Health Insurance 143 views October 14, 2020

10 Things to Remember While Buying Health Insurance

Medical emergencies can come anytime, and the best way to cope with them is to buy a health insurance policy. As you would know that the cost of healthcare is increasing day by day in India. So, buying a health insurance policy is all the more important these days. But with so many options around you, it does get confusing to find a suitable insurance policy. Do not worry, this article is going to help you. Go through this post and know the 10 things that you must consider when you buy a health insurance plan for yourself or your family.

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10 Things to Remember While Buying Health Insurance

Age Criteria

Age is one of the important factors when it comes to health insurance. While purchasing a medical policy, keep in mind the age of the family members who are going to be insured. Because in a family floater health insurance policy, the cost of premium would depend on the age of the eldest family member.

Also, you should check the age limit criterion in the policy. For example, there are different types of health plans and the minimum entry age limit can be 91 days, 25 years, or at times there won’t be any such criterion. So, you have the option to choose a plan according to your age limit.

Premium & Coverage

You must know how much you pay for the health insurance plan and what you get out of it. Because sometimes it can be lucrative to buy a health insurance policy with low premiums. But there can be two sides to that case. A policy with a low premium can be good for you if it is giving you extensive coverage at an affordable premium. The other aspect is that you pay a lesser premium at the cost of the insurance coverage, which means some benefits may be excluded from your policy.

So, you need to look beyond the reduced premium as you shouldn’t compromise on your insurance coverage. The advice is that the buyer should check if there are additional co-payment clauses, deductibles and sub-limits under the health insurance plan or not. Because if there are, you would end up paying more during the claim.

You should choose a policy that gives coverage without compromising on the benefits of the health insurance plan and at a premium that you can afford.

Waiting Period

If you are new at insurance, you shouldn’t be aware of the waiting period. It is the period after which some of your specified diseases as per the policy documents get covered. The insurer will not accept any claim for pre-existing illnesses during this waiting period. And this can range from 12 to 48 months depending on the insurer. The insured will be able to claim the benefits only when this waiting period is over. It is commonly applied to pre-existing illnesses that you may have before buying the policy.

So, you can choose your plan by comparing the health insurance plan waiting period. Because the best insurer for you is the one that gives you the policy with a minimum waiting period.

Cashless Facility

Health insurance companies have tie-ups with some of the hospitals where you can avail of the cashless treatment in the case of a medical emergency. This service not only saves you from the tedious paperwork but also makes the claim process easier. In this process, the insurer pays the sum insured directly to the hospital. So, you don’t need to do any paperwork for reimbursement. The company will ask for the required documents directly from the hospital. So, you must check the list of empanelled hospitals.

Pre & Post-Hospitalization Cover

You might not get coverage for medical expenses incurred during the pre or post-hospitalization period. So buy a plan that covers expenses incurred before and after the hospitalization. Such expenses would include ambulance charges, medical tests, medicines, doctor fees. Choose your plan by making all these calculations.

Maternity Expenses

It is quite common that you will forget the maternity benefits in a health insurance policy. The cost of delivery and maternity care is going skywards, so it will be better to buy a health insurance plan that covers maternity expenses. Insurers put a waiting period of 2 to 4 years before you can claim the maternity benefits.

No-Claim-Bonus 

The insurance company gives you a no-claim bonus for all the years in which you have not filed a claim. This benefit can increase your coverage at the time of subsequent policy renewals for all claim-free years. However, sometimes the health insurance providers specify the bonus limit.

For example, if you buy a health insurance plan of INR 5 lakh and the insurer offers a 10% no-claim bonus for every claim-free year up to a maximum of 50%. Check out this table below to find how it will impact your sum insured.

Claim Free YearSum Insured (In INR)
1st year5,50,000
2nd year6,05,000
3rd year6,65,500
4th year7,32,050
5th year8,05,255

Note: The above example is for illustration only. It doesn’t support any statement from the policy document.

So, check the policy document while purchasing a health insurance plan to know what your no-claim bonus states.

Health Check-up Facility

Make sure you check the coverage limit of preventive health check-ups in your policy. Because preventive health check-ups for cardiovascular diseases, cancer screenings, MRIs are too expensive. So having covers for such expenses will only help you prevent such massive cost burdens.

Co-Payment Clause

At first, you might be confused with this term and tend to ignore it. But this is important. It is the percentage of the amount that you would pay at the time of claim. So, you should check whether there is any co-payment clause or not.

If possible, try to buy a plan that does not have sub-limits. However, when there is a pre-existing medical issue or the insured crosses a certain age limit, most of the insurers would have a co-payment clause in the policy.

Claim Procedure

A smooth claim procedure is what an insured wants at the time of settling health claims. For this, you must read the policy document at the time of purchase. Because in that, all the important things are mentioned. Any negligence on it can cost you later. So, you should know the documents you will need and how much the insurer will pay for your expenses. Also, find the time limit for the claim payment. And if you have any queries regarding the claim procedure, you can immediately contact the company’s customer care or Third Party Administrator (TPA).

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