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Factors for buying Health Insurance

What factors or parameters one should consider before buying health insurance?


Health insurance buying process is quite confusing with the various options available in the market. Below are the factors to be considered to ease the process:

Claim management process: Efficiency of claim process is the key factor to be considered. Higher claim settlement ratio and speedy settlement process shows how efficiently insurer is managing the claims.

Network Hospitals: Check the list of network hospitals to ensure best hospitals with advanced technology for treatment are included. Cashless facility with wider network is a vital factor that will give you a peace of mind.

Pre/post Hospitalization: Most of the insurers cover the expenses incurred before and after hospitalization such as diagnostic tests like X-ray andUltrasound, medicines as prescribed by a doctor etc. It’s essential to have a detailed knowledge of the list of inclusion in the policy to make utmost use of the benefits offered. Number of days covered tend to vary among insurers.

Coverage: Buying adequate cover is very much essential. Ensure to choose the policy that covers all your healthcare need.

Age Limit: Chances of facing health issues are more at an older age. Hence, pay attention to maximum permissible age so that you can renew the comprehensive plan lifelong. Buying fresh insurance is not easy at a later stage.

Co-pay: Generally, insurer imposes co-pay clause in which some part of medical expenses is to be shared by you. Hence, it’s important to choose the policy with lesser percentage of co-pay

Sub-limits: In many plans,there is a cap on reimbursement of hospital room rent. This sub-limit also determines doctor’s fee, nursing charges and certain other hospitalization charges. Hence, it’s important to choose the Health Insurance Policy with higher sub-limits or no sub-limits at all

Exclusions: Every policy comes with the exclusion clause. Check the list of diseases and surgeries that are not covered under the plan before you buy.

Free Medical checkup: Consider an insurer who offers free-medical checkup for policyholders.

No claim bonus: For each claim free year, the insurance company usually provides some benefit as a No Claim Bonus which could be offset with the premium, i.e. a deduction in premium, or a rise in the coverage amount or sometimes even health check-up or other vouchers.

Maternity and New Born Benefits:Maternity and New Born Benefits are provided in some policies but upto a specified limit only. Also, maternity benefits are usually provided after a certain waiting period of 2, 4 or sometimes even 6 years as the case may be. Hence you need to check the waiting period before availing the plan and also choose a plan with higher maternity limits.

Pre-Existing Diseases(PED):Some policies do cover illnesses which you might already have before the inception of the policy. These Pre- Existing Diseases are usually covered after a certain specified waiting period. So, you need to choose a plan with a lesser waiting period if you have any pre-existing diseases.

However, there are certain PED which are not covered even after a waiting period and they are permanently excluded. Please read the terms and conditions properly before opting for the plan, in case you have a PED.

After considering the factors of the health plan, an analysis of own medical insurance requirement also needs to be done before finalizing the plan:

 Existing insurance and further need for enhancing the same

 Family history of ailments and their age bands as premium varies accordingly

 Financial position to pay premium so that coverage can be chosen accordingly

Choose wisely!