10 Things to Consider Before Buying Health Insurance

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Health insurance is extremely essential to safeguard our investments particularly because of the current coronavirus scenario and the uncertainty of a medical emergency. With insurance plans in abundance, it is quite difficult to select the best policy that could cover all your needs. However, before choosing the right insurance policy and covers, there are a few important things that need to be kept in mind. Before you pick a policy, it’s important to do some research and find a policy that fits your needs.

1. The Age Criteria

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

Also, you would need to check out the age limit criterion when buying a health insurance cover. For instance, there are health plans that have the minimum entry age limit of 91 days and the maximum entry age limit of up to 60 years. And there are plans that have a minimum age limit of 25 years up to a maximum of 50 years. However, there are plans that do not have any restrictions on the entry age. So, you have the option to choose accordingly.

2. The Amount of Cover

As clinical costs are on the rise, it has become basic that we consider the sort of cover we need from our medical coverage strategy. While Rs 5 lakh may appear to be a ton of cover today, it might wind up being lacking a long time from now. It’s a smart thought to factor in clinical swelling prior to settling on how much cover would be sufficient to help you and your family through a difficult stretch.

3. Claim Process

Check the policy wordings and go through the health insurance claim process that is followed by the insurance company. A smooth claim procedure is a boon at the time of settling health claims. You can do some research, read customer reviews online and select a health insurance provider that is known for its seamless claim settlement services.

4. Waiting Period

Go for a policy that entails the least waiting period for pre-existing illnesses, experts suggest.

Every policy has a waiting period for pre-exiting diseases. This means if a policyholder has a disease prior to purchasing a plan, a claim for treating the disease can only be made after insurance premiums have been paid for a certain period.

In most cases waiting period ranges anywhere from two to four years. However, some plans may have a lesser waiting period. While purchasing a policy, one should opt for the one with the least waiting period.

5. Limits on treatments and co-Payment

Depending on the kind of policy you choose, the cover you will receive for certain treatments, such as a cataract operation, could have a cap. For example, the limit on a cataract operation may be Rs 40,000. If you choose to go to a doctor who charges Rs 45,000, the extra Rs 5,000 will be an out-of-pocket expense for you. There are also co-payment clauses in insurance policies, which require the insured party to cover up to 20% of the claim settlement amount. Depending on the kind of treatment you’re claiming for, you could end up spending quite a lot of money.

6. Cashless Hospitalization benefits

Health Insurance companies usually have a tie-up with network hospitals where the insured members can avail cashless treatment in case of a medical emergency. It saves you from the tedious paperwork that is required at the time of admission and claim. Moreover, the insurer pays the sum insured directly to the hospital.

So you don’t need to arrange for funds and then file for its reimbursement. It will be helpful if you check with your insurer for the list of empanelled hospitals and know what all network hospitals are there in your vicinity. 

7. Family Health Insurance

When purchasing health insurance plans, make sure that you do so keeping your family members and their age in mind. Before buying the insurance, consider their present ailments if any as well as the family’s medical history. In addition, check with your family members for any pre-existing diseases before buying a policy.

8. Claim settlement ratio

The claim settlement ratio shows the percentage of claims the insurance company has paid out during a financial year. Higher the claim settlement ratio, the more confidence a policyholder can have on the insurance company.

To check the ratio, one can visit the Insurance Regulatory and Development Authority of India (IRDA) website and browse through industry data.

9. Coverage of Maternity Expenses

Ignoring the maternity benefits in a health insurance policy is a common mistake that a lot of people make. With the cost of delivery and maternity care already hitting the roof, it is better to buy a health plan that covers maternity expenses as well. Usually, there is a waiting period of 2 to 4 years before you can claim the benefits. For instance, if you are planning to get married or are planning a family let’s say after three years then a plan with a waiting period of 2-years will work for you.

Choose a plan that also covers newborn baby medical expenses apart from the delivery cost. Also, do not forget to check the limitations that are attached to it.

10. Pre/Post Hospitalization

Before hospitalization, you visit the doctor, get medicines, and undergo tests. You are hospitalized and after treatment, some expenses occur the expenses include follow-up with the doctor, medicines to be taken and many others. Choose an insurance plan which covers these aspects too.