11 factors to consider when choosing a health insurance plan
A Medical Insurance plan offers reimbursement for medical expenses and pays for treatments for medical conditions that are covered under the policy. You can also opt for cashless treatment if you choose to receive treatment at a network hospital. With the various health insurance plans available in India, it can be difficult to compare all the plans and choose the right one. HDFC ERGO, SBI, Bajaj Allianz, Bharti AXA, MAX Bupa, and Reliance health insurance companies are some of the top health insurance providers in India.
Here is a list of factors to consider when to buy health insurance plan:
- Claim Settlement Ratio: Purchase health insurance plans from a reputable health insurance company with a high Claim Settlement Ratio (CSR).
- Cashless treatment: Choose an insurance company that has tie-ups with a wide network of hospitals. When you receive treatment at one of the network hospitals, you can opt for the cashless facility. The insurance company will pay the hospitalisation bill directly through their Third-Party Administrators (TPA), provided all the insurance conditions are met.
- Discount on premium: If you haven’t made any claims, some insurance companies may offer you a no-claim discount on your health insurance premium the following year or increase the coverage amount at the time of renewal. You can get tax deduction on the premiums paid towards a health insurance policy under Section 80D of the Income Tax Act, 1961.
- Free health check-up: Some insurance providers offer free full body check-up once a year. Full body health check-ups can be expensive.
- Policy renewal: Check the age limit for your chosen policy renewal which could be anywhere between 50 years to a lifetime. Choose a health insurance policy that has a higher age limit for policy renewal. Get a health insurance policy that offers coverage and allows renewing during old age. Senior citizen health insurance plans are restrictive. Therefore, it is advisable to opt for a regular plan that offers coverage during your old age.
- Exclusions: Most health insurance plans have exclusions that include pre-existing conditions, self-inflicted injuries, and diseases contracted within the waiting period. Read the exclusions carefully. If you have a pre-existing condition, then choose a plan that will provide coverage for that particular disease or illness.
- Adequate sum insured: Depending on your family medical history, the place you reside in, and your age, ensure you get adequate sum insured. The hospitalisation costs can be higher in urban areas compared to rural areas. An individual with a medical history would require more health insurance coverage. Take the rising healthcare costs into consideration while deciding on the sum insured.
- Pre-existing conditions: Some insurance companies provide cover for pre-existing conditions after the completion of the waiting period, provided the policy renewal has been continuous without any breaks. Take a look at the list of diseases covered by your chosen health insurance policy.
- Co-payment: It is the amount that a life insured has to pay in addition to the health cover provided by the insurance company to share the hospital expenses. Co-payment depends on the hospital where treatment is received, the specified ailments, and specific hospital charges. Check with your insurer if you can waive the co-payment for an additional premium. Lower the co-payment, higher the health insurance premium.
- Sub-limit: It refers to the percentage of sum insured that the insurance company will pay for certain hospital expenses and illnesses such as room rent, doctor fee, cataract treatment, cardiovascular treatment, etc.
- Waiting period: All health insurance plans have a waiting period of 24 to 36 months. You can receive coverage upon completion of the waiting period. Choose an insurance provider offering the lowest waiting period.
With the increasing healthcare costs, the need to obtain a health insurance cover is more important than ever. Provide the best for your family in terms of healthcare with a good health insurance plan. Buy a health insurance plan at the earliest to get no-claim discounts on your premium as you are unlikely to make claims when you are still young. You can depend on a reliable agent to guide you in purchasing a suitable health insurance policy or making a claim when you are hospitalised. Disclose all pre-existing conditions at the time of purchasing a health insurance policy to avoid repudiation of your claim.