I’m a 30-year-old and I have recently relocated to Delhi from Ahmedabad for a new job. Currently, I don’t have any health insurance, but am planning to purchase one soon. Could you advise me on the sum insured that would be appropriate? Additionally, are add-ons like a consumables cover worth considering, and what benefits do they offer? Please also recommend some plans I can opt for.

Sarfaraz

Relocating from a smaller city like Ahmedabad to a metro city like Delhi could be a significant transition, not just in terms of lifestyle but also financially, particularly when it comes to healthcare expenses. The cost of living in metro cities, including medical care, tends to be considerably higher than in smaller towns. This makes it crucial to reassess your financial planning, with health insurance being a primary part of it. It’s commendable that you are prioritising it early in your age, especially at a time when health risks and medical inflation, both are on the rise.

When considering the appropriate sum insured for your health insurance, it’s important to factor in elements like your age, family size, pre-existing medical conditions and the city you are living in. While every individual’s needs differ, metro cities like Delhi come with a higher cost of healthcare. So, it is recommended that individuals in metro cities opt for a sum insured between ₹50 lakh and ₹1 crore. Fortunately, you’re at an age where you can benefit from lower premiums due to your generally healthier, lower-risk profile. This means you can lock in comprehensive coverage at a more affordable rate. This level of coverage ensures that you are adequately protected in the event of serious illnesses or prolonged hospitalisation, which can lead to substantial medical expenses.

Aside from the primary medical costs, it’s crucial to also consider the non-medical expenses that can significantly contribute to your overall bill. Many policyholders are unaware that these costs can make up a substantial 8-13 per cent of their total hospital bill, yet they remain uncovered by standard health insurance policies. Consumables include items such as syringes, bandages, surgical gloves, PPE kits and even charges for an attendant. While these items play an essential role in patient care, they are typically excluded from coverage due to their single-use nature and varying pricing across hospitals. Unfortunately, consumers often find themselves bearing these costs out of pocket, which can be burdensome during an already stressful period of illness or hospitalisation. In some cases, for serious health conditions requiring extended hospital stays, these non-medical expenses can run as high as ₹2-3 lakh, an amount that can significantly strain your finances.

This is where add-ons like a consumables cover become particularly valuable. By opting for a consumables cover add-on, you can drastically reduce your out-of-pocket expenses. The consumables add-on covers the cost of these essential items, ensuring that they don’t become an unexpected financial burden during a hospital stay. Moreover, opting for this type of coverage can also improve your overall claim settlement experience. It has been estimated that policies with consumables cover add-ons can lead to better pay-outs during claim settlements. If your existing policy does not offer a consumables cover, then you could consider either upgrading your plan or porting your policy to another insurer that does provide this option. Health insurance portability allows you to switch insurers without losing your existing benefits like no claim bonus. It may also be beneficial to consult a financial advisor who can offer personalised guidance and help you make an informed decision.  

The writer is Joint Group CEO, PB Fintech

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