Best Health Insurance Policies: Features, Benefits and Costs
With the Internet chock-a-block with options for the best health insurance policies available, it is hard to sort through each and every option. So we did some legwork and found some of the best health insurance plans available in the market that cater to both individuals and families.
After looking through 20 different health insurance companies in India and at least 50 health insurance plans, we’ve narrowed down the search to 6 best health plan options that you might want to consider. But before getting into the best health insurance plans India, let’s take a look at some of the things to keep in mind before buying a health insurance.
Buying Health Insurance: Things to Keep in Mind
Here are a few things that you should keep in mind in order to select the best health insurance plan:
- Choosing The Right Type of Coverage
The first thing to do once you’re convinced that a health insurance plan is a must-have is not to compare health insurance plans. First, you need to make your mind about the details of your health insurance needs. And the first piece you need to figure out is the type of health insurance coverage you want to get. You need to assess your individual as well as family medical needs to select the type of health insurance policy that will be suitable for you – an individual plan or a family floater one.
If you are unmarried and don’t have dependent parents, it makes more sense to get individual health insurance that would cover only you. However, if your parents are dependent on you or you’re married and have a family, a family floater health insurance policy is the suitable type of coverage for you. A family mediclaim policy will cover all the members of your family under one umbrella plan. The cost of family floater health insurance is also significantly lower than having individual plans for each family member.
- Estimating the Amount of Coverage
The sum insured is the maximum liability which the insurance company would pay in the event of a claim. The main aim of buying health insurance is to provide you robust financial protection for your healthcare needs and unforeseen medical emergencies. Thus, you need to choose the sum insured optimally according to the premium amount you can invest in your health insurance.
In addition, you can choose a lower sum insured under your independent health plan if you’re also covered under an employer-sponsored group health plan. Furthermore, you can also consider a top-up or a super top-up health plan to supplement your coverage if you want the premiums of your base plan to be affordable.
There is no fixed rule as to how much sum insured you should have; it should ideally depend on members covered, age, residential city, history of family illnesses, permanent medical needs, and existing illnesses. It should also depend significantly on premium affordability. People living in metro cities must have a cover amount of at least Rs 10 lakh given the high cost of living in class A cities. Medical treatment costs are much higher in metro cities compared with smaller towns. On the other hand, for people living in Class B and C cities, the sum insured should be at least Rs 4- 5 lakh.
- Coverage Features
Health insurance plans are very comprehensive nowadays offer a wide range of coverage features and options. These coverage features serve most often as the deciding factors for policy buyers while buying health insurance. Once you have a list of insurance plans that are aligned with your health insurance needs in terms of the type of coverage, required features, and sum insured, take a look at other coverage features.
Compare health insurance plans on the basis of additional coverage features like and choose the one with the most extensive coverage. Keep in mind that this doesn’t mean that you should overpay for coverage features you don’t need. Just make a list of insurance plans that have the coverage features required by you and select the one that provides more value for money.
- Limits and Sub-Limits
It is very important to know that many coverage features come with a limit on the maximum amount that the company will be liable to pay under that coverage. These are called limits and sub-limits. They refer to capping the reimbursement limit under each or some of such cost-heads. For instance, the room rent may be capped between 1-2% of the total sum insured. Similarly, coverage for daily allowance, ambulance charges, domiciliary hospitalization, maternity benefits, etc., also have sub-limits for lower premiums.
Thus, while comparing the coverage features of health insurance plans, be sure to check the features’ limits and sub-limits. This will go a long way in helping you choose the best health insurance plan.
The ideal choice is to choose a plan with no sub-limits. But the premiums that you’ll have to pay for those plans would be much more than a plan with sub-limits. To make the best choice, choose a plan that offers the least number of sub-limits for the amount of premium that you’re comfortable with. In addition, make sure that you keep your sub-limits in mind while making decisions about rooms, transportation, or other hospitalization costs. It will help you steer clear-off out-of-pocket expenses and use your health insurance optimally.
- Cashless Hospital Network
Every insurance company has a network of hospitals that they’re tied up with where they offer cashless hospitalization benefit to their policyholders. This means that the policyholders can make cashless claims at any of these network hospitals. There’s a representative of the insurance company present at every hospital. Hence, when you make a cashless claim, the representative verifies it and then the hospital settles the claim directly with the insurer.
It is crucial to check for the number of hospitals that the insurance company you’re considering. Cashless claims help you focus on treatment and getting better without worrying about medical bills. Buying health insurance from an insurer with a wide network of hospitals proves to be especially convenient in case of medical emergencies.
