For a Health Insurance policy, there are some basic parameters which you need to consider before making a choice.
- Hospital Tie-up – At how many hospitals is cashless hospitalization valid. The larger the list, the better it is for customers.
- Sum Insured – The total maximum value which the insurer will pay in case of hospitalization, illness, surgery etc.
- Premium – The amount you intend to pay as premium. This premium is exempted from income tax under Section 80 D.
- Top Up Plans – As an option to increase the sum insured on your existing policy so that the overall cover can be increased.
- Type of Surgeries Covered – The smaller the exclusion list of surgeries not covered, the better it is.
- Issuance of Policy with any Existing Pre-Condition – Whether the policy will be issued in case of any existing ailment. There are insurers, who in case of pre-existing conditions, prescribe a medical test and take a call whether to issue the policy, based on the results.
- Waiting Period – What is the waiting period after which special diseases arising out of existing pre-conditions, or special cases like pregnancy, will be covered as part of the policy. The smaller the wait time, the better it is.
You should search for health insurances online and compare the insurer’s benefits, policy guidelines and premium.
Buying a health policy online is very easy as you can compare insurers and very transparently identify which policy suits your requirements the most. You may pay the premium online and get the policy issued to you instantly in case there is no need of an immediate medical test.
The plan features and premiums vary based on Sum Insured chosen and the age of the person buying the policy. Thus, it is best to compare various available plans and choose the one that best suits your need and profile.
Some key things to choose a plan are mentioned below:
1. Cashless Hospital Network: Any good Insurance company should have a host of network hospitals connected. Reputed hospital and accessibility to network hospitals are main priorities for anyone looking for a policy. The reachability to hospital is a critical factor in cases of emergency. Cashless facility is also critical as you would want to run around for arranging the money instead of being close to your loved ones.
2. Room Rent Limit: Some plans have restrictions on the room rent limit one can opt for. In some cases, monetary limits hold, while some others apply a room-category capping. In case you select a room that is higher than your eligibility, deductions will be made on the room charges that exceed the eligibility, also all charges associated during stay in hospital are also proportionately deducted. For example, if your Room Rent eligibility is Rs. 1000 and the hospital room you selected is costing Rs. 2000, not only will Rs. 1000 per day of hospitalization be deducted, but all other charges like doctor consultations, medical checks, surgery expenditure all would be paid as per eligibility criteria, that is @ only 50% of the services charged. So, opt for a plan which has no limit on room rent or atleast offers a single private room.
3.CO - purchase this domain-Payment: Check whether your plan has any co-payment clause, which means that you will have to pay a certain percentage of the Claim amount out of your own pockets. For example: In claim of Rs. 4 Lakhs, the admissible claim is Rs. 3 Lakhs (expenses approved by the insurer as per your original claim), and Co-pay of 10%. The Insurance Company would pay Rs. 2.7 Lakhs, you would bear 10% - Rs. 30000 on the admissible claim, over and above Rs. 1 Lakh of inadmissible claim.
4. Waiting periods: Policies may have a waiting period, i.e. normally wait period is 30 days, which implies any claim arising out of illness/disease contracted within 30 days from the purchase of policy will not be settled except arising from accident. There are many diseases that are covered in a health insurance policy after a specified number of years. Few insurers might cover them after 1 year and few after 2 years or 4 years. Also, Pre-existing ailments are covered after specific number of years, which can be 2 years, 3 years or 4 years, as per insurance company.
5. No Claim Bonus: Insurance companies offer a Bonus in case you do not claim in the policy period. This is termed as No Claim Bonus (NCB). Usually, the NCB increases by a fixed percentage, say 5% or 10% of the Sum Insured, every year. This is a very critical as the medical costs are rising rapidly each year and the NCB helps you to ensure you are adequately covered. Thus, the higher the NCB percentage, the better it is. On a flipside, note that usually your NCB reduces with same percentage in case you claim in a policy year.
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