The Buyt Desk
First-time health insurance buyers struggle with the nuances of a health insurance plan. Here is a guide that might help you in narrowing down your selection.
The Indian health insurance market has many players. And each company has hundreds of health plans. Under such situations, it becomes really difficult to choose one which meets all of our requirements. Before looking for health insurance, you should question yourself about why you need it, how much you need and what facilities you need. Only when you clearly know what you are looking for, sizing down health insurance from many becomes easy. You need to prepare a checklist of important things you need in your health insurance and prioritize each item. When you are a first-time health insurance buyer you need to know many things about health insurance. It is daunting to finalize a health plan for yourself and your family. The jargon used by the insurance company to explain the plan makes it even more difficult. So it is better if you know all this in advance to understand the policy better. There are a few factors that you must look into. Here are a few such things that you should know as a first-time health insurance buyer.
Things you should know as a first-time health insurance buyer
The Insurer’s reputation – Be aware when you find some suspicious plans like the ones which are less expensive yet provide more coverage than the normal standard. This might be because the insurer has no good reputation in the market and not many are buying insurance from that company. The reputation may be down because of bad customer service, poor claim facility, poor claim settlement or some fraud. Go through customer reviews online before deciding on the insurer.
Fast and trouble-free claim process – The claims process should be simple and not troublesome. The claim settlement should happen fast without taking much time. Only such insurers can be considered for buying health plans. Good customer support is a must.
Room rent restrictions – Not all plans allow you to pick the room of choice during hospitalization. Some plans cover only a certain grade of rooms and if you go for a higher grade, you have to bear the room rent. So go for plans that do not cap on room rent or choose the one with a larger cap.
Disease-specific limitations – Some low-cost health plans have limitations for certain diseases which means only certain coverage will be provided and not full.
Insurance amount – Deciding the coverage you need or arriving at the sum insured is a difficult task. At various moments you will feel that the insurance amount is less and you need to increase it. And at some point, you will feel it is too much and you are paying higher premiums. When deciding the insurance amount takes into consideration your age, current health condition, family medical background, possible medical expenses in near future, ability to pay premiums and your emergency fund. Make sure you won’t fall short of cover during health emergencies nor do you pay a very high premium disturbing your day to day living.
Pre and post hospitalization cover – Always opt for pre and post-hospitalization cover as these costs are as expensive as hospitalization. Pre and post-hospitalization costs include diagnostic tests, ambulance, medicine, nurse service and many more.
Waiting Period – Health plans have a waiting period for certain conditions/ diseases before they are covered under insurance. So go to a health plan that has no short waiting period.
Network hospitals – Check the insurer’s list of network hospitals that provide cashless service. This list should be vast and cover all the hospitals that you may need.
Restoration benefit – As the healthcare costs are increasing day by day, the sun insured this year may not suffice in the coming years. You may need higher coverage as age advances and due to inflation in the costs. So go for a health plan that has restoration benefits which means you can enhance your coverage in future.
Co-payment and deductibles – Some plans offer deductibles wherein the insured will bear a certain percentage of every claim made. Co-payment is when the insurer will pay only when the bill crosses a certain amount. Do not go for plans that demand co-payment or deductibles.
Exclusions – Every health plan has a list of exclusions. This list contains diseases and health conditions that are not covered by the policy. So go through this list before buying insurance.
Riders or Add-ons – When certain diseases or health conditions are not covered under the policy but you want them to be covered, you have to go for health insurance riders, also known as add-ons. This comes with the cost which is added to the premium. You can buy these riders at any juncture and not necessarily at the start.
