Buying health insurance has become a need. Now that we are living in a time where medical expenses are soaring to new heights, you cannot not buy health insurance. Health insurance ensures that you don’t need to compromise on the quality of medical treatment if the need arises. Having health insurance can prevent you from financial crunches and provide the best possible medical treatment for you or your family without needing to worry about the heavy hospital bills.
However, a health insurance policy is not like any commodity you can buy off the shelves. You have to give the decision your time and consideration before you choose a health insurance policy.
That said, if it’s your first time buying a health insurance policy or you weren’t satisfied with your previous one, here is a list of all the factors that must contemplate before buying a health insurance policy.
- Choosing a Plan Keeping in Mind the Future Medical Costs
Medical expenses are growing by the day now that the medical infrastructure is developing. Medical bills are not affordable today, nor they will be tomorrow. If a medical treatment is costing you INR 1 Lakh today, then in future it can double and triple.
You must keep inflation into account before you buy a health insurance policy. You wouldn’t want to buy a policy with coverage that seems adequate now but might not be in the future.
At the same time, you have to keep into account your family’s medical history. As some diseases can be passed down by the genes, it is likely that you can get them as well. So, to be on the safer side, keep those expenses in account. If those diseases are not covered in a basic health insurance policy, consider getting an add-on policy.
- Cashless Hospitalization
This is how health insurance works standardly during a medical emergency – you have to pay the hospital bill first, and then the insurer fully or partially reimburses you for the medical costs.
Cashless Hospitalization is a scheme wherein you don’t have to pay some hospitals anything. Some insurance companies have hospital tie-ups where they directly pay them.
That said, it would be a much more convenient option if your policy offers cashless hospitalization. In case it does, you have to ensure that the hospitals near you are in their network so you can avail this facility in the hospital of your choice. If they are not, it’s better to go for a company that has hospitals near you in their network.
- Claim Settlement Ratio
The last thing you’d want in the event of a medical emergency is for your family to make a million trips to the insurer for your health insurance claim. Hence, it would be a sagacious choice if you go for health insurance companies with a high claim settlement ratio.
A claim settlement ratio indicates the potential of the insurer to settle the insurance claims filed by the insured.
A high claim settlement ratio means that the company is reliable and financially capable; implying that you would have less to worry about during a medical emergency.
- Co-Payments and Sub-Limits
Some insurance policies offered by health insurance in India have sub-limits and co-payments clauses.
Sub-limits: Sub-limits are the limitations imposed on the amount you are assured under certain conditions. For instance, if your health insurance policy places a sub-limit of 50 % on your knee replacement surgery, it means you cannot utilize more than 50% of your health insurance coverage for the surgery. If the amount exceeds the limit, you have to pay for the additional expenses.
Co-payments are another clause where only a proportion of hospital bills are settled by the insurer, while the remaining has to be settled by the insured.
In some instances, these clauses can be a disadvantage for you, and an advantage for insurance companies. Hence, if budget is not a constraint, it is advisable to go for companies that offer health insurance in India without a sub-limit and co-payment clause.
- Waiting Period
A waiting period is the time window between which you cannot get insured against a particular illness. A waiting period is generally applicable for pre-existing diseases or when you buy or renew insurance policy. The waiting period can start from 1-2 months and go up to years; it depends on the health insurance company you have chosen.
Ergo, it is highly recommended that you go for insurance companies that have a shorter waiting period.
- Inclusions and Exclusions
Basic health insurance in India does not provide cover for critical illnesses such as cancer, kidney failure, AIDS, dental surgeries, and cosmetic surgeries. So, it is pivotal to know what a specific health insurance policy covers before you decide.
At the same time, know the benefits each health insurance policy gives you. The one with the most benefits should be your pick.