How to Choose Right Health Insurance Plan? : Important Factors to Decide the Right Health Insurance Plan for You and Your Family


5 min read

Updated on Mar 07, 2023

Factors to Decide the Right Health Insurance Plan for You and Your Family

In India, the surging cost of healthcare along with increasing incidence of ailments has made health insurance a necessity for everyone. These days many insurance companies offer the best family health insurance plans in India that suit the needs of you and your family. Each health insurance plan has some alluring features along with USPs. It could be difficult for policy buyers to choose the best insurance plan among so many options. Very often, people end up purchasing health insurance plans in haste without knowing whether or not it would be sufficient for all their healthcare requirements.

In this post, we will discuss some insurance factors that you should keep in mind before purchasing the best family health insurance plans in India.

8 Tips on How to Choose the Right Health Insurance Policy in India?

Here are some useful tips for choosing the best family health insurance plans in India:

1. Select an appropriate plan that offers a wide scope of coverage

If you are not sure about how to buy insurance policy, it’s always better to select a plan that offers plenty of coverage against various health issues. The best family health insurance plans in India covers all treatment expenses, including pre- and post-hospitalization costs, ambulance charges, critical ailments cover, maternity coverage, cashless treatment facilities, in-patient hospitalization, etc.

While choosing the best medical insurance policy for your family, make sure that the plan meets all healthcare requirements of your family members. Compare various policy plans based on their features, restrictions and requirements. Check the policy documents carefully before investing in the plan.

2. Check the flexibility of the plan

Choose a plan that offers you flexibility (in terms of adding or removing family members). For instance, if a senior citizen in the family dies or is no longer eligible for coverage, you can remove his/her name from the policy plan. Similarly, if you want to add any new member under your existing plan, you can do it without compromising on the policy benefits.

3. Don’t overlook the waiting period clause  

Most health insurance plans come with a waiting period clause to cover the expenses for pre-existing ailments, maternity expenditures and some specific treatments like hernia, varicose veins, etc. The waiting period varies from one insurer to the other; however, in most cases, it may range between 2 and 4 years. For example, you’re eligible for maternity benefits only after the completion of the waiting period (2-4 years from the date of policy issuance). Don’t forget to check the time frame for pre-existing ailments that are covered by your selected health insurance plan before buying. Always select a plan with the minimum waiting period.

4. Don’t ignore the co-payment clause

Co-payment is an imperative clause in health insurance under which the policyholder needs to pay a certain amount of the claim from his/her pocket. The remaining claim amount will be paid by the insurer. For instance, if your purchased policy comes with a 10% co-pay clause and your claim amount is Rs. 2 lakh, you’d need to pay Rs. 20,000 from your pocket. The remaining Rs. 1,80,000 will be paid by the insurance company. Hence, opt for a health insurance plan for your family that has a no co-payment clause.

5. Select a plan with lifetime renewability

While purchasing health policy, lifetime renewability is critical. Check the validity of your insurance plan (the number of years for which the policy will remain active).

Most people need health insurance in later stages of their life. Hence, it’s a good idea to opt for a plan that comes with lifetime renewability. This way, you don’t need to go through the hassles of policy renewal and can enjoy the coverage of the plan, irrespective of your age.

To give an example – your health insurance offers renewability until 45 years of age. Upon reaching this age, you may need to purchase another plan by paying higher insurance premium amounts. However, with lifetime renewability, you can enjoy all the benefits of health insurance without a worry.

6. Choose an easily-portable plan

In case you’re not satisfied with your insurance company (in terms of services, policy benefits, claims, etc.), you can transfer your present plan to another insurance company, without losing your accumulated benefits. With the health insurance portability option, you can also upgrade your plan as per your healthcare requirements. The policyholder can also increase the sum insured amount to meet changing health needs. The primary objective of portability is to offer unprecedented services to policyholders so they continue to stay loyal to the insurance company. A policyholder may look for portability option under the following conditions:

  • Inferior services from the insurer
  • Tedious claim-settlement process
  • Hidden clauses discovered by the policyholder later
  • Higher premium rates
  • Inadequate policy coverage

7. Check the list of network hospitals

While purchasing a health policy, don’t forget to check the list of network hospitals under your policy plan. These network hospitals will offer cashless treatment facilities for your treatment. If your policy plan has a wider range of network hospitals, you’re bound to receive several options for your treatment. You can also find out the nearest cashless hospital.

8. Look up the claim-settlement ratio

Buy a policy from an insurer that displays a healthy claim settlement ratio. This ratio depicts the number of claims settled by a company during a financial year. A higher ratio portrays the company’s trustworthiness and credibility.

Which is the best health insurance policy? It is best to compare various insurance plans offered by all health insurance companies. A health insurance plan will not only protect you from medical emergencies but also safeguard the health of your family members. Keep the above factors in mind before choosing the right health insurance for your family.

Also Read: How to Get the Best Health Insurance Plan in India

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FAQs on Health Insurance

What is the definition of health insurance?

Health insurance is a type of insurance that covers medical expenses that arise due to an illness. These expenses could be related to hospitalisation costs, cost of medicines or doctor consultation fees.

Which is better LIC or health insurance?

While Health Insurance covers the expenses incurred towards treatment, Life Insurance can help your family reduce their financial burden in case of your untimely demise. Why should you buy this? Financially safeguards your family in case of your untimely death.

What is the benefit of health insurance?

A health insurance policy provides extensive coverage against medical-related expenses. It helps you stay financially prepared for any medical emergency. Health insurance policies enable you to get the care you need at affordable premiums.

How many types of health insurance are there?

Health insurance encompasses two types - Indemnity Plans and Definite Benefit Plans. The indemnity plans are traditional health covers that cover hospitalization costs from the sum assured. Definite benefit plans offer lump-sum payments on the detection of illness. For those who are suffering from critical diseases.


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PayBima is an Indian insurance aggregator on a mission to make insurance simple for people. PayBima is the Digital arm of the already established and trusted Mahindra Insurance Brokers Ltd., a reputed name in the insurance broking industry with 17 years of experience. PayBima promises you the easy-to-access online platform to buy insurance policies, and also extend their unrelented assistance with all your policy related queries and services.

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