Health Insurance

Things to Keep in Mind When Buying Health Insurance

Many understand the importance of insurance in our lives but there are a few who understand its nuances. Buying insurance is not a child’s play and with the presence of so many insurance companies…

Many understand the importance of insurance in our lives but there are a few who understand its nuances. Buying insurance is not a child’s play and with the presence of so many insurance companies offering various plans for each insurance, it has become more confusing if nothing else. Out of all the insurance policies, one policy which everyone must have in the present times is that of health insurance. Thus, the things to keep in mind when buying Health Insurance become all the more important.

Inflation in the medical expenses is growing exponentially and that too every year and thus, getting the best treatment can become unaffordable sometimes. This is why a health insurance policy is needed. In the medical insurance too, there are several kinds of plans available and thus, one has to understand their exact requirements to know which plan will suit them the most. However, with the umpteen options available, there are some basic guidelines and things to keep in mind when buying Health Insurance policy.

Top #8 things to Keep in Mind When Buying Health Insurance

Renewability: Policies can have an age limit till which they provide coverage. It is a known fact that there are higher chances to fall ill in the later years of life. Thus, a policy with the maximum age coverage is the ideal choice. There are options to buy family floater policies also where one can cover their dependent parents.

Verdict: Most health plans are lifetime renewable plans and these must be the first choice when buying health insurance for the family.

Sub Limits: Some health insurance policies have a sub limit on the room rent, ICU charges, doctor fees, etc. which is predefined as a percentage of the total coverage. For example, if you have a health plan of INR 5 lakhs with a room rent capping of 1%, then your hospitalization coverage will be provided for rooms till INR 5000 per day. If you choose to stay in a room where the rent is more than INR 5000 per day, then the remaining amount will not be covered and all other expenses will also be deducted from the total billing on a pro-rata basis, even though the total billing might be way lower than the coverage limit!

However, there are some health plans which have no sub-limits. Thus, if you have a health plan of INR 5 lakhs and your hospitalization expenses are INR 1.5 lakhs, then the entire amount will be paid, irrespective of the amount of room rent which you chose!

Verdict: Thus, you need to opt for a plan with higher sub-limits or no sub-limits at all so that you can choose the type of room you prefer to stay in your choice of hospital!

Network of Hospitals: The biggest advantage of buying a health insurance plan is that one can get treated in hospitals without paying the huge bills from their own pockets. The cashless treatment is only available to the insured from one of the network hospitals of the insurance company.

Verdict: This makes it imperative to choose a policy which has a large number of network hospitals including the one close to the house with good medical facilities and the one which is a preferred choice for being treated.

Coverage of Pre-Existing Diseases: Most health insurance policies do not cover any pre-existing diseases from the date of policy inception and have a waiting period of 2-4 years for certain listed treatments like piles, fissure, gall bladder stone surgery, cataract, etc. This implies that if the is any hospitalisation during the waiting period for any of the pre-existing diseases, there will be no coverage. Some plans also have a waiting period to provide maternity cover and thus, young couples should be careful about this clause.

However, there are plans which do cover pre-existing diseases as well, maybe with a co-payment or a slightly higher premium.

Verdict: When choosing a medical insurance policy, one must take care to choose a policy which has a low waiting period. Also, if you have an existing health plan where you have completed the waiting period, do not forget to port the same when changing policies or insurers!

No Claim Bonus: No Claim Bonus is a clause that one must check in their health insurance policy. In some policies, it can be an annual free health check-up, some shopping vouchers whereas in some it can be an increase in the sum insured for every claim free year.

Verdict: The No Claim Bonus comes handy in that year where your hospitalization bills suddenly shoot up and so choosing a plan with a healthy no-claim bonus is a good practice!

Add on Covers: Each insurance policy for health has an option to opt for add on covers and riders. These are optional coverage options which can be availed by paying an extra premium. One must know about all the options available and choose the ones they think will be used.

Verdict: Options like riders for critical illness are the ones which can be opted for as they can come in handy if needed.

Ascertain Requirements: The medical requirements of the family members and their age must be considered when buying health insurance for the family. A young couple planning to have a baby need to consider the maternity bills whereas some need to take care of the requirements of the ageing parents. Lifestyle diseases are on the rise, thus a sufficient cover keeping in mind the inflation must be chosen.

Verdict: Sum insured must be chosen wisely keeping several factors in mind and also accounting for rising medical costs.

Restore Option: The restore option is offered by many insurance companies in their health insurance policies. Under this option, by paying an extra premium one has the option to restore the sum insured in case it is exhausted and hospitalisation is needed again. Thus, if you have a policy of Rs. 5 lakh and the bill is Rs.3 lakh, it will be paid under the policy. Now, if due to some reason, the insured is hospitalised again after 6 months and the bill again is 3 lakhs, it will be paid by the company as the sum insured will be reset to 5 lakhs after the first 5 is exhausted.

Verdict: The restore option comes in handy for someone who has some problem and might be needing frequent hospitalisation and also for those who have a family floater policy.

Understanding the Policy

Having a clear understanding of the policy with respect to the inclusions and the exclusion is essential to be able to get the best out of it. While selling there are some aspects which can be not disclosed and thus, one should compare policies and understand the fine print.

There are many options available today when buying a health insurance policy. One must compare all and see which suits their requirements the most. Policies can be compared online on insurance aggregator websites which help in easy comparison. The importance of a good medical insurance policy is only understood when there is a need to file a claim and sometimes, realising the mistakes then can be too late. Thus, one should be careful and use the above points to buy a good policy.

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