Rajani Malhotra (40) (name mentioned for representation only) was shocked to learn that she was suffering from colorectal cancer. She was advised to undergo surgery immediately to avoid any further complications. The only saving grace was her health insurance (mediclaim) policy purchased a few years ago. However, she received a bigger shock when she found that the entire cost of hospitalisation wouldn't be reimbursed by her insurer.

Whether it's Rajani or our next door neighbour, an office colleague or a family member, we all have witnessed the anxieties, shock and fear that one goes through when a loved one is admitted in the hospital. The pain graduates when we realise that the health insurance plan does not fully cover your medical expenses. Moreover, there are incidental expenses that do not fall under the purview of any insurance policy.

What should you do in such a case? Purchase a daily hospital cash plan

Before we delve further, let us understand the difference between a health insurance plan (mediclaim) and a daily hospital cash plan

A mediclaim reimburses the hospital bill; on the other hand, a daily hospital cash plan pays on the basis of number of days of hospitalisation. Irrespective of the actual hospitalisation expenses, a daily hospital cash plan merely looks at the number of days of hospitalisation and pays as per the policy term. In simple words, a daily hospital cash plan isn't an indemnity plan (like mediclaim) but a fixed pay out plan. Moreover, unlike a mediclaim, where you choose the sum insured, in a daily hospital cash policy you choose the daily benefits you need. The daily benefits may range from Rs 100 to Rs 1,000 or more.

Now that we have understood the basic difference between a mediclaim and a daily hospital cash plan let us check the features of Sukshma Hospi-Cash.
 

Features of Future Generali's Sukshma Hospi-Cash (Micro Insurance)

Sr. No	Title	Description
1	Coverage	Hospital admission longer than 24 hrs
		Hospital Cash benefit for each continuous and completed period of 24 hours for a maximum of 5 days/ 10 days/ 15 days/ 20 days/ 25 days as per the schedule
		2 times benefit payable for ICU
		The minimum age of entry is 6 months while the maximum is 65 years.
		Optional Benefits: a) Deductible – Discount will be available if any of the deductible type is opted by the group b) Convalescence Benefit – A fixed amount towards convalescence for Hospitalisation beyond 10 consecutive days will be payable only once per Hospitalisation event. c) Maternity Benefit Expense Cover, with and without 9 months waiting period– This benefit covers treatment taken in Hospital arising from or traceable to pregnancy, child birth including normal/ caesarean section. d) Pre-Existing Disease Cover – Cover any condition, ailment or Injury or related condition(s) for which Insured have been diagnosed, received medical treatment, had signs and/or symptoms, prior to inception of first Policy
2	What are the major exclusions in the policy	Any hospital admission for investigative/ diagnostic purpose
		Infertility, External Congenital Anomaly and related Illness/ defect
		Non-allopathic medicine
		Treatment outside India
		Circumcision, sex change treatment, Cosmetic treatment and plastic surgery
		Refractive error correction, dental treatment Surgery of any kind unless requiring Hospitalisation as a result of Injury
		Organ Donor Expenses
		Substance abuse, self-inflicted injuries, AIDS
		Hazardous sports, War (Note: the above is a partial listing of the policy exclusions. Please refer to the policy clauses for the full listing)
3	Waiting Period	Initial waiting period: 30 days for all illnesses (not applicable on renewal or for accidents)
		Specific waiting periods: 12 months for any types of gastric or duodenal ulcers, stones in the urinary and biliary systems, Surgery on ears/ tonsils/ adenoids 24 months for Cataract, Hernia etc 36 months for Joint Replacement Surgeries 9 months waiting period for Maternity Benefit Expense Cover if opted
4	Pay-out basis	Benefit basis
5	Renewal Conditions	The policy is renewable lifelong. The performance of the product will be reviewed annually and further pricing will be done on experience basis. In case of renewal, grace period of 30 days is admissible

(Note: The above table is for illustration purpose only)
(Source: Sukshma Hospi-Cash's Policy Wordings)

Sukshma Hospi-Cash has 10 plans to choose from—A, B, C, D, E, F, G, H, I and J with different options of 5 days / 10 days / 15 days / 20 days and 25 days. The plans offer daily cash benefit ranging from Rs 100 to Rs 1,000 which doubles in case of admission in an ICU as shown below
 

Benefits	Plans (in rupees)
	A	B	C	D	E	F	G	H	I	J
Daily Hospitalization benefit due to sickness	100	200	300	400	500	600	700	800	900	1,000
ICU benefit (maximum period of 10 days for each hospitalization and maximum period of 20 days during the policy period)	200	400	600	800	1,000	1,200	1,400	1,600	1,800	2,000

(Note: The table is for illustration purpose only)
(Source: Sukshma Hospi-Cash's e-Brochure)  

Let us understand the policy with the help of an example…
Assuming Rajani holds a health insurance plan for a sum insured of Rs 7,50,000 along with a daily hospital cash plan with a daily benefit of Rs 1,000 (Plan J). The total hospitalisation expenses was Rs 5,00,000 and she was admitted to the hospital for 7 days. The hospitalisation expenses would be reimbursed by the health insurance plan, while she would receive Rs 7,000 (Rs 1,000 x 7 days) additionally through the daily hospitalisation cash plan. Moreover, if she was admitted in an ICU, the daily benefits would have doubled (as shown in the table above).

The biggest advantage of a daily hospital cash policy is, it helps to keep the "no claim bonus" intact when the hospital bill is not huge and you can make the payments through the daily cash hospital policy without involving mediclaim.

The highlights of Sukshma Hospi-Cash are lifelong renewal with a minimum and maximum age of entry as 6 months to 65 years respectively and coverage for maternity expenses and pre-existing diseases.

But before you sign on the dotted line, note that:

• Whether you purchase Sukshma Hospi-Cash or any other daily hospital cash policy, the number of days of coverage in a daily hospital cash policy is generally capped. Sukshma Hospi-Cash puts the cap at 25 days for non ICU admissions and at 10 days for each ICU hospitalisation.
• All daily hospital cash policies are triggered when the hospitalisation exceeds 24 hours. Some require hospitalisation of 48 hours or more to be triggered.

To summarise…

Do not consider a daily hospital cash plan as a replacement to a mediclaim plan. As shared above, both have different roles to play. While a mediclaim reimburses your hospitalisation bill; a daily hospital cash plan takes care of incidental expenses. A mediclaim policy is the first line of defence against life's emergencies. Consider a critical illness policy as well; it will come to rescue if you encounter/ diagnosed with critical illness (es).

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