Wading through health insurance plans can be quite intimidating since the terminology is often unfamiliar and confusing.
While zeroing down on a health insurance, finding your way through to the best plan that suits you is a tedious process. Here is a checklist to consider before buying health insurance. Hopefully, these tips will leave you a bit more healthy, wealthy, and wise.
- Claim Settlement Efficacy: Higher the settlement ratio and faster the settlement time is generally means that the insurance provider is doing a good job with genuine claims.Claim settlement time and claim settlement ratio should be one of the most important factor that must be considered.
- Co-Pay or Co-payment: Co-payment mandates that as a policyholder you will bear a pre-defined percentage of the claim amount and the rest will be settled by the insurance company. It is a general clause with most group health insurance policies (your employer provided policy). While you may find an insurance plan to be cheap, it may not offer you compete coverage if it comes with a co-payment clause.
- Day-care procedures: Mostly, day-care procedures are not covered when you buy health insurance. To make a medical claim, hospitalization for at least 24 hours is mandatory. Thanks to numerous innovations in technology, today, most procedures do not require hospitalization. Thus, it is best to opt for a plan that covers maximum number of day-care procedures. For instance, dental surgery. Treatments taken in the out-patient department (OPD) are not considered under Day Care Treatments. So a dental clean up would be considered as an OPD procedure while a dental surgery would be reimbursed as a day care procedure. Moreover, the list of treatments covered depends on the plan you select.
- Network hospitals: In cashless hospitalization, all of the medical expenses covered in the insured’s policy are settled directly by the provider with the hospital. Cashless health insurance is one of the most necessary aspects of a health insurance plan, and most health insurance firms offer cashless hospitalization to its customers. It is also an important factor to consider if you travel or move cities. Your health insurance should travel with you. Also, cashless facilities can only be availed in network hospitals.
- Pre/Post Hospitalization: During hospitalization, some part of the treatment extends a little further. Follow-up visits to the doctor, medicines to be taken or follow-up investigations to be done fall under the category of post-hospitalization expenses. Only those expenses relevant to the ailment for which you have been hospitalized will be claimable.There is provision to claim these expenses through your health insurance policy.These expenses are payable for a policy-defined period. Both pre-hospitalization and post-hospitalization expenses can be claimed only after the settlement of the main hospitalization claim.
- No claim bonus: Insurance companies offer a no-claim bonus/discount, in case, you make a claim-free year. In such a case, either the sum insured is increased or the premium decreases or both. Depends on the insurance provider.
- Maternity Benefits: If you’re planning a baby, it is important to check whether the policy offers maternity coverage. When you buy health insurance, women need to ascertain four key points:
- waiting period applicable for claiming maternity expenses
- Consider the Room-Rent;For instance, if room rent cap in your plan is Rs 3,000 per day and you stay in a room that costs Rs 5,000 per day, you will have to pay the difference of Rs 2,000 from your pocket.
- Free medical checkup: Buy health insurancethat entitles policyholders to a free medical check-up. The tests/checkup has no bearing on the premium when policies come up for renewal.
- Lifetime Renewal: A health insurance policy that can be renewed lifelong, therefore, it doesn’t have any age limit for the renewal. Extremely important factor to consider if you’re planning to cover your parents in your policy.
If you happen to be self-employed or an entrepreneur, then it is essential to have a comprehensive plan covering the entire family. If affordability is an issue, you can always buy a basic plan and supplement the coverage amount with a top-up or super top-up plan as per your needs.
Regardless of your income level, your family too needs protection. Moreover, if any member of your family faces any medical emergency, you will have to shoulder the responsibility of paying the medical bills. Give your family the gift of health insurance. You might want to give it a thought to avoid burning a hole in your pocket with those costly medical bills in the future.
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