The Ideal Checklist to Consider Before Opting for a Health Insurance Policy

With the rising healthcare expenses in India, one cannot afford to ignore health insurance for long. When you purchase comprehensive health insurance from a reputed insurer, you’re safeguarding yourself against sudden medical emergencies that can cost a lot.

But with the rising demand for health insurance plans, the number of options available is also rising rapidly. To help people pick the best health insurance plan from the rest, we’ve curated an ultimate checklist that will assist you in choosing the right plan ideal for your requirements.

Here is the list of checklist items to consider before purchasing a health insurance policy:

Also read: 10 Easy Tips to Choose Affordable Health Insurance Plans In India

• Choose insurance policies wisely

There are two main health insurance policies, they are individual and family floater health insurance. In an individual health insurance plan, only one person is secured against medical emergencies.

This plan is ideal for unmarried people or those who don’t have any dependents and are looking forward to securing only their medical needs. Family-floater, on the other hand, refers to an insurance plan wherein all family members are covered under a single plan. Under family-floater plans, the premium amount and total sum insured is shared by all the family members covered in the policy.

You first have to assess and decide if you want to purchase separate health insurance plans for each of your dependents or secure them all under a single policy. Choosing to secure all your dependents under a single family-floater plan will be less expensive than securing them individually.

Plus, it will also save you from the hassle of managing multiple health insurance policies simultaneously. You should look for a comprehensive health insurance policy that covers you and your dependants under a single plan.

• Check the list of network hospitals

Every insurance company in India has tie-ups with some hospitals that the insured can visit for cashless hospitalization. You should check the list of approved network hospitals before finalizing any policy to know if the list includes some multi-speciality hospitals or not. The location and reputation of hospitals also matter, so make sure you thoroughly check the list of network hospitals before finalizing any policy.       

Also read: How to Choose Health Insurance Policy for Diabetes Patients

• Look out for the co-payment clause

A co-payment clause requires the insured to pay a certain amount of the hospital bill, and the insurer pays the remaining. Usually, you can see the co-payment clause around 10% to 15% of the bill amount, but it can vary. The higher the co-payment percentage, the higher you’ll have to pay from your own pocket.

If you don’t want to pay a considerable amount for sudden medical emergencies, opt for a health insurance policy with no or minimal co-payment charges. Such policies will be expensive, but they will save you from unexpected medical expenses on a future date.

• Go through the room rent restrictions

All health insurance policies come with varying room rent restrictions that you must be aware of. Some policies may have a fixed amount on the room rent, while some may offer 1% or 2% of the room rent.

Also read: Do You Have a Health Plan? Time To Get a Super Top Up Policy

If you want your dependents to get treated in good hospitals, be sure the room rent limit is on the higher side, as speciality or reputed hospitals charge a higher room rent than others. Also, check if there are any sub-limits imposed to prevent unpleasant surprises during claim settlement.

• Look for coverages that assist in pre-existing conditions

Pre-existing conditions refer to any ailment, disease, or condition that a person was diagnosed with up to 2 years before buying any health insurance plan. Diabetes, hernia, osteoporosis, hypertension, psychiatric illness, cataract, thyroid, non-affective arthritis, and varicose veins are some of the pre-existing conditions that come with a waiting period in health insurance policies.

If you have any pre-existing conditions, you should check the waiting period for those conditions to get covered.  Some policies may have a minimum waiting period of 2 years, while some may have a waiting period of 4 years. So when comparing policies, make sure you also compare the waiting period of pre-existing conditions. The lesser the waiting period, the better!

Also read: What do you need to know about Healthcare Medical Billing?

• Choose comprehensive coverage over a lower premium policy

The sole purpose of getting a health insurance plan is to secure oneself against financial emergencies arising out of sudden hospitalizations or treatment. You wouldn’t want to get stuck with a limited-coverage policy that fails to cover you during medical emergencies. A comprehensive policy offers the best coverage; hence, the premium amount is higher. You can also take additional add-ons if you want more coverage.

You can compare multiple health insurance policies against features, and premium amounts to find out the best available option. If you’ve decided the type of coverage you want, but are uncertain of the premium amount, take the help of online premium calculators. An online health insurance calculator can be used to find out near-accurate premium amounts for customized health insurance policies. When you have these many details to compare, you’ll probably end up picking the best available option.

• Check for cashless network hospitals

Health insurance providers partner with hospitals to provide a seamless, cashless hospitalization experience. It saves the insured from arduous paperwork and funds arrangements that usually take up much time during admission. Also, the funds are transferred directly to the hospital by the insurer, so you have nothing to worry about.

But not all health insurance plans have the same terms for cashless health cover, so be sure to check it out. Look for the list of empanelled hospitals you can turn to for cashless treatment, and also enquire about the cashless health cover limit.

• Check the exclusions

The worst mistake one can make while purchasing health insurance is assuming it will have all the benefits other similar policies from different insurance company’s offer. All insurance policies come with specific exclusions that you should be aware of before finalizing any plan.

For example, not all health insurance plans include maternity benefits, and you may have to purchase an add-on to get it covered. There are several other exclusions similar to maternity benefits that you should check out to avoid any trouble at a later stage.

Also read: What Ailments Are Covered Under Critical Illness Insurance?

• Availability of free medical checkup

Certain health insurance policies cover the insured for a free medical checkup. It can greatly benefit those who have taken a family floater plan, and whose dependents usually visit a doctor for a yearly medical checkup. You can end up saving a few thousand because of this facility alone. So look for insurance plans that include a free medical checkup in their plan.

• Invest in policies with maternity benefits

With the costs associated with pregnancy increasing day by day, women should secure themselves by taking a comprehensive health insurance policy. If the policy doesn’t include maternity benefits, check if the same can be availed by purchasing an add-on.

Most insurance plans don’t include it, so if you’re able to find one that does, you might want to consider that. But before purchasing it separately, don’t forget to ask about the available waiting period for claiming maternity expenses and any associated sub-limits.

• Look for pre & post hospitalization coverage

Nothing can be better than finding a health insurance policy that covers both pre and post-hospitalization expenses. Medical expenses start from a visit to the doctor, and it keeps piling up as a person undergoes tests and buys medicines. These are pre-hospitalization expenses that we often ignore.

And once you’re discharged from the hospital after being admitted for treatment, your post-hospitalization expenses like routine check-ups with the doctor, tests, and medicines also make up a considerable amount. If you want to secure yourself against these expenses as well, look for a policy that covers both pre and post-hospitalization expenses with generous limits.

• Opt for policies that offer lifetime renewability services

Young individuals should prefer buying health insurance policies that come with lifetime renewability services. It is because you may not have any diseases currently, but the chance of getting diagnosed with an illness during old age is inevitable. It is then when you can take advantage of this feature.

Besides the points included in this checklist, also check the reputation and claim-settlement ratio of the insurance company you’re considering to proceed with. If you evaluate a health insurance policy against all the points discussed above, you’re certain to find the best policy, ideal for your requirements.