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10 Important questions to be asked while buying health insurance
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Important questions to be asked while buying health insurance

Sayan (23-years-old) works in an accountancy firm in Kolkata. But Sayan is not covered under any corporate health insurance scheme. Being a meticulous person, Sayan wants to purchase a separate health insurance plan that will give him financial assistance and adequate coverage against various perilous diseases like the COVID-19. After seeing the dangerous destruction caused by the COVID-19 especially during the second wave, Sayan didn’t want to take any chances with his health, despite being a healthy and vigorous person. Since Sayan is a first-time buyer, he should ask some insurance questions to his insurer to get the best deal.

Here, we are going to explain some prominent health insurance questions and answers so that every buyer can choose the right health policies for them.

10 Important questions to be asked while buying health insurance

10 Important questions to be asked while buying health insurance

What type of health insurance plan are you going to offer me?

This is the first common question that you ask your health insurance company before making any commitment. Some health insurance plans that are available in the market are Individual Health Insurance Policy, Family Floater Policy, Critical Illness Plan, and Senior Citizen Insurance Plan. Note down your healthcare requirements and check all the benefits of each plan. After comparing, choose the most suitable plan for you that goes well with your needs.

What are inclusions or coverage under the policy?

Health insurance plan coverage or inclusions is a set of ailments/diseases that are covered by your health plan. Most health insurance plans offer coverage for pre-and-post hospitalization costs, ICU charges, in-patient hospitalization, laboratory tests, ambulance charges, prescribed medications, organ donor charges, doctor’s consultation, nursing costs, and so on. If you need any special coverage, talk to your insurer about the same. Always go through the policy documents carefully to understand what you are going to get against your policy.

What are the common exclusions under the plan?

Exclusions are a set of conditions that your policy doesn’t cover. Many health insurance plans don’t offer coverage for the treatment of certain diseases in the first one/two years. This period is known as the waiting period. During this waiting period, you can’t initiate any claim for these treatments. Once the waiting period is completed, you will enjoy the benefits of your policy. But every policy has some common exclusions including adventurous sports injuries, self-inflicted injuries like suicide, cosmetic treatments, venereal or sexually transmitted disease, treatments related to dental, hearing, and vision, obesity treatment, war or nuclear injuries, etc. So, before purchasing a health plan, we must be aware of all exclusions so that you can decide the best health plan for you.

How much does health insurance cost in India?

Several market studies have claimed that if you purchase a floater policy of Rs 5 lakh in India (the policy covers you, your spouse, and one child), then your premium amount would be between Rs. 10,000 and Rs. 17,000 per annum. On the other hand, if you purchase an individual health policy of Rs. 5 lakh at the age of 35 years, then, your premium amount would be between Rs 4,000-7,000 a year. Several experts recommend purchasing a health policy as early as possible because your premiums increase with your age. Your health insurance premiums also depend on the type of policy you choose and your coverage amount.

Does your policy cover routine tests?

Many people are suffering from various health disorders that need a routine health check-up. So, it is imperative for you to ask whether your policy will offer such coverage or not. Many insurance plans offer coverage for this medical expense to their policyholder once a year.

How is the policy premium decided? 

Age is a pivotal factor that decides your health insurance premiums. Older people are more susceptible to various diseases. That’s why their premium amounts will be on the higher side. Moreover, your health history also contributes a prime role in deciding the premium amount. If you are a wholesome person with no medical history, your insurance premium will be low. Various features and benefits also determine health insurance premiums.

When can I avail cashless treatment?

Usually, health insurance companies are partnered with various hospitals (network hospitals) to offer cashless treatment to the insured policyholder. If you get admitted to these network hospitals, you don’t need to pay anything from your side. You can enjoy cashless facilities as your insurance company directly settles the bill with the hospital. So, ask your insurer to provide the list of network hospitals and check your nearest hospitals to avail of cashless facilities.

How many times can I file claims in a year?

The number of claims depends on your selected sum insured amount. You are free to initiate claims until the sum insured amount exhausts. So, understand everything regarding the claim initiation at the time of purchasing health insurance.

What is the claim settlement ratio?

The claim settlement ratio of an insurance company portrays a lot about it. The claim settlement ratio depicts how the company has treated its customers in the past and how efficiently it has cleared the claims of customers. The higher the claim settlement ratio means the company is more loyal and trustworthy than its contenders.

What are out-of-the-pocket costs?

While purchasing a health policy, you should be prepared for all out-of-the-pocket expenses. Co-pay, sub-limits, etc. are popular out-of-the-pocket expenses that a customer should be aware of. To get the best deal, always calculate these costs before purchasing a health insurance policy.

The above article gave you an idea regarding how to ask about health insurance-related questions to your insurance provider. The aforementioned items are some popular questions related to health insurance that you must pay attention to. Always do thorough market research before purchasing a health policy to get the best deal and coverage.

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