- Waiting Period
One of the biggest reasons to buy the best health insurance plans at an early age is to avoid the limitations of a waiting period at later stages of life. This is something that most policy buyers realize when they buy a health insurance plan with a pre-existing illness. All health insurance plans cover pre-existing illnesses, but only after a waiting period of few years. Most health insurance plans cover pre-existing illnesses after a waiting period of 48 months. The best health insurance plans India cover these illnesses after 36 months or lesser.
Be sure to check the waiting period for pre-existing illnesses when buying health insurance. Some health insurance policies also have a waiting period for availing maternity benefits. Buying health insurance at a young age is the best way to avoid waiting periods. Choose the best health insurance plans for yourself that have the lowest period so that you can enjoy extensive coverage at the earliest.
- Co-Payment Feature
The co-payment feature is generally applicable only for policyholders who are more than 60 years of age. The aim of adding the co-payment feature is to make the premium rates more affordable for the policyholders since premiums are higher for higher age groups. The co-payment ratio in the clause represents a portion of the claim which is payable by the policyholders themselves. The rest of the claim is settled by the insurance provider.
For instance, if an insurance plan offers a co-payment ratio of 10%, they are liable to pay 10% of every claim while 90% of the claim amount will be settled by the insurance provider. Note that the co-payment clause applies to each and every instance of a claim. While it makes the premiums low, it can also create financial instability if the co-payment ratio is too high. If you are buying a policy for senior citizen parents or if you yourself are more than 60 years of age, the co-payment clause might be applicable for the policy. So, make sure that you select one of the best health insurance plans that offer a low co-payment rate.
The bottom line while selecting the best health insurance plan for yourself is to ensure that you research every health insurance plan that offers coverage aligned with your medical and insurance needs. Check the additional benefits, coverage features, waiting period, limits and sub-limits, and buy the health insurance plan that stands out.
Now that we’re familiar with the things to look for in a health insurance policy, let’s take a look at six of the best health insurance plans in India.
Max Bupa Health Companion Family First
Company: Max Bupa
Claim settlement Ratio: 91.2%
Allowing 19 members to be insured in the same policy, this family floater plan proves ideal for joint families and large families. A key feature that sets this family plan apart is that each individual member in the policy can have an individual sum insured. The plan is also one of the best health insurance plans in India because of its comprehensive coverage that covers all hospitalization expenses as well as pre and post hospitalization expenses. Let’s look at some of its features and benefits.
- In-patient hospitalization offers cashless coverage towards hospitalization expenses for all the members of the policy at network hospitals
- 30 days pre hospitalization and 60 days post hospitalization expenses covered.
- Room rent covered for select categories (suite and above excluded).
- Day care procedures including dental and ENT covered, among others.
- Domiciliary hospitalization coverage includes medical treatments taken at home due to non-availability of a hospital bed.
- Organ donor treatment expenses.
- Lifetime plan renewability ensures a policyholder can have a long term health insurance plan security and need not have to worry about being uninsured in the future
- 20% increase in coverage for every claim-free year
HDFC Ergo: My Health Suraksha
Company: HDFC Ergo
Claim settlement Ratio: 90.32%
Its features make it one of the best health insurance policies. With multiple sums insured options and multiple premium payment options, this policy caters to a wide range of health insurance seekers, no matter the budget or the needs. The plan is also flexible in terms of entry age and provides protection to people with any age entry option. HDFC Ergo My Health Suraksha also offers lifetime renewability. Here are its key features and benefits:
- Entry at any age, which makes it suitable to insurance seekers of all age groups as well as ideal for family plan seekers
- Lifetime renewability ensures that policyholders can enjoy long term benefits, whether individual or family plan
- Sum insured ranging from Rs 3 lakhs to 75 lakhs
- Air ambulance cover ensures fast medical attention and quality hospitalization options
- Choose room rent capping, co-payment
- Avail of discounts such as family discount, long term discount and more
- Covers a broad range of hospitalization expenses including mental healthcare, home healthcare, and domiciliary hospitalization
Manipal Cigna ProHealth Insurance Plan
Company: Manipal Cigna Health Insurance
Claim settlement Ratio: 84.91%
Available for individuals and groups, this is a comprehensive health insurance plan that offers wide basic coverage, and options for add-on cover, value-added covers and optional coverage, too. Multiple options for coverage, add-on covers, value-added coverage, and optional coverage allows policy buyers to select a tailor-made plan to server their distinct health insurance needs. The plan also takes care of your hospitalization, day-care procedures and domiciliary treatments. Let’s look at some of its key features and benefits:
- The plan allows alterations to the sum insured at the time of renewal. Sum insured ranges between Rs 4 lakhs and 50 lakhs.
