The Tax season is in and as usual is the scramble for filling tax forms and searching ways to save money through Tax exemptions. If you looking at maximum savings on tax benefits as the prime objective, you need to consider ICICI Lombard Health Advantage.
The Plan has some unique advantages which include a cover for Outpatient Expenditure. Outpatient expenditure includes- doctor’s consultation, maternity, dental and other charges incurred as an outpatient.
Medical Tax Exemption:
For beginners, you can get health insurance tax benefits up to a premium of Rs. 15,000 under section 80 D, for senior citizens the tax exemptions are up to Rs. 20,000.
Health Advantage Plan has two fixed Premium brackets of Rs. 15,000 and Rs. 20,000 for senior citizens. This ensures that you get the entire Tax benefit.
Other than the health insurance Tax benefits, the other important health features that this Product has are:
A Choice of cover of Rs. 2 lakh and Rs.3 lakh at the same premium rate
Since the Premium bracket is fixed there is no change in the premium as per as the sum assured. You can either choose a cover of 2 lakh for more Out Patient expenditure cover or take a 3 lakh cover with less OPD expenditure cover.
You can avail Outpatient treatments under this policy
You can avail an insurance of orthopedic, maternity, dental, medical practitioner’s consultation fees and other medical expenses incurred on OPD basis. These treatments are not covered in most of the insurance policies. This is one of the important benefits of this plan.
The amount of expenditure covered depends upon the oldest member in the policy and whether the cover is 2 lakh or 3 lakh.
You can cover 2 individuals in the same policy at the same rate.
You can either cover your spouse, your child or your parent with no additional charge. The cover amount will be shared by both of you with the Out Patient expenditure cover decreasing slightly.
When you opt for the same plan for more than two years, your pre-existing diseases like Diabetes and Hypertension are covered. The common waiting period in most other policies for pre-existing disease is 4 years.
There are no sub limits except the Outpatient expenses limits.
There are no sub-limits on the amount payable on room rent, limit on ICU expenses, ambulance services etc. There is also no co-payment on any disease. There is a sub- limit of Rs. 20,000 per eye for cataract treatment.
No pre-screening or medical tests till age of 55.
There are no medical tests required for being covered in the policy until the age of 56. After the age of 56 you have to undergo Medical tests at the company designated diagnostic centers.
The Premium does not change with age.
In most policies, the premium increases with age, in this policy there is fixed premium for all ages covered. Only the outpatient expenditure covered decreases with age.
- Maximum entry age of the oldest member is 65 years and the renewals are guaranteed till the age of 70.
Points of Caution:
- Even though the entry age is upto 65, there are no plans for floater when the oldest member is over 56.
- No claims for Outpatient expenditure can be made up to 90 days of buying health insurance policy and 30 days after the period of insurance ceases.
- The Premium doesn’t change with age but the OPD expenditure limit decreases.
- Outpatient expenditure is payable through reimbursement mode only.
Is it really a Money Saver?
The logic of the Health Advantage Plan- the fixed premium of Rs. 15,000 and Rs. 20,000 looks at covering your entire tax exemption limit. This point makes it the selling point but comparing the price of other policies within the same age group shows that even with Outpatient benefit, you are not getting your money’s worth.
For example Premium for an individual policy for a 45 year old in Apollo DKV’s Easy health for Rs. 2 lakh cover is Rs. 6000; compare that to the 15,000 premium you pay for Health Advantage plan. Even taking the Outpatient expenditure i.e. Rs. 6000 for a 45 year old, you pay Rs. 3000 extra to the insurance company!
ICICI’s Health Advantage is a good investment for someone who wants to invest in health insurance mainly for health insurance tax benefit purpose. It isn’t such a good option for a buyer who really wants it mainly for health insurance.