Buy comprehensive protection against heart ailments

Purchase a combination of mediclaim and critical illness policy while you are still in your thirties

Heart-related ailments have emerged as a major killer in India. According to World Health Organization (WHO) statistics, more Indians than people of any other nationality suffer from cardiac arrests. The country has around 30 million heart patients. Claims data from various insurers show an increasing number of people below their forties are falling prey to it. This World Heart Day (on Friday) can be good day to start an insurance strategy that will provide you with adequate protection against this dreaded disease.

A heart-related ailment can deal a severe blow to your finances. Says Sandeep Patel, chief executive officer (CEO) and managing director, Cigna TTK Health Insurance: "In a metro city, if you include the cost of a private room, a coronary angiography could cost you around Rs 30,000 (inclusive of cost of materials); a coronary angioplasty could cost about Rs 3 lakh (including the cost of stent); a CABG (bypass) Rs 5.5 lakh; and an open heart surgery Rs 5 lakh.” A heart transplant could set a person back by Rs 15-20 lakh.

Your first line of defence should be a mediclaim policy with a high sum insured of Rs 20-30 lakh or more. Insurers like New India nowadays offer these policies targeted at high net worth individuals. A more cost-effective option would be to have a base mediclaim policy of Rs 5-10 lakh and a top-up policy of Rs 10-15 lakh. "You can buy competitively priced products in both the categories to reduce your costs. The only drawback of this option is that you will have to make a claim from two companies, which could be more tedious," says Prawal Kalita, director-benefit solutions, JLT Independent Insurance Brokers. 

A mediclaim and top-up will cover you for hospitalisation costs only. There are also costs that one incurs after hospitalisation. Many people who suffer from a heart ailment are also forced to adopt a more relaxed lifestyle and may consequently suffer a loss of income. A critical illness cover, which pays a lump sum on diagnosis, can take care of the post-hospitalisation expenses. If invested, the money can also serve as replacement for the loss of income the patient has suffered. 

Next, let us turn to a couple of specialised policies targeted specifically at heart-related conditions. The usual mediclaim policies will not cover, or have a prolonged waiting period, for those with a heart condition. One option available to them is Star Cardiac Care Insurance which covers people who have undergone coronary artery bypass grafting or coronary angioplasty. "This policy offers coverage for pre-existing cardiac ailment from the 91st day after commencement of policy while the industry normally covers any pre-existing disease after a waiting period of four years," says Anand Roy, executive director and chief marketing officer, Star Health and Allied Insurance. It also offers regular in-patient hospitalisation benefits and can hence serve as a mediclaim cover for such people. Outpatient treatment charges are covered up to certain limits. Personal accident death cover equivalent to the health sum insured is also provided. No medical check-up is required. Underwriting is done based on the patient's cardiac-related health records. 

Then you have a policy such as Sanjeevani from Exide Life Insurance, which works as a fixed benefit plan. It provides a lump sum payout on diagnosis of heart and cancer-related conditions. While a policy like this will cover you for heart and cancer-related problems comprehensively, it has a narrower coverage than a critical illness policy (which can cover you for about 15-30 ailments). Most people should opt for a combination of mediclaim and critical illness first. Then, if their family history or living conditions put them at high risk of heart disease or cancer, they may consider this policy.