Things to keep in mind while selecting a health insurance policy

HEALTH INSURANCE HEALTH INSURANCE POLICY



Health without any doubts is the most significant aspect of our lives with Good Health being the key to not just a happy but prosperous life. While most of us focus on living healthy and adopting a better lifestyle as a way to maintain good health, we overlook how despite our best efforts there are times a medical adversity could knock our door. As a result, in such situations we find ourselves in a financial distress & often it leads to depletion of our hard-earned savings.

Hence it is important to not just have a Health Insurance policy but choose one that is comprehensive & best in the Industry. With so many Health Insurance companies and even more plans available in the market it can be a daunting task to choose the right plan. But here we attempt to demystify and try to make the process a lot simpler for you.

The very first question to be answered is what is the adequate amount of cover you require? With the cost of medical expenses rising every year the cover you take today might not even be relevant 5 years down the line. So it is best to think of future costs and not merely select an amount you feel is necessary today. We advise first time insurers to choose at least INR 25 lakhs of cover.  

The next most important factor is the servicing commitment of the company. At the end of the day a health insurance is a promise by the health insurer to pay when you need them. One must look for a company that have the best claims settlement ratio & the turn-around-time in which they settle their claims.  

Furthermore, it is all incomplete without a cover that is truly comprehensive. Like today apart from covering allopathic treatments, health insurance companies also cover non-allopathic ones such as Ayurveda, Unani, homeopathy & siddha.  If the organisation where you are employed is taking care of your health needs for you and your dependents, there is nothing like it as the payment of premium shall be covered by the company under your cost to the company. In case that option is not available for you or your family, health insurance is a must to avoid any burden of expenses and stress related to health.

Invest Wisely and Choose the Best Health Insurance Policy and Company

As mentioned earlier network hospitals give cashless treatment throughout the country. With the help of your policy number, you can get cashless treatment in any of the health insurance company’s empanelled hospitals. This is the preferred a mode of treatment to avail under health policy as it is free of any reimbursement related formalities which can be cumbersome. Some of the popular insurance companies have pre and post hospitalisation expenses covered as part of the claim. Ambulance fee is also one important feature when it comes to Mediclaim policies. There is also another advantage of not availing your policies during any previous years of insurance wherein you become eligible for No Claim Bonus. It is given as a discount on the premium paid or as an additional amount added to the sum assured. Always remember to ask about No claim bonus during annual renewal, if you have been continuing with the same insurance company for more than two years or above the waiting period. Some health insurance policies also provides the insured with a certain amount of money on the yearly checkup, if no claims have been made in the past. Also check for the sub-limits under the conditions of hospitalisation such as room rent, doctor consultation and visit charges, medical examination fee, cost of medicine, surgery etc.

Many insurance companies have these sub-limits, and some of them are not open about it, and the claimant of medical policy only comes to know about it later when hospitalisation situation arises. Always make sure to check for these sub-limits before availing the sum assured for which you are paying under the policy. If you wish to be a participant in your health-related costs, you can choose the co-payment option for reducing the premium amount. 

Most of the medical insurance companies cover the cost of medical and surgical cost due to illness or accidental injuries. Further, there is a tax rebate that can be claimed under Section 80 D of Income Tax Act, 1986. Tax benefit can be availed up to Rs. 25,000 per annum under medical insurance if you are below sixty years.  The first step, of course, is what are your needs with regard to your health. You should also be able to map the expenses that you would like to bear and ones you cannot or would not want to incur.  Therefore, the maximum sum assured at a pocket-friendly premium is important.

Is it individual or is it for the entire family or for a particular member(s) such as your elderly parents or children who are to be covered under the policy. Start comparing the insurance companies and their policies as per your needs and then verify the network hospitals and the related query of your health need such as eyes, dental or general health, parental health, maternity health etc. What is crucial is to keep an eye for those clauses in the policies that can overrule or contradict one another as the medical insurance company can use these clauses to deny you any claims on your health or ailments. Also, make sure the health insurance policies suits the health need of those getting insured as sometimes the ailments and benefits under the Mediclaim policy may not be useful to you at all. These days there are several online platforms where you can search and compare health insurance policies and also leave the contact details that can be used by the representative(s) of the insurance company to get in touch with you and share the details of the policies that they have to offer. This saves a lot of time and effort and keeps you from personally calling or visiting the office of the health insurance company for taking a decision. Currently, India has nearly 200 health plans to suit various needs.

