With the times we are in, health insurance is on everyone’s mind, and it’s rightly so. Buying the right policy can make all the difference in your life. With medical inflation skyrocketing, it is even more pertinent to be familiar with health insurance policies.
The number of health policies available in India is upward of 150 – you may not be entirely correct if you think this gives you a lot of choices. A large number of choices gives rise to what is known as the paradox of choice –it describes how people generally get overwhelmed when faced with a large number of options. Decision fatigue sets in, and that 150+ number isn’t helping. It can be a daunting task but don’t sweat because we are here to make sure you don’t get overwhelmed and make a decision that matters.
Below are the key things you should check before buying any health insurance policy in India:
- Know your policy: There are different types of health policies available in India like individual health plans, family floater plans, critical illness plans, senior citizen plans, etc. Individual plans cover a single person, and family floater plans cover the entire family. Critical illness plans can be standalone or a part of your existing policy. They cover several illnesses like cancer, stroke, bypass surgery, organ failure, etc. Senior citizen plans are meant for senior citizens. Choose the one that best meets your current needs.
- Look at insurer’s services: Buying an adequate health cover and paying premiums on time is an excellent decision. Knowing the nitty-gritty of your policy and reading the policy documents is one too. Please try to get familiar with the claim settlement process of your insurer. You can talk to family & friends who have made claims earlier, look at the insurer’s reputation, financials and keep an eye out for a transparent and straightforward claim settlement. Be sure to choose an insurer with a very smooth claim settlement process.
- Prefer an insurer with a high claim settlement ratio: Claim settlement ratio is calculated by dividing the total number of insurance claims settled by the total number of claims – a higher percentage is better.
- Look for an insurer with a large number of network hospitals: Insurance companies’ tie-up with hospitals where you can avail cashless settlement. You should check the number of hospitals covered in your city or if your preferred hospital is one of them. You wouldn’t have to arrange finances at the last minute and file for reimbursements later because the insurer will pay the hospital directly.
- Pre- Existing Cover: Health insurance policies have a waiting period before you can claim expenses arising from pre-existing illnesses. This is at least 24/48 months, depending on the insurer and your chosen plan. You will be able to claim the benefits only when this period is over. Make sure to read the policy details or brochures to clarify this.
- Pre and Post Hospitalization Coverage: Check if insurers cover pre-and post-hospitalization expenses. This will save you some costs incurred post-hospitalization like doctor fees, medical tests, medicines, etc.
- Maternity Coverage: Maternity insurance covers pregnancy-related costs. This can be an add-on or a standalone policy. You can expect a waiting period of 0-4 years to cover your maternity expenses. It is advisable to opt for it as early as possible because there aren’t a lot of plans available without a waiting period, and premiums increase as you get older. It can be a costly oversight on your part if you are planning a family. These policies cover expenses up to a specific predefined limit. Insurers offer coverage for standard as well as C-section deliveries. They may include pre-and post-natal costs and newborn coverage for a particular amount.
- Co-payments & sub-limits: A widespread inclusion in senior citizen policies, co-payments are a % of the claim you will have to pay out of your pocket, with the insurer paying the rest. You may find the premium of these policies attractive. It is best to gauge your financial health before going for these policies or avoid them altogether and opt for a comprehensive cover instead. Sub-limits are monetary caps attached to your policy; they can either be a percentage of sum assured or a fixed amount for a particular illness/treatment. This means if a specific treatment has a 60% cap, it won’t be possible for you to claim more than 60% of the cost incurred in that treatment. Try to choose plans that have affordable capping or avoid them altogether and go for a comprehensive health cover.
- Look for No-claim benefits: In policies with no-claim benefits, in case you don’t file claims during a year, the insurer may offer you a discount on your next premium or increase your sum assured. A little less out of your pocket can make all the difference sometimes. This is a reward for not claiming your health insurance. You can consider this as per your discretion, but it is advisable to go for policies like these.
We hope this helps you make an informed decision when you buy health insurance. Please stay tuned for more blogs like these.
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– Nischay Avichal