“Accidents happen fortuitously”. No one plans to get hurt or fall unwell, somethings just happen. But does that mean things to go wrong? Without being planned for the rainy days?
Of course not! You need to hope for the best but at the same time be prepared for the worst. And when it comes to being prepared, having a Health Insurance is of extreme importance.
In order to purchase your own health insurance plan, here are a few things to remember when buying a health insurance plan.
Do I really need Health Insurance?
When you are young and healthy, spending money on Health Insurance might seem a waste of money. In fact, you may also be tempted to save the premium for any latest electronic gadget, etc. However, this decision might prove to be extremely expensive if you get hospitalized or meet with an accident, etc. So, it’s always better to be safe than sorry. You will realize the entire expenses for the insurance policy even if you get hospitalized once in a tenure of 10 years or so!
Data states that health inflation is about 20% year-on-year and Indians spend more than 90% of the hospitalization expenses out of their own pockets! Isn’t it time to rethink insurance from a completely different perspective?
Also, when you come to a point that you might think of opting for a health insurance plan, maybe in your 30’s or 40’s, then you might not be able to avail all the plans if you are not completely physically fit! If you happen to get any of the basic chronic ailments like blood, sugar, etc. and get on daily medicines, underwriting a health insurance plan, especially for a high sum insurance might be extremely difficult! Also, there might be restrictions on claim, co-payment, etc. imposed at that time! So, the best time to opt for a health insurance plan is as-soon-as-possible. The earlier the better!
How to choose the “right” Health Insurance Plan for yourself and your family?
This is the most difficult and common question asked by all. If get to decide what is the best plan for yourself, opting for the same becomes simple. However, the concern is to choose the plan as per your needs and requirements!
The aspects that you need to consider while choosing the “right” or the “best” health insurance plan for yourself and your family would be:
- The amount of coverage that you may need, i.e. the Sum Insured.
This can be calculated by the daily tariff of the type of hospital your go to. For example, single bed charges of your choice of hospital is say Rs 4000, then about Rs 4 lakhs is a good coverage for yourself. However, the same needs to be reviewed annually.
- The number of dependents also helps you decide the amount of coverage and the best health plan that you need
So, depending on your need, you need to opt for your health plan accordingly.
- The Benefits that your plan offers is one of the most important factors of choosing your health plan.
The benefits that you may need like OPD, maternity, alternative treatment cost, number of days for pre-hospitalization and post-hospitalization, pre-existing ailments, annual health check-up, etc. Basic plans are cheaper but as soon as you opt for these additional benefits, the cost might rise.
- Network of hospitals for Cashless Treatment and its PAN India presence:
This is a very important factor to check the network of hospitals for cashless treatment so that it is convenient for you to go to the hospital of your choice rather than selecting the hospital from their list in case of an emergency! This needs to be checked and evaluated at the time of opting for the health plan.
Also, whether the insurance plan has a large network of hospitals across the country so that you do not need to change your plan in case you shift your city!
- Incurred claim ratio of the company:
At the time of choosing the plan, checking the incurred claim ratio of the company is a good practice so that they are not overcharging or undercharging you and that they have enough money to pay the claims! If the incurred claim ratio is about 98-100% or even more, it means the company is undergoing a loss and it might not be able to pay further claims! That is quite tricky! And if the incurred claim ratio is about 40-50% then it simply means that the company is overcharging you for the premium as compared to the benefits it offers! So, an ideal incurred claim ration is anything between 70-90%.
- Will you be eligible for a claim if I’m in a non-network hospital?
A good Health Insurance Plan should travel with you, as you might end up in a non-network hospital in case of an emergency. If it is a planned hospitalisation then you have the liberty to choose a network hospital, but in case of an emergency, you might be admitted to a non-network hospital. In that case, you may not be able to make the cashless claim. You will have to pay the expenses at the hospital and then file for a reimbursement claim.
- The claim process, documents and after sales service:
A smooth claim processing and good and strong after-sales service attracts good customers who do not want the hassle of undergoing a difficult and tedious process of claim settlement! Thus, most companies have a smooth after-sales service department and a super-friendly claim processing process to enhance customer experience!
The basic documents for a claim depend on the type of claim, i.e. whether it is cashless or reimbursement.
- For cashless claim, you need the duly filled and signed claim form, identity documents of the insured, the identity card from the insurance company, doctor’s advice of admission and all tests and reports for pre-hospitalization claim!
- For reimbursement, the process is a little longer since you need all documents mentioned for cashless along with all tests and reports during hospitalization, discharge summary and a fit certificate from the doctor on discharge!
Thus, once you know all about the things to remember when buying a health insurance plan, you can simply renew the plan for life and keep upgrading the same as and when your need or health requirements rise!