What Should I Look for When Buying Health Insurance?

Until a year back, we were not aware that a major pandemic would strike the world so alarmingly. People now understand the importance of having health insurance. Health emergencies are on the rise, insurance companies are venturing into the market with newer and better policies. But, a number of choices and complex jargons are making ‘health insurance buying’ difficult.

Don’t fret. Here is what you should look for when buying health insurance to avoid complex jargons and make any misinformed decision.

Age Criteria – When buying health insurance, consider the age of the family members who are going to be insured. Age determination is one of the crucial deciding factors in health insurance. Like in a family floater policy, premium rates depend on the age of the eldest member. In addition, when buying a health insurance cover, check out the age limit in the policy document.

  • Many health insurance products come with a minimum entry age limit of 91 days and a maximum of up to 60 years.
  • There are some plans that cover people with a minimum age limit of 25 years and a maximum of up to 50 years.
  • However, some policies do not have any restrictions on the entry age.

Sum Assured – When you buy health insurance, it is good to consider inflation and invest in a policy with high sums assured. A health insurance plan with the sum insured of Rs 300,000 and Rs 500,000 may not be sufficient enough due to the soaring healthcare costs, medical procedures, apparatus, and surgeries.

With the rising rate of inflation, heart surgery may cost Rs 3 lakh to Rs 4 lakh today. But it may cost you Rs 9 lakh to 10 lakh in the next few years. Therefore, a plan with a high sum assured is recommended. Consider inflation while buying a health insurance plan.

Premium and Coverage – Determine the right combination of premium and coverage while purchasing a health insurance product. Going for the lowest premium could be lucrative. A plan with a low premium is ideal if it offers extensive coverage. Look for the reasons why you want a low premium. Make sure if there is an additional clause of co-pay, sub-limits, deductibles. If so, you will end up paying more at the time of claim. Avoid selecting a policy with these clauses. Instead, opt for a policy that provides you with adequate coverage, without compromising on the benefits and at a premium that you can afford.

Claim Process– Claim process should be simple and claim settlement fast enough. Besides this, quality customer support is another area of concern for additional benefits. Determine these factors when it comes to selecting a policy during this pandemic.

Critical Care Policy and General Health Policy – Critical illnesses like kidney failure, cancer, tumours, stroke require expensive medical treatment and your general policy may not be enough to bear these costs. The treatment is so expensive that you will exhaust all the sum assured of your regular policy still you may require to pay from your pockets. As a precaution, it is good to invest in a critical illness policy, especially in case you have a medical history of critical illness in your family.

Cashless Network Hospitals– Always check Cashless Network Hospitals with the insurer. At the time of a medical emergency or hospitalization, hospitals in the network offer a cashless treatment option. That means the insurance company settles medical bills directly with the hospital. Choosing insurance providers with a high number of network hospitals in its network is good.

Claim Settlement Ratios (CSR) – At the time of hospitalization, the insurer financially assists you. You will never want the insurer to reject your claim or only approve a small amount of claim. To determine the credibility and legitimacy of an insurance company, check the claim settlement ratios. You will find CSR details on the insurer’s website. You will be able to see the total number of claims settled, the number of days taken to settle a claim and check the pending claims.

Check Customers Review – Before you buy a health insurance policy, check reviews of customers online. On many online forums, customers give their insight about claim settlement procedures, reasons for claim rejections, time taken to settle claims, and how easy or difficult it is to access the insurance provider. Check these forums that allow you to read detailed reviews about insurance providers.

Inclusions and Exclusions – Do remember to read the fine print of insurance policies i.e. terms and conditions of the policy. It is the document wherein insurance companies list inclusions and exclusions. For example, diseases such as STDs, HIV, AIDS are not covered under health insurance. In addition, claims for cosmetic treatments (not arising out of injuries or accidents), dental and cataract surgeries under certain policies are not allowed. So, checking what treatments are covered and which are not covered is essential so that you don’t encounter any issues while filing a claim.

Bottom Line

Now that you know the points to be considered while buying health insurance. Remember you are getting your money’s worth when investing in health insurance. Search for a trusted online portal to compare health insurance policies and get customized quotes from top health insurance companies.

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