Suffering from hypertension- Should I opt cardiac plan or regular health insurance?

As part of routine annual health checkup from his company, Vikas went to a well-known hospital for the same. He was quite surprised to know that his blood pressure or BP was high. He was diagnosed with hypertension. Hypertension indicates a high risk factor for cardiovascular or heart ailments. Vikas was worried as he did not have any individual health insurance plan. This led him to investigate health plans which cover critical illnesses related to the heart.

Research shows that in India over 320 lakh people are cardiac patients in 2015. Medical Inflation is almost 20% per annum. It can thus make a large hole in one’s pocket.

Vikas comes across a Cardiac Care Plan and wonders if he should opt for that! To understand a Cardiac Special Plan, you need to know who can opt for the same.

Who can opt for Cardiac Special Health Plans?

Star Health has a cardiac special health plan called Cardiac Care Plan. Star Health Cardiac Care Plan has been especially designed for people who have undergone heart surgeries for the first time or had an angiogram. Heart surgeries include PTCA (Stenting) through Angioplasty or CABG (By Pass Surgery).

Therefore, the basic question is answered here. Vikas has been diagnosed with hypertension. He, however, has not undergone any of the heart related surgeries. Thus, he needs to apply for a regular health plan immediately. Along with basic lifestyle changes to keep the high BP under control. If the medications start, it becomes difficult to get the regular health plan issued, even with additionalpremium.

Now, you may have an ischemic heart or other heart related disease in the family. Even then, you need to apply for a regular health insurance plan. This should however be done after making the necessary declarations. Heart related ailments would then be considered as a “pre-existing” illness and might have a waiting period. Cardiac Care Health Plans can be bought ONLY if you have undergone any heart related surgeries. Not otherwise.

Uniqueness of Star Health Cardiac Care Plan.

Eligibility.

It can be taken by anyone till 65 years of age and can be renewed lifelong. This policy can be taken by anyone who has undergone Angioplasty or Bypass surgery. However it needs to be within 6 months to 3 years prior to applying for such plan.

Small Waiting Period.

This plan has 2 variants, Gold and Silver. The benefits can be summarized as under.

In both Silver and Gold Plan, all Hospitalization and Accidental expenses are covered from day 1. Even out patient expenses upto the specified limit are covered. Pre-existing non-cardiac ailments are covered after 4 years of continuous renewal. This is similar to many plans in the industry. The Gold variant covers medical management treatment as well where surgery is not mandatory.

The uniqueness of this plan is the small waiting period of only 3 months from commencement for all Cardiac Related Pre-Existing Ailments. Thus, all heart related treatments are covered from the 91st day onwards. As long as the treatment requires at least 24 hours of hospitalization.

Other Exclusions.

  • Dental treatments, other than any damage due to an accident.
  • Any ailment or costs related to hearing/visual impairment, spectacles, contact lenses, wheelchair, etc.
  • Pregnancy and other maternity expenses.
  • There is a 2 year waiting period for treatment of certain illnesses. The illnesses under this category would be cataract, tonsillitis, piles, fistula, gall bladder, etc.
  • Unconventional treatment.

Is the Star Health Cardiac Care Plan very expensive?

Let us take an example of a 40-year old man with heart surgery. If he opts for a coverage of Rs 4 lacs in the Silver Variant, he needs to pay a premium of Rs 25,300.

If he did not have any heart surgery, he would require to take a regular health plan. Star Health Medi Classic Policy would cost him Rs 5992 only. Star Health Comprehensive Insurance Plan would cost him Rs 9286 for a comprehensive coverage of Rs 5 Lacs.

So, yes this plan is quite expensive. That is the cost you need to pay if you have had a heart surgery and yet do not have any health plan!

Moral of the story is take your health insurance coverage ASAP. It should be taken much before you are even diagnosed with any serious ailment. Else be prepared to pay more premium!

Read more about how to lower your insurance premiums

Read more about Dejargonizing health insurance plans

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