- The entry age for the plan is 91 days and there is no limit to the entry age.
- Flexible options for the amount of deductible – Rs 1, 2 or 3 lakhs.
- Option for waiver of copayment for senior citizens
- Critical illness additional coverage available for policyholders between the age of 18 and 65 years
- Offers discounts – long-term discount, family discount, no-claim bonus and staying healthy rewards.
Religare Care Health Insurance Plan
Company: Religare Health Insurance Company
Claim settlement Ratio: 97%
Another health insurance plan that offers a wide range of sum insured options, and can be purchased for individual or family, this insurance plan offers maximum flexibility to its customers. Let’s take a look ats ome of the key features and benefits of this plan:
- Sum insured ranges from Rs 4 lakhs to Rs 6 crore.
- Pre-hospitalization 30 days and post-hospitalization 60 days.
- Organ donor treatment expenses Rs 50,000 to Rs 5 lakhs.
- No-claim bonus up to 150%
- Automatic recharge of sum insured
- Annual health check-up
Star Health Gain Insurance Policy
Company: Star Health
Claim settlement Ratio: 98.72%
Going by a testimonial on the company’s website, this insurance plan provides maximum benefits at affordable premiums. It is one of the best health insurance plans in India with 9000+ wide network hospitals, 90% cashless claim settlement record and hassle-free claim settlement. Let’s look at its features:
- It provides flexible premium options ranging from Rs 15,000 to Rs 30,000
- It offers flexible sum insured options from Rs 1 lakh to Rs 5 lakhs
- This insurance plan caters to individuals as well as families
- It covers all day care procedures
- It has waiting periods: initial 30 days, specified diseases 24 months, pre-existing diseases 48 months
- Pre-hospitalization 30 days and post-hospitalization 60 days
- Entry age group: 91 days to 65 years
Tata AIG MediCare Insurance Plan
Company: Tata AIG
Claim Settlement Ratio: 95%
This is a comprehensive health insurance plan for individuals and families with the sum insured ranging from Rs 5 lakhs to 50 lakhs. Global health cover, lifelong renewability, bariatric surgery cover and a huge network of more than 3,000 hospitals across India are just some of the benefits that this plan offers. Here’s an overview of its features:
- This plan offers global coverage for expenses related to inpatient and day care procedures.
- It offers additional coverage for maternity. Organ donor, and newborn baby cover
- Automatically restores sum insured to 100%
- It offers lifelong renewability.
- OPD treatments covered after the completion of two years of policy.
- Domiciliary treatment is included if the insured person’s treatment exceeds three days.
- Provides compassionate travel coverage of up to Rs 20,000
By now, if you’ve selected at least 1 or 2 options from this list, we’ve done a good job and so have you! Now all you need to do is go online, look up the company website or approach our insurance representatives to help you out, and add insurance to your personal finance strategies.
FAQs: Best Health Insurance Plans
How much health insurance does an individual need?
The requirement of sum insured varies from individual to individual, as each individual may have different healthcare needs and economic conditions. Experts suggest that a person should typically have health insurance ranging from Rs 3 lakhs to Rs 10 lakhs depending on individual needs, location and financial capacity.
What are the factors that ascertain whether an insurance company is good or bad?
There are many factors that one must consider in order to determine the strength and reliability of an insurance company. Some key factors are:
1. Claim settlement ratio
2. Incurred claim ratio
3. Reviews by customers
4. Performance history
5. Customer service quality
6. Type and quality of health insurance products
What is the claim settlement process that insurance companies follow?
Different companies may follow specific claim settlement processes. However, there are two types of claim settlements: cashless claim and reimbursement.
Cashless claim: the insurer directly pays to the hospital on behalf of the policyholder
Reimbursement: the policyholder has to file a claim after which, the insurer reimburses the amount.
What are some of the best health insurance plans in 2020?
Activ Asure Diamond Plan by Aditya Birla Insurance offers sum insured of 2 lakh to 2 crore, HDFC Ergo offers the Health Optima Restore Plan that offers sum assured options of Rs 3 lakh to Rs 50 lakh, Bajaj allianz Health Guard Plan offers options of sum insured of Rs 1.5 lakh to Rs 50 lakh. Among other plans are Royal Sundaram’s Lifeline Supreme Health Plan that has options of sum insured of Rs 5 lakh to Rs 50 lakh.