Important Tips for Choosing the Best Health Insurance Plan

In this world of unbound uncertainties, the last thing you want is to dig bigger holes in your pocket to meet the medical exigencies. With health insurance by your side, you are completely protected against such medical costs.

Spending in the health care sector has increased significantly over the past five years. This increase can directly be compared with the rising cost of hospitalization and medical treatments. While hospitals today offer the comfort similar to a 5-star hotel, it comes at a higher cost burning a big hole in the pockets of the patients.

To cover you for these expenses, insurers today offer complex Health Insurance Policies to serve your needs.

What Is Health Insurance?

Today, the medical costs are soaring high. The amount of money required to treat a disease is significantly higher. Even a small hospitalization can cost you a high amount of money. In such a case, Health Insurance proves to be a savior. It is an insurance policy that covers you against medical, hospitalizations & diagnostic costs. While some health insurance policies cover certain critical illnesses too, some include maternity cover in their scope of coverage. Overall, it’s a great investment to protect your financial well-being in case of a medical treatment or medical exigencies.

Types of Health Insurance

In India, there are over 20 health insurance companies providing various health insurance plans. These can broadly be classified into two categories –

·         Individual Health Insurance – As the name suggests, this type of plan provides coverage for an individual. The sum insured is dedicated to a single person.

·         Family Floater Health Insurance – This policy provides a single sum insured for the entire family. If there is more than one family member to be insured, the Family Floater Health Insurance is a perfect choice. For example – If a family of 3 (Father, Mother, and Child) opts for a Family Floater policy with a sum insured of Rs.5 Lakh, any insured member can utilize the said amount during the policy period.

Choosing the Best Health Insurance Plan

Now that we know different types of health insurance coverage, choosing the right plan can be a tiresome affair. With most insurers trying to distract you with heavy insurance jargons, you might end up frustrated and completely drop the idea of having one. But, don’t worry, here are a few tips which will make you ask the most relevant questions and arrive at a firm decision.

·         Decide upon the Right Sum Insured – Depending upon the number of people requiring coverage and their age group, make a judgment about your expected yearly expenses on medical cost. For example, a person between the age group of 25-30 yrs would require a maximum coverage of Rs.3 lakh. Based on your family’s medical history, choose an appropriate sum insured. To avoid being underinsured, take an informed call. If you have a high-risk profile, then opt for a higher coverage or top up your base plan with a top up or super top-up policy.

·         Individual Cover Vs Family Floater – You need to be clear about which policy suits you best. If more than one person needs to be insured, Family Floater is an obvious choice. It is likely that not everyone will be hospitalized or incur huge hospitalization costs in the same year. Also, a family floater will be cheaper than opting for individual policies. But, if the eldest member of the household is more than 45-50 years, you might want to take a separate Individual Policy for him/her. As the premium of the Family Floater Policy depends on the age of the eldest member, adding him/her to floater policy would significantly increase the premium.

·         Capping on Hospital Room Rent – Once you have zeroed on the sum insured and type of policy, look at the capping on room rent. It’s best to choose a plan that has no limit on the room rent or the one that offers the use of a single private room in the hospital. If your policy has a capping on room rent and during hospitalization if you opt for a higher room rent, then you might be surprised to see your claim settlement amount. The hospital will charge the treatment, in proportionate to your room rent, but the insurance company will settle the claim only by the room rent capping. This will only lead you to bear the additional costs from your pocket.

·         Sub-Limits and Co-pay – Every policy has sub-limit and/or co-payments for specified illnesses or treatments. That is the maximum amount the insurer will compensate you for in case you are treated for those specified ailments. For example, some health policies have a sub-limit of 2% of the sum insured in the event of heart surgery. Check for these conditions before buying healthinsurance coverage. Choose the one which has the minimum constraints.

·         Hospital Network – Every insurance company offers a cashless facility today. But this can be obtained only in the network hospitals of the insurance company. Make a choice based on the number of network hospitals in your vicinity for convenient cashless treatment in case of a hospitalization.