Top 10 Tips To Help You Pick Up The Best Health Insurance Policy
We always wish for the best health for ourselves and our loved ones, and we tend to prefer the health insurance policy that offers an array of solid features and maximum benefits to protect us from the unforeseen events which might occur to you and your family.
With so many options around, it can be a daunting task to pick up the best, thus, to help, Forbes Advisor India has prepared a detailed guide which will assist you in picking up the best plan for you and your family.
Why Do I Need a Health Insurance Plan?
The reason why one should choose a health insurance plan is primarily because of the increasing number of lifestyle diseases and their expensive treatment costs. Moreover, medical inflation in India has been on rise which is generally quoted approximately 15% per annum. To cover such exorbitant pricing and not to play with your and your loved ones health, it is very much required to have a proper and comprehensive health insurance policy.
Having a health insurance policy will not just take care of your all kinds of hospitalization expenses but will also provide immediate coverage against accidental injuries and other kinds of health related complicated contingencies as well, which might otherwise cost you a bomb or propels you to take a financial loan, if there is no health insurance policy in place.
Top 10 Tips To Help You Pick Up The Best Health Insurance Policy
Wide Coverage:
You must check the coverage of your health insurance policy first before buying it. It is always advisable to get comprehensive coverage so that you do not get short of coverage when you need it the most. Plus, the enhanced coverage will also secure you against a wide range of medical and other health related emergencies. Comprehensive coverage includes:
Coverage for hospitalization expenses
Ambulance costs
Daycare procedures
Regular health check-ups
Pre-and-post hospitalization expenses
Critical illness
Alternative treatment options
Automatic restoration
Cumulative bonuses
Second medical e-opinions
Less sub-limits on the plan
To know the coverage and the benefits, it is important to read the policy documents carefully so you do not miss on the inclusions and exclusions of the health insurance plan.
Pro Tip
Make sure to choose a family floater health insurance policy which addresses the health issues related to each family member covered in the family under the single coverage plan.
Read: Best Family Health Insurance Plans
Sum Insured
In health insurance, sum insured means the maximum amount for a particular year which an insurance company can pay you in the event of medical emergencies and hospitalization expenses. Any cost exceeding the total sum insured amount will not be borne by the insurance provider and has to be paid from your own pocket. That’s why choosing the right amount of sum insured is very important while selecting the health insurance policy.
As a rule of thumb, the sum insured amount should be at least 50% of your annual income. So, if you earn INR 10 lakh, then an INR 5 lakh health insurance policy may be the apt choice for you.
Sum insured must be increased at every stage of your life. For instance, if you’re planning to start a family, then make sure you get your maternity costs covered.
Also, the higher the sum insured; the higher will be its premium cost. And, if you select insufficient sum insured, then you might not get enough coverage at the time of need. Thus, choosing the right kind of value as sum insured becomes a very important decision while selecting the policy.
Pro Tip
Another way of enhancing the sum insured coverage is to opt for a “Top Up” policy. A Top Up Health Insurance plan is designed to provide more coverage once the basic sum insured value gets exhausted.
Flexible Plans
A health insurance plan must be flexible enough to allow you to add family members such as your spouse, parents, parent-in-laws or a newborn baby. This sort of flexibility may cut the cost of getting a separate policy and paying extra premium for your family member. Otherwise, in a family floater policy, you receive coverage for your entire family under a single premium plan. However, you must know that the chosen sum insured is shared among the added members.
Moreover, plans must be flexible enough to take care of your short-term and temporary needs. The flexibility should also be given in terms of premium payments. The insured must be allowed to choose the mode of premium payment or premium payment term.
Waiting Periods
We often hear about insurance companies claiming zero waiting periods or one or two years of waiting period. So, what is this waiting period in health insurance and why one must consider it before buying a health insurance plan. Generally, all the health insurance plans have waiting periods, which denotes the time during which no claims are accepted by the insurance company. Insurance companies have waiting periods for pre-existing diseases, specific health conditions, maternity which varies from one to two years. Thus, any claim made under the specific waiting period is not acceptable.
Pro Tip
You must buy those health insurance policies which have a low or minimal waiting period clause, so that you are able to raise claims within a short period of time.
Check the Co-Payment Clause
Co-payment simply refers to that percentage of the amount which has to be borne by the policyholder along with the insurance company, in case any medical emergency arises. Here, one part of the percentage is paid by the company and the rest of it is taken care of by the insurance company. For instance, if your health insurance policy has a co-payment clause of 10%, which means that out of the claim made for INR 1 lakh, you have to shell out 10% (INR 10,000) from your pocket and while the insurance company will INR 90,000 as the part of claim.
Thus, you must always check the policy with a low co-payment clause or buy a policy without a co-payment clause. However, if you select the co-payment clause, it will help you to lower down your premium amount.
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High Claim Settlement Ratio
While purchasing a health insurance plan, select an insurance company which boasts a high claim settlement ratio or popularly known as CSR. The CSR is the percentage ratio of the total claims settled with the total claims received by the insurance company. Thus, a higher CSR always indicates a greater chance of your claim getting settled by the insurance provider.
Compare Multiple Health Insurance Plans
At the time of buying a health insurance plan, try to compare the various plans on the basis of various parameters such as sum insured, benefits, add-ons and premium quotes and network hospitals. When one compares the plan, they get to know what they are receiving in their policy at the best of rates and coverage. The policyholder can easily compare the plans online on various insurance companies and get the best deal.
Lifetime Renewability
Lifetime renewability is one of the most essential factors while selecting the health insurance plan as it provides you freedom from renewing your plan again and again. So, when you buy a health insurance plan, kindly check the number of years that your policy will be validated and also does it offer lifetime renewability or not.
This particular element is important as we generally need a health plan at the later stage of life where there are more chances of falling sick and hospitalization occurs. So, if your policy has the renewability of lifetime, then you will be able to continue for the same plan without the hassle of buying another policy which becomes expensive when you grow in age.
Room Rent Limit
The health insurance policy gives you the freedom to select a hospital room which can be fully private, semi-private or might be on a sharing basis. It totally all depends upon the kind of policy you choose and its various sub-limits.
We advise you to select the health insurance policy which provides less restrictions on room rent.
Networked Hospitals
While buying the health insurance policy, always check if the important or nearby hospitals to your residence have been covered in the policy or not. If your preferred choice of hospital or nearby to your locality is covered, it will always give you an advantage of claiming cashless from the insurance company, if any medical emergency arises. Cashless claims are very easy for the insured, as all the required bills get settled directly between the insurance company and networked hospital without any involvement of yours.
Thus, before buying the policy, always check the number of hospitals that have been tied-up by your insurance company or not.
Bottom Line
All these above tips can be used when you are buying a health insurance policy for yourself or your family. Always, remember that your health insurance policy must be able to help you save a lot of money, whether on your doctor’s fees, medicines costs, check-up cost and so on.
Thus, before buying a health insurance policy make sure you tick mark all these above points and research thoroughly, so that you are able to make an informed and prudent decision.
