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Top Things to Look for When Buying a Health Insurance Cover

With the insurance market offering a plethora of different policies, selecting the right policy can be challenging. Intimidating jargons can make the selection process more cumbersome. But even though buying insurance may seem a tough task, it is actually easy if you know some basics.

Here are the top things you should look for when buying a health cover:

Check the age criteria

Most health policies have age criteria depending on the type of insurance plan. Usually, it ranges between 18 years and 60 years. But it can vary across providers. Check the minimum and maximum age limitations before buying health insurance. Choose a plan that offers a high age cover or no upper limit. At the same time, keep track of the premium payable, since it is directly related to your age. In case of family floater plans, the age of the oldest member will determine the premiums.

Right balance of premium and coverage

A low-premium health plan might appear more lucrative. But often such plans have limited coverage and exclude significant healthcare costs. It is best to balance your premium and coverage. Opt for a policy that has affordable premiums but also offers considerable health insurance cover. Check for any co-payment, deductibles, and sub-limits clause. In case, any of these exist, read the terms properly before purchase. These clauses could require you to pay more at the time of the claim.

What is the waiting period?

Most health insurance policies have a waiting period clause for specific illnesses, diseases, etc. The insurer does not accept any claims made for these specific ailments or any pre-existing conditions, like thyroid, blood pressure, diabetes, etc. The waiting period can vary from insurer-to-insurer. Mostly, it is between 24 months and 48 months, which is long enough. Choose a provider with minimum waiting period clause.

How wide is the hospital network?

Health insurance companies have tie-ups with several hospitals and diagnostic centres that offer cashless treatment to the policyholders. Cashless treatment implies that you do not pay anything for treatment in the hospitals which are part of your insurance company network. This reduces tedious paperwork and saves time, which would otherwise go into filing for reimbursement. In this case, the insurer will pay the sum directly to the hospital. So, before buying a health cover, check the hospital networks. The wider and more comprehensive the hospital network, the better the insurance plan. Focus on the network in your area of residence.

What are the policy benefits?

Choose a health plan that offers the maximum benefits. In most cases, insurers only cover standard hospitalisation costs. Buy a plan that also covers pre-and post-hospitalisation expenses, ambulance charge, medicines, consultations, special procedures, etc. Do not ignore the maternity benefits in a health insurance policy. Take an insurance plan that covers the cost of delivery, maternity/newborn care and more. Policies that include preventive health check-ups are a bonus. Read all the limitations and waiting period clauses underlying the benefits before buying the healthcare plan.

No Claims Bonus (NCB) benefit

The insurer grants NCB to you for every claim-free year. As part of the benefit, they increase the sum assured by a defined percentage. However, this is subject to specific limits. But overall, this clause is beneficial to you. This increase in the sum insured can help you offset the impact of inflation in the long-run. So, choose a health insurance plan that offers liberal No Claim Bonus or NCB.

How steep is the co-payment clause?

A co-payment clause defines the amount that you would need to pay as part of the claim. The insurer reimburses only the agreed percentage to you. So, before you buy a medical insurance policy, check the co-payment terms. Choose a provider with no such clause or one that suits your financial condition. A high share could burden you financially at the time of claim processing, even though it would reduce your premiums in the present. It is a trade-off.

How smooth is the claims process

A long or complicated claim process is a strict “NO”. Check the policy wordings and understand how your insurer reimburses you. Opt for an insurance company with a smooth claim procedure. You can read customer reviews online. Also, check the claim settlement ratio (CSR) of the insurer. It reflects the number of claims paid by the company against the total claims made in a financial year. Choose an insurer with a high CSR. It improves the probability of your claims being paid easily and on-time.

Over to you

These few parameters can help you select the ideal insurance policy as per your healthcare needs. It is important to be meticulous and read all insurance-related documents in detail before buying the plan. Don’t miss the fine print. In case you require expert guidance, seek help from professional insurance advisors, and make the right choice!

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