The rising health care costs, along with increasing risks of suffering from lifestyle diseases, necessitates one to take health insurance little more seriously. One cannot deny the fact that no matter how careful you are about your health, sudden and unforeseen medical requirement cannot be avoided, leading to situations that can dig a hole in your pocket. To steer clear of such situations, you can purchase a health insurance. However, before embarking on a health insurance shopping, you need to keep certain points in mind in order to choose the apt health insurance plan that does not create a financial burden.
To purchase the right plan for yourself or your family, it is imperative to understand the types of plans and their benefits. Health insurance can be categorised under two broad sections - indemnity plan which covers hospitalization expenses up to the limit decided during the purchase of the policy, and fixed benefit plan which does not offer hospitalization benefit, but pays a fixed amount for certain listed diseases and conditions. You can also consider the individual plan, family floater plan, unit linked plan or the preventive insurance plan as per the requirement and need. Let us look at six aspects that should not be ignored before buying a health insurance plan.
1. Requirement: Before deciding about the type of plan and its add-ons, you should be clear about your and your family’s needs. This can be done on the basis of the age, number of family members, family history regarding diseases, the current situation and pre-existing diseases. Thus, you can opt for either an individual plan or a family floater one. For instance, if you are buying a health insurance plan after you have planned your family, you don’t need an insurance with a maternity cover, but you do need a family floater plan which would cover you, your spouse and kids. A plan for a family with senior citizens will be very different from the plan for a family with two kids. A family floater usually turns out to be more cost-effective.
2. Affordability: Even if you select a health plan as per your requirements, you should be able to afford the premium for the plan. Don’t opt for a plan with a lot of features that entails a high premium. The premium should not become a burden for you later, forcing you to surrender the plan midway. Thus, go for features for which you can pay till the end and also, reap the benefits. Don’t include features about which you are sure you will not use. You can consider family health insurance plans instead of individual ones to make the premium affordable.
3. Correct Insurance Amount: Take into account your age, number of family members, their age (in case of family floater) and everyone’s health condition before deciding the insurance amount. The sum insured should not fall short when you need the most. The amount should also consider the inflation rate over the years, as with each passing year, the cost of health care and treatment will go up.
4. Claim Settlement: It is important to choose a reliable insurance company which settles the claims in a timely and hassle-free manner. It should enjoy a high claim settlement ratio (CSR) which increases the chance of settling the claims quickly. Health insurance claims can be in either cashless or reimbursement mode. As part of the cashless facility, the insured is paid through third party administration (TPA) for which the patient has to get hospitalised. For the reimbursement part, the insured has to pay the health care cost which is reimbursed later by the insurance company. One should be careful in choosing this feature. A cashless settlement method is more feasible to avoid shelling out huge amount for treatment.
5. Exclusions and other Coverage: Always understand the exclusions listed under each health insurance plan. The exclusions are certain conditions not covered under the health insurance plan. These also depend on pre-existing diseases. Evaluate these exclusions and other coverage like room eligibility, hospitalization charges, alternative treatment cost before finalising a plan.
6. Cumulative Bonus: Bonuses and discounts are important aspects of a health insurance plan. Know the little things that you can opt for to make your plan more attractive and cheaper. The No Claim Bonus (NCB) feature kicks in if you do not make any claims in the previous year. As part of the NCB, you get a percentage increase in the sum assured. This goes on till you reach a certain limit. Apart from this bonus, you can also enjoy discounts on your premium. Companies like HDFC Ergo and Tata AIG offer discounts if you include more than one person under your health insurance plan. You can also avail discounts if you happen to buy a policy for a two- or three-year term. Some insurance companies offering this benefit are ICICI Lombard and Max Bupa.
Thus, a proper planning is needed to buy a suitable health insurance plan in order to prevent any regrets later. You should also compare the plans well to understand the conditions and benefits which can be easily done online today.
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