Purchasing health insurance is a must, not just to avail tax benefits but also to ensure that you are taken care of financially when you are not well.
We’re getting to the end of the financial year, and it’s often the time many people start buying insurance products – especially life and health insurance, since these help you save tax.
Health insurance is of paramount importance due to the ever-rising medical costs. If you’ve decided to buy a health plan for your family, well done; it’s a step in the right direction. However, you would be confused about what to look for in a health plan and are puzzled by the jargon and the fine print.
To help you out, we’ve shortlisted some points to consider to make your insurance-buying decision easier. Hopefully, these will help you shortlist a good health plan.
Opt for adequate and comprehensive coverage: With rising competition, insurers are offering a wide range of features in a single health insurance plan. Along with a hospitalization cover, insurers can also cover critical illness, pre- and post-hospitalisation expenses, OPD expenses, and much more. Opting for a comprehensive plan with adequate sum assured is important while making health insurance decisions. So don’t just go by premium costs while finalizing your plan. Also compare all other features and get the best possible coverage at a price you can easily pay. Also, keep increasing your coverage limit from time to time to take care of the healthcare inflation.
Go for plans with wider network: Insurers network with hospitals around the country. At the hospitals networked with your insurer, you can avail cashless facility where claims are settled conveniently with little hassle or paperwork. Outside the network you must settle your bills out of your own pocket before filing out the paperwork to make a claim with your insurer. Hence it’s advisable to have a health plan that offers you the best possible hospital coverage, especially coverage in the city you currently live in.
Look at pre- and post-hospitalisation costs: A typical hospitalisation is preceded and succeeded by several tests and consultations. Many health plans can cover these expenses to a specified limit. For example, one well-known insurer covers 30 days of pre-hospitalisation expenses and 90 days post. These costs can be significant, therefore having this cover will help you reduce your out-of-pocket expenses during the treatment.
Read through co-payment clause: The insurer offers you an option of co-payment, wherein you will have to settle a pre-decided percentage of your medical bills yourself. Sometimes, the clause is specific to particular treatments/ailments only. For instance, you have a health plan which has a 20% co-pay clause, and if your claim amount is Rs. 80,000, then you would be liable to bear Rs.16,000 (20% 0f 80,000) while the rest will be settled by your insurer. A higher co-pay means lower premiums. If you are young and healthy with no medical history, you could consider a higher co-pay and thus save on premium costs.
Consider sub-limits on room rent: Room rent is one of the main expenses you bear during hospitalization. Many insurers have a cap on daily room rent. This decides what kind of a room you’ll be able to afford through your health plan. So do pay attention to this section. For example, you may want a private room instead of a shared room, therefore you must ensure that your insurance plan provides you what you need.
Make it cost-effective with the family floater: If premium rates are beyond your budget, consider buying a family floater health insurance instead of individual health plans for each family member. Family floater covers everyone under one health plan. This will lead to marginal reductions in your premium costs.
Prefer policies with restoration benefits: Opt for a health insurance policy which gives you the benefit of restoration of the sum assured in case the entire sum is utilized in a year. This helps cover situations where you require multiple hospitalizations in a year – which is very common in the case of critical illnesses such as cancer. Read the restoration clause carefully to understand under what circumstances it can be utilized.
Understand the exclusions: Do take the time to understand what your health policy will not cover, or will cover after a fixed waiting period. A policy that has fewer exclusions is preferable. For example, pre-existing diseases are covered only after a specified period of a few months or years. Check those time limits before you buy. Also understand what treatments may not be covered. For example, some policies will not cover non-allopathic treatments.
Compare health plans online: Go to an online aggregator of financial products where health plans can be compared across multiple parameters, including cost. This way, you can take your time to understand various products and not be pushed into buying one that doesn’t represent your best interests.
What else can you look out for? Ask for details of the no-claim bonus, maternity benefits, OPD coverage, day care coverage, free medical checkups, non-allopathic treatment option, ambulance charges, home treatment coverage, daily cash provision, and convalescence benefits.
Now that you are aware of all the vital elements that help you arrive at a wiser decision, go ahead and choose the ideal health insurance plan and set aside all your worries. It is health that is real wealth.