatment, you end up paying for a lot more than just hospital bills. Add to this knowledge, the fact that today’s jobs don’t support any frills outside of the bare necessities, and you’re looking at a scenario that goes beyond mediclaim policies and employee health insurance schemes.

But what does this mean? Since mediclaim policies already cover a person’s medical expenses, should any need arise, why would it make sense to get additional cover through a second health insurance policy?

Yateesh Srivastava, Chief Marketing Officer AEGON Religare elaborates, “In Indemnity (Mediclaim) plans medical expenses are covered depending on the undefinedassessment of the claim being made and there is a discretionary element to the plan. A fixed benefit plan guarantees payouts based on various elements. A fixed benefit plan can be used to plan expenses better or used to top up an existing indemnity plan.”

Inflation and rising healthcare costs cast a valid doubt at this point. When costs rise, how can one keep the predetermined payout relevant? In answer, fixed benefit plans offer a simple solution - increase coverage to a higher slab by paying the higher premium. However, like all other plans there is an overall cap on the cover.

Therefore, a second health insurance scheme that helps you cover additional costs, over and above actual medical costs, is a good idea.

Deepak Yohannan from MyInsuranceClub concludes, “Yes, this is one area where a plan’s predetermined payouts can help if they are taken in addition to a standard health insurance plan.  Stand alone, it would not serve the purpose as you still stand the risk of having to spend more than what will be paid out to you. If you have taken both, then let the plan that covers actual costs take care of the treatment costs and the fixed payout plan can take care of the additional expenses.”



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