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Last Updated : Feb 13, 2020 08:30 PM IST | Source: Moneycontrol.com

7 Things to Consider Before Buying Health Insurance

neycontrol Meta Description – Things to know before buying health insurance - While purchasing a health insurance plan, one must consider seven vital things like inflation, maximum coverage & more.


Health insurance is the most significant investment you can ever make. You need to invest in a policy with adequate coverage and high sums assured so that you can seek the best treatment when required. A good insurance policy is one wherein the insurer compensates you for over 90% of your total hospital bills. However, you need to do your research to find such a policy that is truly valuable in terms of the coverage you get and the premium you pay. Consider these seven things while buying health insurance.

  1. Consider inflation and invest in a policy with high sums assured


When you buy health insurance, you must select a plan that comes with high sums assured. Policies with sums assured of ₹300,000 and ₹500,000 may not be sufficient any more. With the rising cost of medical procedures, surgeries and apparatus, a plan with lower coverage is simply not enough. Sure, the sum may feel sufficient at the moment, but while buying insurance, you have to factor in inflation. With the rising rate of inflation, a heart procedure that costs ₹250,000 to ₹300,000 today will cost ₹800,000 to ₹1,000,000 within a decade. Therefore, choosing a policy with higher sums assured should be your priority and you should factor inflation while doing so.

  1. Consider investing in a policy where you can get maximum coverage


If you read the terms and conditions section of your policy document, you will find that there are several essential points listed in it. There are caps or limits on the expenses associated with the treatment. For instance, you can get hospital room-rent cover of only ₹3,000 to ₹5,000 per day. You cannot file a claim if you’re suffering from a pre-existing illness. In some policies, you cannot avail ambulance cover and so on. Thus, it is essential to ensure the kind of coverage you can get. Choose a plan in which you can get coverage for a wide range of diseases, including pre-existing conditions. 

  1. Consider investing in a critical care policy along with your general health insurance policy


The coverage you get under a general health policy may not be sufficient to pay for critical illnesses like cancers, tumours, kidney failure, etc. The treatment for these diseases lasts more than just a few days. A critical illness can drain away all your savings. A disease like cancer, which was considered rare, has now become a common lifestyle disease. Sometimes, surgery may not be enough for cancer patients, and they may have to undergo several rounds of chemotherapy and radiation. So expensive is the treatment that you’d have exhausted your sum assured and may need to pay from your own pockets. What’s more, your premiums could increase the following year. Thus, as a precaution, you must invest in a critical illness policy, especially if you have family members who’ve suffered from critical illnesses. 

  1. Consider the network hospitals


Health insurance companies’ tie-up with various hospitals, wherein their customers can avail cashless treatment. These hospitals are in the insurance provider’s network and are therefore known as network hospitals. At a network hospital, you can concentrate on seeking treatment, while the insurance provider’s representative and the hospital together take care of the expenses related to the treatment. You only have to pay the sums exceeding your coverage amount. There is no stress of depositing an advance or making cash payments when you seek treatment in a network hospital. Thus, it is essential to check the list of network hospitals. If you prefer seeking treatment in a specific hospital, you should check with them about the insurance providers they are affiliated with. 

  1. Consider the insurance provider’s claim settlement ratios 


The reason we buy health insurance is to ensure that the insurance company comes to our aid when we need treatment. You don’t want to be in a position where the insurer rejects your claim or only approves a small amount of the claim. You need a policy wherein you can get maximum coverage. An excellent way to check the legitimacy of an insurance provider is through their claim settlement ratios. You can find the details of the claim settlement ratios on the insurance provider’s website. You can even see the number of claims settled the number of days taken to settle a claim and check the pending claims. 

  1. Consider how existing customers have reviewed the insurance provider


Today, you can read reviews for almost everything before you spend your hard-earned money, on the internet. The same is true of health insurance as well. Insurance brokers and agents will typically only highlight the positive attributes of the brands they are representing. Still, they may not necessarily give you an accurate picture of the insurance provider. You need to do your research and read customer reviews. There are several online forums wherein you can read detailed reviews about brands. Existing customers often give their insight about their claim settlement procedures, time taken to settle claims, reasons for claim rejections, and how easy or difficult it is to access the insurance provider. 

  1. Consider all inclusions and exclusions in the policy


Most insurance buyers are guilty of not reading the fine print in their insurance policies, i.e. the terms and conditions section of the policy. It is here that the insurer lists the inclusions and exclusions. For instance, diseases such as HIV, AIDS and STDs are not covered under insurance. You can also not file claims for cosmetic treatments (not arising out of injuries or accidents), dental and cataract surgeries. It is essential that you check what treatments are and are not covered so that you don’t face any issues while filing an insurance claim.

Final words: While buying insurance, you must ensure that you get your money’s worth. After all, insurance premiums are high, and you may not need to file an insurance claim for many years. As such, it is essential to consider all the points mentioned above and make an informed decision while purchasing insurance.

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First Published on Feb 13, 2020 08:30 pm
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