Top Things to Consider When Buying Health Insurance Policy in India

Life is full of surprises and not all of them turn out to be good specifically if it's related to our health. In the time and age we are living in, it has become important to have a health insurance policy in place. However, with a plethora of health insurance plans available in the market, sometimes one may find themselves being confused as to, which medical insurance plan to go with. In this article, we have covered the key aspects that need to be taken into consideration to make an informed decision.

Factors to Consider When Choosing Health Insurance Policy in 2024

Here’s a quick rundown of the factors that should be considered by any individual planning to buy mediclaim insurance for themselves or their family:

Waiting Period

It refers to the period within which the insured cannot raise any claim against the medical insurance. This is usually applied to any pre-existing diseases or ailments. The duration for it varies from insurer to insurer and also as per the plan chosen. Before one chooses the plan, ensure to check the waiting period on the health insurance plan.

Co-payment

It refers to the claim amount percentage that will be borne by the policyholder during a health insurance claim. This implies that the insured and insurer will split the medical bills wherein the insurer will pay a higher sum. The smaller part will be settled by the insured. For instance, if the insured has a 20% co-pay, the insurance company will bear the reaming 80% of the claim amount. When opting for a high co-pay, enables lowering the health insurance premium. It means that the insured will have to pay a large sum during claims. It's important to understand that a lower co-pay does increase the premium but the insured will pay less during claims. There are health insurance companies that come with a mandatory clause for the co-payment while some offer the insured to opt for a voluntary co-payment sum.

Pre/Post Hospitalization Cover

It encompasses any tests, doctor visits, treatment, and so forth that are conducted either before or after the insured gets hospitalization. The terms and conditions will vary as per the insurance company and plan chosen. Generally, health insurance plans offer a cover for the expenses incurred during hospitalization. However, check with the insurer and go with a plan that offers cover for both pre and post-hospitalization expenses.

Day Care Procedures

There are specified treatments that can get completed within the day itself. Those medical procedures require hospitalization but less than 24 hours. So while buying the policy, ensure that such treatments are covered within the plan. These procedures could be tonsillectomy, nasal sinus aspiration, cataract surgery, and much more.

Room Rent Capping

When hospitalized, the hospital may charge a room rent for the time till the patient is admitted. In a hospital, there are different types of rooms. Right from a general ward, semi-private rooms, private rooms, and so forth, with different rent for each. Insurance companies at times set a maximum room rent limit within an insurance plan including a cap on the ICU rent rooms too. It means if the insured chooses a hospital room with a higher rent, then the amount needs to be paid out of their pocket.

Cover for New-age Treatment

Compared to conventional treatment, there are advanced medical treatment options that are accurate and give better results. Check with the health insurer whether they offer a cover for modern treatment methods. Some of the new-age treatments include stem cell therapy, robotic surgery, etc.

Add-on Cover Option

The health insurance add-ons help to enhance the base plan. It's also important to understand to choose only those health insurance add-ons that you need and customize the plan accordingly. Every add-on cover comes with an additional premium amount that is added to the base policy premium.

Claim Process

When choosing the health insurance plan also research the company’s claim settlement process. A hassle-free health insurance claim process is crucial. Read customer reviews online and do not forget to check the company’s claim settlement ratio.

Wrapping it Up

When buying health insurance for family or yourself never hide any critical information from the insurer. In case you are buying health insurance for senior citizens declare their medical history. Go through the policy wording carefully and in case of any queries, get them cleared. Last but not the least, choose a health insurance plan that fits your pockets and fulfills the requirements. If you have an existing policy ensure to renew the health insurance timely.   *Standard T&C apply Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.