Your checklist to buy the right health insurance policy

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There are multiple health insurance policy providers in India. How do you then make a choice? By now, we are aware of the general benefits of our health insurance. Yet, it is not so simple to choose the best policy. Every insurance company will try and offer the best, to the buyer. They will perhaps (seemingly) offer more or less, similar benefits.

There are various factors to choose from while buying a health insurance policy, most importantly, what your healthcare needs are and how much you can afford.

For example, if Mr. X is looking for a family cover, he has multiple options to consider. Yet, it is likely that he will only consider-

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· The premium amount (as that is the expense)

· The insurance coverage amount (as that is his benefit)

· Cashless payment (as that will offer him convenience)

· Insurance provider (usually referred by a friend or family)

Illustration: Mr. X is a 35-year old engineer who is working in an MNC. His annual salary is Rs 15 lakhs per annum. Though he was aware of health insurance policy, his knowledge was limited. Last month he came to know that his former colleague (Y) bought a health insurance policy. Since it was on his mind too, he decided to buy one. He consulted Y and bought the same insurance coverage of Rs 10 lakhs at an annual premium of Rs 12,000. Now X is a happy man, and his family is insured. He doesn’t have to worry about hospitalisation expenses.

So, what is wrong? Well, nothing except that he had much more to consider.

Your checklist

Point to be consideredTo-doScenario
Long-term outlook
Estimate the right insurance coverage amountCompare the listed benefits by sourcing multiple insurance policies quotes. Also, be sure if you want a high insurance coverage at a high premium, or you want low premium and higher out-of-pocket expenses.X is seeking a family cover, for insuring his wife and one child. His mediclaim insurance coverage amount of Rs 5 lakh is now not sufficient. He is planning to have a second child and also has a 3-year old child to care of. He can increase his insured amount at a slightly higher premium cost now.
Don’t delay buying a policyBuy a basic health insurance cover at an early age, even if you don’t feel the need for it.X is 35-years old. He should buy a policy as treatment cost is very high now. He will only end up losing his income and savings. Also, if a health calamity strikes him, he is likely to be denied a health insurance later offered a policy at high premium rates..
Assess your lifestyle Understand the most-suited health insurance cover. It should be tailor-made for you. The future health risk assessment has to be considered.X is a smoker, therefore at high risk of suffering chest infections. He has a family history of heart attacks. He is also prone to heart problems.
Hospital networkCheck the list of hospital network of your insurance provider. Make sure you get maximum coverage.X’s father suffers a stroke. He needs to be hospitalised immediately. He is living in Delhi. If X doesn’t have a hospital close by (covered under his health insurance policy), he is likely to lose precious time or income.
Excluded disease/ Sub-limitRead the policy document carefully. Know about what is not covered under the policy.X is a hernia patient. The treatment expense for this health condition is not included in his insurance policy. He will have to foot his surgery bill on his own.
Hospital room capping Your health insurance policy has hospital room capping too.X is in the hospital. His room rent limit is Rs 5,000. His room cost is Rs 8,000 per day. At the time of discharge, he would have to pay Rs 3,000 from his pocket.
Tactics
Select inclusionsKnow what is not required so that you pay the right amount of premium.X is living in Delhi with his wife and two kids. He doesn’t need to go for a maternity cover under his health insurance policy.
Policy tenure Opt for long-term policies, if you require it.X is a busy man and forgets to renew his policy in time. He will be a loss if his policy lapses. He can go for a 3-year period.
Claim procedureRead the terms and conditions carefully.X should know how to approach the insurer and what are the documents that should be submitted to settle the claim. He should have a clear understanding of the claim procedure.

With the rising medical costs across the globe, a health insurance policy can help you stay relaxed and financially protected during medical emergencies. With the right health insurance policy, you can easily save thousands, perhaps even tens of thousands. On the face of it, all insurance policies will look same and therefore, it makes complete sense to read the policy document carefully.