New India Sixty Plud Mediclaim policy could be a good choice if you’re 60+ or if nobody is willing to insure you. However, if you have other alternatives, this policy could be a letdown, considering, they'll make you wait 4 years before they start covering pre existing complications. Also you won't have the full cover for many diseases.
What's bad here?
You will have to pay a portion of the bill
The policy will only cover 90% of the final bill. The rest is on you. They call this a co-payment.
Restrictions on the rooms you can pick and much more
Your insurer won’t let you stay in a room whose rent exceeds 1% of the sum insured. If it’s an ICU they’ll bump it to 2% of the sum insured. And in the event you breach these limits, then you’ll have to pay a lot more - Read more here
Has disease wise sub-limits
Your insurance cover won’t be fully available in case you are treated for Angiography, Joint replacement, major cancer surgeries and a few other diseases. Meaning the insurance company has a cap on the total amount they’ll pay out if you are treated for these specific illnesses.
Long waiting period for pre-existing diseases
If you’re already dealing with diabetes, cardiovascular problems or any such illnesses, the insurer will cover all costs arising out of these pre-existing problems only after 4 long years. It could be much shorter you know? Like 2 years perhaps!
No coverage for Day Care treatments
If you’re hospitalized for less than 24 hours in lieu of a minor procedure, then the insurer will not cover these costs. Think dialysis, chemotherapy or minor surgeries.
No coverage if you are forced to hospitalize at home
The insurer will not cover the costs if you are forced to hospitalize at home due to a medical condition. In insurance lingo, they call this a policy with no domiciliary cover.
Pre & Post hospitalization expenses covered up to a certain limit
No worries if the doctor had to run a host of diagnostic tests before or after hospitalizing you. The insurer has your back. They will cover this amount upto 10% of sum insured for about 30 days before you are hospitalized and 60 days after discharge. This includes the cost of medication by the way.
What's lacking here?
No Restoration Benefit
Some policies will tell you - Even after you claim part of the cover on one occasion, you will have the full cover restored, if you are hospitalized another time during the same year. So if you have a family cover and multiple members of the family are hospitalized in the same year, this feature will come in handy. Unfortunately, this policy offers no such benefit.
No Bonus for being healthy and not claiming insurance
Some policies offer you extra cover if you go an entire year without claiming your insurance. This policy, however, offers no such benefit.
Your insurer doesn’t provide free health check-ups
If you want to get a full-body checkup just to make sure you’re in fine working condition, be ready to pay for it yourself.
No Cover for Alternative Medicine
Think of getting Ayurvedic, Homeopathic or other alternative treatment to cure an illness. Tough Luck!!! Your insurer won’t cover this expense.
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