30 December, 2010

Got a medical cover? See if it is adequate

Life for Gopal was sipping tea in the mornings with his newspapers. His balcony, overlooking the park, was an ideal retreat to soothe frayed nerves, although Gopal seldom had those.

His office was nearby and being in a small town, he could reach either way in 20 minutes. A picture of contentment, if there was one.

But these days, Gopal has turned jumpy. He is irritable very often and gets into arguments with his colleagues. His bosses have noticed his change of demeanour and have mildly brought it to his notice too. But, Gopal can’t help it.
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It all started when his wife had a heart attack. Gopal refused to believe the news when his neighbour called around 3 pm that afternoon to say his wife has been admitted in the hospital and the doctors suspected a heart attack. Mohini and heart attack? After all, she was always so strict about her diet and had a lean frame, and there was no prior indication whatsoever of any malady.

But, it was. Gopal almost had an attack himself when the doctor said she might have had more than one attack in the past couple of days. It was diagnosed later through angiography that there was one severely blocked artery and one that was partially blocked. Angioplasty had to be done. Gopal consented, somewhat relieved that it would be a non-invasive procedure.

But a bolt from the blue came with the bill the hospital presented —- a whopping Rs4.15 lakh. And they hadn’t even conducted an operation (he learnt later that the cost was so high precisely because it was non-invasive)! The medicated stent cost Rs1 lakh; the doctors’ fees were Rs1 lakh more; there were so many other charges that brought in the rest.

Gopal’s medical insurance would pay him only Rs2 lakh. So he would have to bear the rest.

He rued ignoring his agent’s advice that the cover was very low and he should increase it. Given the cost of medical treatment these days, it helps to have a bigger medical cover —- typically, Rs5 lakh for adults and Rs3 lakh for children — Dinesh had said.

With all his family members in good health, why waste it on insurance, Gopal had asked himself then. Only if he had factored in an emergency of this order!

In fact, Dinesh had also suggested a critical illness cover, which he turned down. That would not have covered Mohini’s condition. But, it would have certainly come in handy if an open-heart surgery had become necessary.

Much as Gopal wishes Mohini would not require any further medical attention in future, he can’t help cursing himself for being under-insured. Not only did he have to shell out Rs2.15 lakh from his pocket, but has also got to continue spending on the medicines which she must continue to take.

Many came forward to help, though he quickly paid them back by taking a personal loan at an interest of 15% per annum. Now, the loan has become a burden. He has to pay Rs5,115 every month for 60 months.

Worse, Dinesh has told him it would not be possible to enhance the insurance cover immediately, though the existing cover has been renewed.

No wonder, Gopal has become irritable. The morning tea doesn’t taste as good any longer. The newspapers have failed to grip him. The park in the foreground, which he used to gaze at endlessly, has no appeal left.

In the mornings, he just paces up and down the hall, thinking how to make up the extra expenses of about Rs7,000 a month (towards EMI and medicines). He has started giving lectures after work, which saps him of whatever energy he has left. He hates the evenings.

And the last few days, he has started hating the hospital ceiling, for that is all he is able to see. He had passed out in the office and they admitted him here. The doctor fortunately diagnosed it as just stress and high blood pressure. He would be discharged this afternoon.

Published in DNA Money on 30/12/2010

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