What Questions Should I Ask When Buying Health Insurance?

When the second wave of coronavirus is engulfing India dangerously, health insurance is the most significant investment you can ever make to fight a financial crisis arising out of a medical emergency. A good insurance plan is one wherein the health insurance company compensates you for 100% of your total hospital bills. However, the availability of so many health insurance policies makes ‘choosing the right policy’ a tough task. What else? A lack of awareness often results in choosing a bad product. Most of us tend to choose insurance that is affordable, irrespective of it offers the required cover or not.

To enable you to settle for the right health insurance policy, ask your insurer the following questions:

What type of health plan you are providing me?

‘What type of health plan is it. This is the first question you should ask the insurance provider. The most common types of health insurance plans on offer are Individual Health Insurance Policy, Family Floater Policy, Critical Illness Plan and Senior Citizen Insurance Plan. Exercise your due diligence and check all the benefits of each plan, then choose one that is suitable for you.

What are inclusions or coverage under the policy?

Health insurance plan coverage or inclusions is a set of conditions that are covered by the plan. The coverage may include pre and post-hospitalization, hospitalization charges, in-patient hospitalization, laboratory tests, ambulance services, prescription drugs, organ donor charges, doctor fee, nursing costs, and more. It is advisable to read the policy document carefully to understand the exact coverage offered by the plan.

What are the common exclusions under the plan?

Exclusions under a health insurance plan are the condition that the policy does not cover. Some health insurance plans do not provide coverage for the treatment of certain diseases in the first year but after a waiting period. Some common exclusions include expenses incurred due to participation in any adventurous sport, medical costs arising out of self-inflicted injuries including suicide, pre-existing conditions are not covered during the waiting period, cosmetic treatments, venereal or sexually transmitted disease, treatments related to dental, hearing, and vision, cover for accidents due to participation in defence operations and expenses incurred on treatment of obesity.

These exclusions may differ from one plan to another. It is therefore important to be aware of all the exclusions to decide which health plan is most suitable for you.

How much does health insurance cost in India?

As per the data,Rs 5 lakh family floater covering self, spouse and one child will cost anywhere between Rs 10,000 and Rs 17,000 per annum. An individual health plan with the sum insured of 5 lakh cost a 35-year-old Rs 4,000-7,000 a year. The cost of the policy is the premium or the amount paid monthly to the insurer by the insured person. It is required to keep your health cover active. The cost of the plan depends on the type of policy you choose and the amount of coverage you needed.

Does your policy cover routine tests?

There are many health disorders that require a routine medical health check-up. So asking whether or not your health plan will pay for your routine health check-up is paramount. Many insurance plans provide coverage for this medical expense incurred on a medical routine check-up.

How is the policy premium decided? 

Age is a major factor that determines health insurance premiums.  The older you are, the more prone you are to illness. That’s why the premium cost will be higher. Moreover, medical history also has a pivotal role to play to decide the premium. If you are healthy with a healthy medical history, then your insurance premium will be low. Apart from all these, different features and benefits also determine health insurance premiums.

When can I avail cashless treatment?

In general, every health insurance company has a tie-up with healthcare providers to offer cashless treatment to the insured. You can avail cashless treatment if you are admitted to one of the network hospitals. So, ask your insurance company about the list of network hospitals to avail of medical services without paying even a single penny from your pocket.

How many times can I file claims in a year?

The number of claims depends on the sum insured. You can raise claims until the sum insured amount exhausts. However, you cannot file claims for the same disease to the same person within a policy year (for details, check policy document). It is good to understand it with the health insurance provider at the time buying health insurance.


These are some common questions you should ask when buying health insurance. Another critical thing to keep in mind is either health insurance policy you choose to buy, go through the policy wordings carefully and completely. In addition to all, do thorough research to buy a health insurance policy that is truly valuable in terms of coverage you get and the premium you pay.

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