Things To Know Before Securing a Health Insurance Plan

Are You Finalising a Health Insurance Plan? Do you know that over 5 crore Indians move below the poverty line every year due to insufficient financial medicare protection and only 5% claim to have suitable health covers per their age, family status and location? Are you aware that corporate or group insurance plans are usually in the single-digit lakhs and they are often not enough for your family of four?

The growing awareness around medical insurance in our country means more people are now showing interest in buying a health cover for themselves and their loved ones.

A large section of our population realises that it’s not merely a tax exemption tool or the first step towards your financial planning, as suggested by most professional financial consultants. It brings much more to the table.

Our double-digit medical inflation, rising healthcare costs, expanding
uncertainties and increasing lifestyle diseases make securing “the right health insurance plan” an unavoidable necessity.

What’s the right insurance plan for you? In simple terms- the plan that allows you to look beyond fancy punchlines, complex jargons, in-depth but often puzzling policy wordings and provides adequate coverage.

Let’s analyse ten key aspects you must take into account while choosing a health insurance plan.

1. The Age Factor

  • Check the age limit criteria.
  • Some plans may come with the minimum entry age limit of 91 days and a maximum of up to 60 years.
  • Other plans could have a minimum age limit of 25 years and maximum up to 50 years.
  • Many plans may not have such restrictions.
  • Consider you, your family members’ age in mind and decide accordingly.

2. Indemnity Plan Or Defined-benefit Plan

  • An indemnity plan reimburses your hospital expenses. It could be an individual health policy, mediclaim or family-floater insurance policy.
  • A defined-benefit plan pays you a lump sum amount irrespective of the actual hospitalisation expenses.
  • Critical illness plans are usually defined-benefit plans and can be added to indemnity plans.
  • Similarly, one can top up indemnity plans with hospital cash plans to cater to hospitalisation-related incidental costs.

3. Individual Health Plan or Family-floater Plan

  • In an individual-oriented health plan, every member of your family has an individual plan and schedule.
  • Premium is based on the age of the insured member and also on the sum insured.
  • Claims by members are separate from each other.
  • In a family-floater plan, more than one family member is covered with single premium payment and a single claim.
  • The total insured amount can be claimed.
  • Specific coverage needs must be evaluated by you while choosing one out of these two options.

4. Insurance Amount

  • There is no thumb rule for deciding your insurance amount.
  • Your decision could be based on a variety of factors including your age, income, lifestyle, location and the average cost of treatment in your city.
  • The amount should cover your medical expenses for at least a year and must not have a substantially high premium.
  • Also, do not forget to find out the sub-limit. (where the amount paid by the insurer is fixed for certain costs irrespective of your actual expenses).

5. Pre-existing Illnesses or Ailments

  • Read the terms and conditions, understand the “waiting period” clause in detail and know the actual duration (that could be from 24 to 48 months).
  • Please note, claims arising out of pre-existing ailments or illnesses during this period will not be accepted.
  • One must aim for the minimum waiting period possible.

6. Network Hospitals

  • Check the list of “cashless network of hospitals” with your insurance provider (where the hospital settles your bills directly with the insurer).
  • Also check if such a list has the ones you frequently visit.
  • Prefer insurers with a high number of network hospitals.

7. Pre/Post-hospitalisation Coverage

  • Choose a plan that covers pre-hospitalisation expenses such as doctor visits, medicine bills, tests and ambulance charges.
  • It should also include post-hospitalisation payments like follow-ups with doctors and medicine costs.

8. Claims Process

  • Pay attention to factors such as claim settlement ratio and settlement time.
  • Opt for plans with simpler claims processes and faster settlement records.

9. No-claim Discount (No-claim Bonus or NCB)

  • NCB is the discount provided by your insurer for all the years with no claim filing.
  • It could result in increasing your sum insured or decreasing your premium at the time of renewal.
  • Check the NCB limit offered by your insurer, as an increase in your sum insured could depend on it.

10. Free/Preventive Health Check-ups & Lifetime Renewal

  • Go for a plan that insures your free medical check-ups without impacting premium at the time of renewal.
  • Also, you can save money by checking the insurance coverage limit for preventive check-ups (cancer screenings, cardiovascular diseases, MRI and others).
  • Must give preference to a health insurance plan that provides lifetime renewability.

At this stage, you and your family members may be blessed with excellent health; however, the vagaries of life could bring undesired circumstances in the future. An appropriate health insurance policy always comes in handy.

Selecting the most accurately useful health insurance plan could be a tiresome process. As a proactively responsible individual, you should thoroughly compare all the available health insurance plans in India, explore their inclusions and exclusions to pick the correct one for your relevant needs.

Quickinsure enables you to seamlessly compare all healthcare insurance plans by taking you through quotes from multiple established health insurance providers across the country.

Sources: World Health Organisation, British Medical Journal, Nielson, Livemint, The Pioneer, Economic Times, India Times, ET Money and other information channels.

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