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, your healthcare needs and how much you can afford.
For example, if Mr. X is looking for a family cover, he has multiple options. 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 working in an MNC. His annual salary is Rs 15 lakhs per annum. He knew the health insurance policy, but his knowledge was limited. Last month, he learned 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 hospitalization expenses. So, what is wrong? Well, nothing except that he had much more to consider.
Your checklist
| Point to be considered | To-do | Scenario |
| Long-term outlook | ||
| Estimate the right insurance coverage amount | Compare the listed benefits by sourcing multiple insurance policy quotes. Also, be sure if you want high insurance coverage at a high premium or low compensation 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 plans to have a second and 3-year-old child to care for. He can increase his insured amount at a slightly higher premium cost now. |
| Don’t delay buying a policy. | Buy a basic health insurance cover early, even if you don’t need it. | X is 35-years old. He should buy a policy as the treatment cost is very high now. He will only end up losing his income and savings. Also, if a health calamity strikes him, he will likely be denied health insurance and 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 a high risk of suffering chest infections. He has a family history of heart attacks. He is also prone to heart problems. |
| Hospital network | Check the list of the hospital networks of your insurance provider. Make sure you get maximum coverage. | X’s father suffers a stroke. He needs to be hospitalized immediately. He is living in Delhi. If X doesn’t have a hospital close by (covered under his health insurance policy), he will likely lose precious time or income. |
| Excluded disease/ Sub-limit | Read the policy document carefully. Know about what is not covered under the policy. | X is a hernia patient. His insurance policy does not include the treatment expense for this health condition. 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 discharge, he would have to pay Rs 3,000 from his pocket. |
| Tactics | ||
| Select inclusions | Know what is not required so that you pay the right premium amount. | X is living in Delhi with his wife and two kids. He doesn’t need maternity coverage under his health insurance policy. |
| Policy tenure | Opt for long-term policies if you require them. | X is a busy man and forgets to renew his policy in time. He will be at a loss if his policy lapses. He can go for three years. |
| Claim procedure | Read the terms and conditions carefully. | X should know how to approach the insurer and what documents 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 save thousands, perhaps even tens of thousands. On the face of it, all insurance policies will look the same; therefore, it makes sense to read the policy document carefully.