Health Insurance Policy Tip: Here 's What To Consider Before Buying A Health Plan

It is extremely important to arrive at the right amount of health cover to be undertaken for your and your family members because medical expenses are on the rise.

New Delhi: The importance of health insurance cannot be undermined in times such as these when people are struggling to meet medical expenses owing to hospitalisation and lack of facilities. In a recent study, the Indian Institute of Technology Madras stressed on the need for more investments in public healthcare to mitigate the impact of the pandemic on the elderly.

“Only 18.9 per cent of the elderly had health insurance and therefore may not be able to bear large expenditures on health. 27.5 per cent of people aged 80 years or above are immobile and 70 per cent of elders are partially or wholly financially dependent on others” said the study based on the 75th round of the National Sample Survey (NSS) 2017-18.

Hence, it is important to opt for a health insurance policy to protect your family and yourself against any health emergency.  But there are a huge number of health plans in the market that it becomes difficult to wade through all the options before deciding the best plan for you.

 Here’s are a few things to keep in mind before you buy a health plan

Amount of coverage: It is extremely important to arrive at the amount of health cover to be undertaken for you and your family members because medical expenses are on the rise. Considering a Rs 5 lakh may look sufficient for today, but such a cover may not be adequate 10 years from now.  Make sure that you also consider medical inflation before deciding on the amount. But make sure to check every five years whether there is a need to change or upgrade the plan.

Coverage for the entire family: If you are looking to buy a health cover for your entire family, then try to consider all options starting from a single-family floater policy, or individual plans for each family member. In case of a family floater, the sum assured gets divided amongst the family members under the policy.

Limits on treatments and co-payment clause: Some insurance plans it covers you partially for certain treatments.  For instance in case of a cataract operation the limit may be Rs 40,000. Hence if the cost of treatment is Rs 45,000, then the extra Rs 5,000 will be settled out-of-the pocket expense. Some covers have co-payment clauses under which the insured party needs to cover up to 20 per cent of the claim settlement amount. Besides, you also need to check on the waiting period and exclusions in the health insurance plan such as medical conditions that are not covered in the policy. 

Cashless Claim Facility: Most importantly, go through the insurance provider’s list of network hospitals to ensure that you can avail the cashless claims at your preferred hospital. Most insurance providers have a comprehensive list of network of hospitals where individuals can get treatment without having to pay anything upfront.

Check the brand: Don’t forget to compare the plans online but it is equally important to check the credentials of the company. Also, don’t forget to check the claim settlement ratio of the insurer. Claims settlement percentage is a ratio of total claims settled by the brand, compared to the total claims received.