Did you know that around 39 million people in India are forced into extreme poverty every year simply to cover their medical expenses? Choosing the right health insurance can shield you from such financial shocks. From coverage scope to hospital networks, understanding what truly matters can help you make a smarter choice.
Let us explore the top 13 factors you must consider before selecting a health insurance policy.
5 Factors You Should Consider About Coverage and Costs of a Health Insurance Policy
Considering the cost and coverage, it is about balancing your finances with the coverage you need. Under this area, you should consider the following factors:
- Sum Insured
Go for a health insurance policy that will cover you and your family members adequately in your city of residence. Always factor in the healthcare inflation rate, which currently stands at 12-14% per year.
- Scope of Coverage
Make sure that the policy covers all of the essential things beyond inpatient hospitalisation, such as pre- and post-hospitalisation expenses. Expenses for diagnostic tests, follow-up visits, day care procedures, and ambulance charges should be present in the insurance policy you are planning to get.
- Exclusions and Caps on Specific Expenses
Remember to review the exclusions of the health insurance policy. Most plans do not cover cosmetic surgeries, self-harm injuries, and more, so if you want them to be covered by your policy, search accordingly. Additionally, analyse the caps on specific expenses, such as room rent or certain treatments, to avoid unexpected out-of-pocket costs.
- Deductible Clauses
Go through the deductible clause of the policy coverage. Look into how much you will have to pay out of your pocket in case of hospitalisations and more. There are policies without these clauses for better coverage, but they have higher premiums.
- Customisable Coverage
Select a plan that fits your budget, balancing comprehensive coverage with affordable premiums. See if the health insurance policy has the option to pick up new add-ons or drop any unnecessary add-ons when necessary.
5 Factors You Should Consider About Policy Features of a Health Insurance Policy
Again, there are a few essential features you should consider when choosing a health insurance policy. They are as follows:
- Waiting Periods
Check the waiting period for specific illnesses and pre-existing diseases. Some policies will provide you with 30 days, and some will have a 90-day waiting period. Opt for plans with shorter waiting periods, especially if you have existing health conditions.
- Lifetime Renewability
Choose a policy that offers lifetime renewability. As per a report by The Times of India, about 75 million adults over 60 have a chronic illness in the country. Hence, lifetime renewability will make sure that you have continuous coverage even as you age, when you are more likely to need medical care.
- Network Hospitals
Verify that the insurer has a wide network of hospitals near you, especially if you are exploring medical insurance family plans. This can provide you and your family members with easy access to cashless treatment during emergencies.
- No-Claim Bonus (NCB)
Look for plans that offer a good NCB, which rewards you with a discount on your renewal premium or an increase in the sum insured for every claim-free year.
- Add-on Availability
Consider optional add-on covers, such as Hospital Cash Allowance, Non-Medical Expense Rider, or Health Prime Rider, if they align with your specific healthcare needs and enhance your base coverage.
3 Factors You Should Consider About Insurer Reliability for a Health Insurance Policy
While choosing the insurer from whom you will buy your health insurance policy, you need to keep in mind the following things:
- Claim Settlement Ratio (CSR)
You should always prioritise insurers offering a health insurance policy with a high CSR. This is because a high CSR indicates a greater likelihood of a hassle-free and prompt claim settlement process in the future.
- Claim Process
You should also choose a company known for a smooth and simple claim procedure. A complex process can add significant stress during a medical emergency.
- Insurer Reputation
Finally, before choosing a personal medical insurance policy or any medical insurance family plans, check customer reviews. With an idea about the insurer’s track record to you can figure out their reliability and quality of customer service.
Bottom Line
Checking the insurers’ CSR, reputation, policy coverage details, and the sum insured are a few essential things to keep in mind while choosing a health insurance policy. Remember, when you analyse and put in the work, you will have a stress-free future.