The amount of premium you pay for your health insurance policy should not be the only determinant for selecting a health insurance plan. Cheaper plans provide only a basic cover and may not offer all the features you need. In contrast, the more expensive ones may provide additional benefits which you may never use. Before you choose a Health Insurance Policy, you may consider the following pointers to select the most suitable option for yourself-
• Individual Policy vs. Family Floater Plan – This covers all family members from children to senior citizens under a single plan. The cover floats on all the members covered and can be consumed by a single member or collectively. A family floater policy is very suitable when you have senior members like parents or parents in law to include under the floater scheme.
• Critical Insurance Cover – This option covers specific dreaded diseases and pays the cover amount on detection of the specific condition. This may be opted for as an add-on by paying an extra premium; Critical diseases are chronic and require a very high cost of treatment. A single instance of hospitalization may erode the full insurance cover. It is advised to include the Critical Diseases Cover as an add-on to take care of this need. Accidental Insurance benefits may also be included as an add-on by paying an extra premium.
• Pre-existing disease cover (waiting period)– Most schemes offer a waiting period of 48 months. Some premium plans provide a waiting period of 2/3 years. Please check the waiting period for various pre-existing diseases before you make a choice.
• Policy exclusions are conditions/ diseases which are not covered under the scheme. Check the exclusions to see if any of them goes against your requirements.
• The list of Network Hospitals where you may avail of the cashless facility. Do check if this list includes hospitals that are close to your/your parents’ residing place.
• Co-payment: – This is a % of the claim amount you can voluntarily pay out of your pocket. It varies from 10% to 30%. Premiums of these plans are lower, and co-payments are mostly under senior citizen policies. Whether you should go for this or not depends on your income and health condition.
• Claim Settlement Ratio of the Health Insurer to understand the number of claims paid against the total number of claims received.
• Ambulance Expenses and frequency of payment within a policy year.
• Please check if organ transplant and donor’s treatment costs are covered in the policy. This may come in handy if you have diabetics or other conditions in your family who may require this facility.
• Duration of claiming the Pre and Post Hospitalization expenses. Some of the premium plans cover the costs for up to two months under pre-and post-hospitalization. While these may cost you an additional premium, this is a significant benefit you should look into before you finally make a selection.
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– Konica Bhattacharya