An Eye for Detail Helps to Choose the Best Health Insurance Policy

When comparing the company and plan to choose for your health insurance, there are few pointers to keep in mind. The company from which you are planning to buy the insurance is very critical. Its credibility counts for this purpose you should check the ICR, i.e. the Incurred Claim Ratio.  Compare the ICR of the companies that are calculated each year from the amount settled as claims against the amount collected as premiums. The average of five to ten years should give you a good and wholesome picture of the health insurance company. 

The next important detail that you should pay attention to is the customer feedback or experiences shared by them about the health insurance company. If you see a tilt towards a negative feedbacks, it might indicate that after the policy is sold the after service is not as claimed or portrayed when the policy was sold to the customers. Another key information that will avoid all the headaches related to the insurance claim is how easy or difficult the claim process is that once the bills are submitted. Renewable period and waiting period to claim insurance are another two important pointers for choosing your best health policy apart from the maximum number of persons who could be covered under the health insurance. Always also see the premium amount you pay, often low premium does not indicate good health insurance plan. Always see how much is covered comprehensively under your plan.  Always renew your policy annually by asking your insurance company of any more benefit that can be added based on your credentials with the insurer. You can also increase the amount as you age or based on your health conditions

Need is the Key in Choice for Health Insurance Policy

The need decides if the policy is for an individual for a particular type of ailment that can give the benefit of cashless treatment when hospitalised, the sum for the pre-hospitalization period and after discharge or general health insurance that can be availed whenever hospitalised. In family health plans, the cover can include up to six members where policy is a floater and the sum assured can be applicable for any member of the family during hospitalisation. There are policies especially meant for senior citizens aged above sixty years up to sixty-five years for sickness and health issues that age-related. There is also an insurance plan that is meant for surgeries and critical health conditions. This may include critical illness such as cancer or heart health or kidney related diseases. These policies can be either stand-alone or they can be riders for critical diseases that are highly expensive to treat. They mostly provide a lump sum amount if the insured is found to be suffering from any of these conditions.

Maternity insurance is also being opted for these days where the person can get a policy for maternity care if they are planning to have a baby in the near future.  The policy covers pre and post the natal cost of both normal and caesarian delivery including medical coverage of baby during the insured period. Some health policies also cover the vaccination of the newborn babies and also the cost of ferrying the mother to be to the nearest network hospitals of her choice.  Accident related fixed benefit policies are yet another rider policy where in case of unforeseen eventualities the insured person gets the benefit in case of death, or any physical disability caused other than the sum assured.  Most of the insurance companies have now stated to consider sickness of pre-existing forms to claim health insurance if the insurrection has specified any illness that was pre-existing in the insured after either two years or after the waiting period is completed.

There also health insurance policies that are meant for preventive healthcare these includes checkups of health on a periodic basis, medical consultation charges,  examinations such as x rays, etc. the objective is that insured person can take precautions and also if there is any ailment, it could be detected on time for proper treatment.  In India, preventive health care is slowly picking pace as there are many ailments that are now being detected due to poor lifestyle rather than age. These health policies allow a person to keep an eye on their health condition on a regular basis rather than falling sick due to serious ailments arising from lifestyle when it is quite late to treat as well as expensive. Also, now there are also health policies that are Unit linked called Unit Linked Health Plan or ULHPs as they are popularly known. They not only provide the health insurance coverage but also help in accumulating a fund that can be used as per your health needs during the waiting period. These can be applied especially for those diseases that were pre-existing and were not covered under the waiting period.  Also, check with the health insurance company if you can switch as it can sometimes be advantageous. There is also restoration benefit plan for family floater scheme in case you have already availed the sum assured.

FAQs:

1. How much is the health insurance per month for a single person?

Most health insurance company have premium calculators based on your the sum assured. The variation for a similar sum may exist between health insurance company.

2. Which Mediclaim policy is best for the family?

Family floater and senior citizen Mediclaim are best for families as they provide cover to entire family including children and elderly parents who might be suffering from age-related ailments.

3. What is the difference between health insurance and Mediclaim?

Mediclaim is a health insurance policy under indemnity policies where you can avail cashless treatment or claim for reimbursement by submitting bills to your health insurance company. Health insurance is mostly traditional benefit policies that pay the sum assured in case of accidents or diagnoses of ailment or health condition.

4. Are parents covered under health insurance?

Parents can be either covered under family floater scheme or another Mediclaim for a senior citizen or predicting ailments can be bought for them as a rider to meet their medical needs.

5. What is a family floater plan?

This indemnity Mediclaim policy also provides coverage to other members of the family of the insured who have been added along with primary person insured. The claim can be availed by any of his dependents who are covered under the Mediclaim policy.