10 Vital Factors to Consider When Choosing a Health Insurance Plan

With rising medical costs and degrading quality of life, having health insurance is important. It is even more important to choose the right health insurance cover so you can protect the health and well-being of you and your family.

Having just any health insurance policy is not enough. Most people with insurance coverage are only under the illusion of being protected. The reality is often revealed when they make a claim, only to face rejection.

To avoid being in such a position, here are the 10 vital factors that you need to consider, to choose the best health insurance plan.

1. Sum assured

Choosing the appropriate sum assured for a health insurance policy is essential because you neither want to be under-insured nor over-insured.

A few important things to consider for getting appropriate coverage, are the city you live in, your family’s medical history, diseases you are susceptible to, and their treatment cost, cost of the standard of hospitals you would want to be admitted in and your budget.

2. Type of plan

Individual and family floater are the two basic plans for a health insurance cover. The justify you should opt for depends upon the number of members in your family, their health and any pre-existing conditions.

If it’s just you, your spouse and children, it’s advisable to opt for a family floater plan, provided no member has any critical disease.

3. Waiting period

Most health insurance covers have a waiting period ranging from 60 to 90 days during which no claims can be made. There are different waiting periods for pre-existing diseases, maternity benefit and other benefits.

It’s essential to look for a health insurance policy with the minimal waiting period because you don’t want to be unprotected for a long time, despite having a health insurance cover.

4. Co-payment clause

The co-payment clause means that while making a claim, you have to bear a part of the total cost depending upon the amount or percentage that was agreed upon as per the policy.

The health insurance policy that has a higher co-payment percentage will charge a lower premium as the financial burden on their part is reduced. On the other hand, health insurance covers with a low co-payment percentage will charge higher premiums.

Therefore, it’s important to thoroughly go through the terms and benefits of a policy instead of just focusing on getting a good premium.

5. Lifelong renewability

One of the most vital factors to consider while opting for a health insurance policy is to check whether or not it offers lifelong renewability. Health insurance becomes more important as one ages and choosing a plan without the benefit of life long renewability is not recommended.

6. No-claim bonus

No claim bonus is a benefit provided by the insurance company as an incentive for not making any claims during a year. In case of a claim-free year, the insurer may increase the sum assured without charging extra premium or decrease the premium without decreasing the sum assured.

While choosing a health insurance policy you should look for one that provides the maximum no claim bonus.

7. Network hospitals

The best health insurance plans offer cashless hospitalization benefits if you get admitted to any of the listed network hospitals.

Cashless hospitalization is a significant benefit especially in case of emergencies but it can only be utilized if there’s a network hospital close to your home or the kind of hospitals listed match your needs. Going through the list of network hospitals is necessary before buying health insurance coverage.

8. Sub-limits

Health insurance covers usually have a percentage restriction for a particular expense, like doctor’s consultatfees fess, ICU charges, ambulance charges and room rent cost, while making a claim.

It’s crucial to scrutinize all sub-limits while opting for a health insurance policy because you don’t want to be caught off-guard later while making a claim.

9. Claim settlement ratio

The claim settlement ratio tells you a lot about an insurance company. It is the ratio of the number of the claims settled to the number of claims received. While some insurers may offer very appealing benefits, their claim settlement ratio may be poor, showing the real picture. Hence, you want to opt for a health insurance policy from a company with a good ratio.

10. Premium

The common mistake many people make is giving too much importance to the premium while selecting a health insurance cover. While it is definitely central to the plan, the amount of premium charged ultimately depends upon the kind of terms offered in addition to the sum assured.

Only after considerable research and careful consideration of these 10 vital factors should you buy health insurance. With the help of online health insurance, the needed research and comparison between health insurance plans in India is easier to carry out.

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