LIC JeevanArogya Health insurance plan: Should I buy it?

Medical insurance has formed an integral part of investments and savings. With the change in eating habits and lifestyle, individuals have become more prone to diseases. A health insurance plan is bought to avail the best of medical facility for your near and dear ones in case of any medical emergencies or planned surgeries.

The medical costs are rising steeply, thus making it mandatory to adequately insure oneself with sufficient sum assured. LIC, the oldest life insurance company in the history of our country has introduced a health insurance plan called “LIC JeevanArogya Plan�. It is defined benefit and non-linked health insurance policy which will help you in managing the medical costs incurred due to illness/disease.

This is a health cover for the entire family. You can insure yourself, spouse, children, parents as well as parents-in-law.

Features of LIC JeevanArogya plan :

• Provides disbursement irrespective of the medical costs incurred
• Covers yourself, spouse, children, parents and parents-in-law i.e. one policy for all
• Add new members of family (marriage/new borns) in the existing plan.
• The No Claim Benefit can be availed
• Flexibility for paying premiums
• Policy can be bought with other existing health policy purchased for the same medical reason
• Avail a quick cash of 50% of Major Surgery Benefits.

Mode of payment of premium

The payment can be made in flexible modes like monthly, quarterly. Semi-annually and annually.

Calculation of premium

Premium is calculated taking into account the age of the applicant and the HCB opted for. HCB is hospitalization Cash Benefit, which can be availed for Rs.1000, Rs.2000, Rs.3,000 and Rs.4000. It is payable after 24 hours of hospitalization.

• The minimum entry age is 18 years (self and spouse) up to a maximum entry age of 65 years.
• Minimum entry age for children is from 91 days to maximum entry age of 17 years
• Minimum entry age for parents and parents-in-law is from 18 years to a maximum entry age of 75 years

This plan insures the policy holder up to the age of 80 years. However, in case of children, the age is restricted to 25 years.

Below is the table used for calculating premiums :

Entry Age	Premium (Principal Insured – Male)	Premium (Spouse/Parent/in law – Female)
20	1923/- approx.	1393/- approx.
30	2243/- approx.	1731/- approx.
40	2780/- approx..	2241/- approx.
50	3768/-	2849/- approx.

Premium calculation for a Child :

Entry Age	Premium for a child
0	792/-
5	795/- approx.
10	812/- approx.
15	871/- approx.

All figures above are in Indian rupees.

Assuming a HCB of Rs.1000/- per day.

The premium is guaranteed to a period of 3 years from the date of initiation of policy. After the end of 3 years, LIC will review the premium as per the previous records and claims made during the period, and consider revising it (subject to approval of IRDA). If the premium is revised, it will be fixed again for another 3 years.

Benefits of this policy:

Hospitalization Cash Benefits

Hospitalization cash benefit is a unique benefit provided to the insured in case of hospitalization disregarding the expenses he incurs on the treatment.

Ambulance benefit

Up to Rs.1000/- ambulance charges will be provided to the insured in case of ambulance services obtained.

Major Surgical benefit

If the insured undergoes a major surgery during the term of the policy, this policy will provide major surgical benefits which are 100 times the HCB. Suppose, the HCB is Rs.3000/- , then the MSB shall be Rs.3,00,000/-

Other surgeries

If the insured undergoes medical treatment for surgeries not listed in the annexure relating to major surgical benefit or day care benefit, the policy will pay twice the HCB to the insured.

Premium waiver benefit

Premium will be waived for a period of 1 year if the insured has undergone major surgery as per the annexure of major surgery of LIC.

Day care procedure benefit

This benefit will be provided if the insurer avails listed day care procedure. This amount will be paid in lump-sum sum and is ideally, 5 times the HCB.

Term insurance rider and accident rider

You can add the rider of term insurance (which is 100 times of HCB) and accident benefit rider which can be for a maximum value of the term insurance rider to your existing Jeevanarogya plan.

Disadvantage in this policy :

The maximum limit of sum assured is Rs.4 lacs, which is inadequate keeping in mind the advancement in technology and inflation attached medical costs.

No benefit if you are hospitalized for less than 24 hours

Both parents/parent-in-law should be included (assuming they are live). You cannot insure only one of them.

Exclusions are :

• Pre-existing disease,
• Any treatment not in nature of allopathy
• Epidemic sickness
• Change of gender, cosmetic surgery.
• Surgery for donating an organ
• Congenital anomalies
• Dental treatment
• HIV/AIDS
• Physiotherapy treatment

After reading this article, it would be easier to decide whether to buy this plan or leave it considering it suits your needs and is adequate after taking into account your current situation and future financial goals.