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Learn to choose your health Insurance policy carefully

Harsh Roongta

The cost of hospitalization has risen sharply over the past few years and is still rising at a fast clip. With rising concerns about health conditions and medical costs, Mediclaim is becoming mandatory for every individual right from an infant to an old person. A Mediclaim policy will cover you for all the medical expenses in case you are hospitalized for some reason.

The biggest problem is that which Mediclaim policy to choose amidst plethora of policies available in the market for self and family. Once you have compared all the Mediclaim policies over the criteria mentioned below, you should look at prices of the policies. 

Listed below are few parameters which should make the basis of your choosing the particular health insurance policy in their order of importance:

1. Maximum renewability age � Though health insurance is important for every individual, it becomes really valuable once a person crosses 60 years of age. Many policies available do not allow one to renew after certain age. Moreover getting a policy at that age maybe very difficult as health conditions do not remain same. In case, your policy is not allowing you to renew after certain age, it means that you will not have any insurance cover, when you need insurance the most.

2. Sub-limits � This means that the overall coverage is broken down into the maximum payable for a particular kind of expense. For e.g. A few insurance companies now provide that room rent cannot exceed 1% of the covered amount or that doctors/consultants fees cannot exceed 20 or 25% of the covered amount. Whilst most of these sub-limits are reasonable it is better to take a decision after being aware of them. This is a very significant provision as most hospitals charge hugely different rates for doctor�s fees and operation charges depending on the class of the room. For e.g. A angioplasty for a twin sharing room in Mumbai where the room rent is say Rs. 3000 per day might be only Rs. 1,50,000 whereas the same angioplasty for a patient who books a single room with room rent of Rs. 5,000 per day might be Rs. 3,00,000. In most cases the room rent sub-limit will mean that you will be entitled to a reimbursement of only Rs. 1,50,000 rather than the full sum assured of Rs. 3,00,000 due to the condition regarding sub-limit for room rent.

3. Co-payment � Certain Mediclaim policies ask the insured to share the bill with the insurer in certain proportion. This called as co-payment. A policy with no co-payment will always be better than a policy with co-payment. 

4. Exclusions � Exclusions may be permanent or temporary. Permanent exclusions means that hospitalization arising out of the conditions mentioned in the list given will never be covered under a Mediclaim policy. Temporary exclusions means that hospitalization cost arising out of these conditions will be covered but only after certain waiting period.

5. Pre-existing coverage � This can be the most important criterion if you have any pre existing disease. Almost all health insurance policies will not cover diseases which you already have before buying the policy after certain number of years. This point becomes very crucial in case one is suffering from any pre-existing diseases. Like if you are suffering from diabetes and hypertension, a few insurance policies will cover you immediately for diseases caused due to that on payment of extra premium.

6. Maximum coverage amount � In case you are looking for a very high sum assured, (more than Rs. 5 lacs) then this may be an important criteria.

Once you have evaluated various options available based on these broad parameters, you can go ahead and buy Mediclaim policy for yourself and your family.

ApnaPaisa helps Indian consumers take informed decisions say should I pre-pay my existing loan? How much life insurance cover do I need? What must I look for before buying health insurance?

Mr. Roongta can be reached at www.facebook.com/apnapaisa


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