How to decide on the best health insurance plan for the family?
There are many health insurance companies selling health insurance products in different propositions in India. But the most important thing is what you should know before buying a health insurance policy?
Selecting a health insurance company and buying the right health insurance policy is not an easy task.
You will find key decision-making points here and the terms. These points will help you to understand health insurance better. Please read this article before making a decision. This will guide you to buying a health insurance policy.
Key Points you should know before buying health insurance
You should keep the following factors in mind before making a choice to buy health insurance. Read the points that you should know before buying health insurance.
- Claim Process and cashless hospitalization
- Family Health Insurance
- Selecting the right insurance amount
- Network Hospitals
- Maternity Benefits
- Pre and Post Hospitalization
- Lifetime Renewal
- Free Medical checkup
- Capping and Co-pay amount in the policy
- Pre-existing diseases and waiting period
- Sum-Insured and Policy Premium
Claim Process and cashless hospitalization
The simpler & faster the cashless hospitalization process, and the faster the claim settlement process, the better is the insurance company or health insurance policy.
These are the 2 major factors when it comes to the selection of a health insurance policy.
- Faster Claim settlement and cashless hospitalization process.
- Faster the discharge and claim approval process.
Good customer support is an important additional advantage one should look for.
Family health insurance
A family floater plan is always a better choice. Make sure that you do so. Keep your family members and their details including age and present ailments ready.
The medical history of family members and themselves should be disclosed with honesty. No fact or information should be hidden. If any pre-existing illnesses like heart diseases, hypertension, diabetes, etc. should be disclosed.
Selecting the right Health Insurance amount
You should select the amount wisely and should keep in mind a few factors. Like income levels, a premium amount that is not too exorbitant and a sum insured which will not fall short in case of emergency.
Take your age into account; the younger you are, the lower the sum insured you need.
Network Hospitals for Cashless Hospitalization
Check the Network of Cashless Hospitals when you decide to buy a health insurance plan. A hospital near to you, offering 24*7 emergency medical services and an enrolled in-network hospital’s list is the better choice.
If you visit a non-network hospital you will have to pay the total billed amount from your pocket first. After that, you will have to send bills to the insurance company directly for claim settlement. This is called the reimbursement process. which can be a tedious and time taken process.
Health Insurance Maternity Benefits Coverage
It is advisable to buy a health insurance plan that offers maternity benefits. Maternity expenses are very high and most retail plans do not give maternity benefits coverage.
Choose a policy with maternity benefits if you are planning your family in the coming years.
One more important thing in regards to maternity benefits, you should check the waiting period applicable for maternity benefits in the policy.
Pre and Post Hospitalization Coverage
Choose a plan which gives you the benefits of pre and post-hospitalization. Generally, 30 days of pre-hospitalization and 60 days of post-hospitalization expenses are offered by many health insurance companies.
Pre hospitalization expenses include:
- Doctor’s consultation fee
- Investigation tests are done to diagnose the disease
- Expenses on medicines for the treatment before hospitalization.
Post hospitalization expenses include:
- Medicine used after discharge from hospital
- Investigations if any
- Follow-up Doctors consultation Fee
- Any other procedures like dressing change
Health Insurance Lifetime Renewal Plan
Nowadays few insurance companies have started offering lifetime renewal products. This is recommended to look for health policies that offer lifetime renewability. There are higher chances of suffering from diseases when you are old compared to when you are young. As you grow older your policy premium also increases with the age so better to choose a lifetime renewal plan.
A health policy that offers lifetime renewability is what you should definitely buy without a second thought in your mind.
Free Medical checkup options
You should go with the policy that offers free medical health check-ups. Insurance companies claim that this does not affect the premium. But you should always check with the insurance company if this will impact your renewal premium or not. This helps to diagnose life-threatening diseases like obesity.
Calculate the cost of extra premium paid and the cost of tests included in the medical health-check package. This will help you to make a decision accordingly.
Capping and Co-pay amount in the policy
You should know about the terms written in policy like co-pay and capping. Co-pay is an amount to be paid by the insured against the total bill or expenses incurred.
Generally, co-pay is defined as a percentage in the policy. Insured or policyholder has to pay the co-pay amount to the hospital. Or if you are going for the reimbursement, then the insurance company will pay you the amount after deducting the agreed co-pay as per policy.
Capping is a limit defined against a procedure or the type of treatment in health policy. For example, if there is a capping on a medical procedure of INR 100000/ and the total bill amount is INR 120000/. The insurance company will pay you only INR 100000/ and you will have to pay the remaining INR 20000/ from your pocket.
Pre-existing diseases and waiting period
The ailments and diseases that policyholders had before buying the policy were called pre-existing diseases. These can be Obesity, hypertension, cardiac disease, diabetes, Liver Failure, kidney disease, etc.
This is the point where most the policyholders do a mistake that causes a big loss to them and cashless claims are denied. Insurance companies deny the claim if found any past history of pre-existing disease in the medical records of the patient.
Non-Payable and Non-medical expenses
Insurance companies do not pay for Non-payable items like some consumables and disposable medical items. Insured or policyholder has to pay these items to the hospital as per the IRDA guidelines.
So never think that everything will be covered if you have a health insurance policy. You have to pay a minimal amount for a few items from your pocket. These items are called non-medical expenses or non-payable items.
Sum-Insured and Policy Premium
Sum-insured is an amount that is a total limit of your policy that will be paid by the insurance company against the medical expenses incurred.
Premium is an amount that is paid by you to the insurance company to buy a policy or renew the policy
If you will keep these points in your mind before buying the health insurance policy. I am sure you will be able to get the right health insurance product/policy.
The right product selection will give you long-term benefits. Please make a note and do not forget to renew your health insurance policy before the expiry date. Older the policy maximum are the benefits. If you forgot to renew your health insurance policy and there is a gap in between then you may lose your benefits of covering pre-existing diseases and waiting periods.
I hope, now you understood what you should know before buying a health insurance policy.
