No clarity on which policy to buy - 10 points you must consider

Thinking of buying a health insurance policy? Must be a confusing and tough call, right? You must be wondering what exactly to look for or are you from that set of people who just agree to whatever the agent says, sign the papers, pay the premium and enclose the policy document in your files forever - taking them out when that hospital emergency strikes.

I would strongly recommend not to be the latter one. It’s so important to be aware and informed about what you step into and what you choose for yourself.

Ultimately, you are the user of the policy you buy and we want you to use it to the fullest. And we say this, because we have studied thousands of policies to understand how they impact a hospital bill. The bottom line - no one likes to pay extra, so being aware is the key!

When you know about the factors that can affect your policy utility and claim experience, you are in a position to make better decisions.

I’m writing this for you to do precisely that - to inform you about all the factors involved that you must consider when buying a health insurance policy.

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1. Policy coverage (inclusions and exclusions)

Being aware of your policy coverage is very crucial. You must know what your policy covers (inclusions) and what it doesn’t cover (exclusions) as you cannot make a claim against exclusions.

Your coverage determines whether your claim will be settled or rejected. It also determines your out of pocket expenses that you have to bear on your own.

2. Waiting period

Most policies come with a waiting period. During this period, you are not allowed to file a claim against the health insurance policy. This varies across insurers and policy plans. There is a waiting period of different time frames varying from a few months to a few years on different treatments and diseases. Two things to note here are - that you know what waiting period is applicable on what disease; and you choose a policy with a minimum waiting period across treatments.

Also Visit: Hospitalization Insurance In Health Insurance And More

3. The right health insurance company

When it comes to health insurance, you should only choose the best insurer that offers a quick claim settlement.

Thanks to the internet, nowadays, it is easy to go online and search for a reliable health insurance company.

Go through their customer reviews to know more about the services offered. That way, you can compare and make a better decision.

4. Availability of add on covers

Check for the add-ons your policy provider is offering. If you are satisfied with your base policy coverage, you might not need any add ons (which is preferable to save any additional cost).

However, if there’s a need you can take add-on cover. Remember, add on cover comes with add on premium cost.

5. Pre and post hospitalisation

Certain expenses like consultation, tests, medicines that are incurred before and after hospitalization are also covered by many health insurance policies. Terms and conditions to claim these expenses vary. Do check if your insurance covers pre and post hospitalization expenses or not.

6. Network hospitals

An insurer’s network of hospitals is definitely of importance. You must not miss checking on this. Verify the insurer’s extensive hospital network to see where you can avail cashless treatment. You will be able to pay substantially less for medical care as a result.

7. Copay clause

Whenever there’s copay applicable in any policy, the policyholder has to pay some fixed percentage of the claimed amount out of your pocket. It’s important to understand whether to have this clause incorporated into your policy or not.

Premiums in such policies might be less but also offer less compensation at the time of claim as you have to pay a considerable amount out of the bill.

Read, check and understand what’s convenient for you - paying less premium and sharing the hospital bill or not having any copay clause at all.

8. Room rent limit

Room rent again is something crucial when you come to file a claim. There’s a room rent limit for different policies that can vary according to policy plans and insurers.

A hospital’s room rent may sound like a trivial charge, but it can be exorbitant depending upon the type of hospital. The treatment cost can go high if the patient is admitted to a room that costs more than the allowed limit.

The room rent limit in health insurance specifies the maximum room rent coverage allowed under the policy. If the policyholder chooses a hospital room with a higher rent, he would have to proportionately share the load of the entire hospital bill.

9. Specific illnesses and daycare procedure

Medical insurance plans list some specific illnesses and treatments for which coverage is available after a specified duration. For instance, in many plans, coverage for piles, fistula, hernia, etc., is available only after the first 2 policy years. These ailments are called specific diseases.

Reach out to the insurance company if you are unsure about this coverage being offered.

Nowadays, certain medical treatments are completed within a day called daycare procedures.

Thus, it is important to ensure if such treatments are covered under your health insurance plan. These are small medical procedures like cataracts, tonsillectomy, etc.

10. Premiums

You pay a premium to purchase a health insurance policy with a certain coverage. The higher and more comprehensive the coverage, the higher the premium amount. Understand the details pertaining to the coverage and the premium amount thoroughly while buying health policies.

Also Read: How To Port Your Health Insurance Policy?