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Health insurance: How to choose the best plan

Don't forget about out-of-pocket expenses. High deductibles or co-payments might lower your premiums, but they can also mean more money out of your pocket when you need to make a claim. Another thing to consider is a no-claim bonus.

August 15, 2024 / 08:12 IST

A recent report by Apollo Hospitals, one of India's leading healthcare groups, paints a grim picture of the nation's health. Released in April, the report dubbed India the “cancer capital of the world”, highlighting a worrying rise in cancer cases and other non-communicable diseases (NCDs).

Stark findings

The findings are stark: one in three Indians is pre-diabetic, two in three are pre-hypertensive, and one in 10 battles depression. Chronic conditions such as cancer, diabetes, hypertension, cardiovascular diseases, and mental health disorders have become alarmingly common, reaching what the report calls "critical levels”.

This isn't an attempt to incite fear, but rather a stark reminder of our contemporary reality.

It underscores the urgent need for comprehensive health measures and plans to address and manage these growing health challenges.

Selecting a health insurance plan isn’t just a good financial choice — it’s what you need, to be able to live with peace of mind, especially when health concerns hit you!

See here: Moneycontrol-SecureNow Health Insurance Ratings: Your one-stop guide to choosing the right policy | Simply Save

Understanding your health insurance needs

Start by assessing your current health and medical history to identify immediate coverage requirements.

Consider potential future health issues based on your family medical history and lifestyle choices. For example, if there is a history of diabetes or heart disease in your family, you might want a plan that covers these conditions extensively.

Your health insurance needs also change with varying life stages.

When you are single, you might focus on plans with basic coverage and low premiums. As you get married, look for family floater plans that cover your spouse. When you have children, ensure the plan covers pediatric care, vaccinations, and other child-specific healthcare needs. Finally, as you approach retirement, opt for plans with extensive coverage for critical illnesses and hospitalisation, as medical needs typically increase with age.

The key aspect to remember is that securing health insurance coverage early on in life provides both immediate and long-term benefits. Certain coverage options might be unavailable or be more expensive as you age.

What are the key features to look for in a health insurance plan?

Coverage

Look for plans covering inpatient and outpatient care, including maternity and critical illnesses like cancer as per your health care needs.

Network

Ensure a wide network of hospitals with cashless facilities for hassle-free claims.

Pre-existing conditions

Check waiting periods and coverage details for existing health issues.

No-claim bonus

Another thing to consider is a no-claim bonus. If you stay healthy and don't make any claims, some plans may reward you by increasing your coverage by increasing your sum insured. Alternatively, as a reward for your healthy habits your premium may be discounted over time. This can really add up and save you money in the long run.

Daycare and domiciliary treatment

Coverage for treatments not requiring full hospitalisation, and medical care at home.

Ambulance and post-hospitalisation

Look for coverage of ambulance charges and expenses before and after hospital stays.

Wellness programmes

Plans that reward healthy habits and incentivise healthy behaviours.

Financial considerations

When it comes to choosing a health insurance plan, financial considerations are key. It's all about finding the right balance between what you pay in premiums and the coverage you get. While higher premiums may mean better coverage, you want to make sure you are getting your money’s worth.

Don't forget about out-of-pocket expenses. High deductibles or copayments might lower your premiums, but they can also mean more money out of your pocket when you need to make a claim. Look for an insurer with a good track record for settling claims quickly and fairly.

Flexibility and additional benefits

Consider top-up plans to enhance your existing coverage without significantly increasing your premium. These plans act as additional coverage in case your base plan’s sum insured gets exhausted.

Look for plans that offer regular health check-ups to catch potential health issues early, preventing more severe health problems in the future. Plans that include wellness programmes and incentives for maintaining good health can add value and promote a healthier lifestyle.

Also see: Moneycontrol-Securenow Health Insurance Ratings: Here’s how insurers fare on claim settlement

Evaluating and comparing plans

When it comes to choosing the right health insurance, taking the time to evaluate and compare plans is essential. Start by doing some research on the options available. Use online tools, dive into the policy documents, and look at the benefits and costs of each plan. Remember, the cheapest plan isn't always the best one — make sure it meets your specific needs.

Talking to insurance advisors or experts can be really helpful. They can break down the details of different plans and offer insights that you might not have considered. Don’t forget to check out what current policyholders are saying. Real-world feedback can give you a better idea of the insurer’s service quality and reliability. Look for reviews on their claim settlement process, customer service, and overall satisfaction. This way, you will have a clearer picture and can choose a plan with confidence.

In the end, choosing the right health insurance plan means thinking about your current and future health needs, understanding the key features, considering the costs, and looking at how flexible and beneficial each plan is. Take your time and be proactive about it. The right plan will not only protect you financially but also give you peace of mind as you go through different stages of life and face health challenges. Make sure your health insurance grows with you, giving you the support and coverage you need every step of the way.

Priya Deshmukh is Head of Health Products, Operations & Services at ICICI Lombard
first published: Aug 15, 2024 07:04 am

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