How to choose health insurance?

Here is a guide on how to choose your next health insurance to help you make a smart decision for you & your family. Find tips & FAQs to choose health insurance

One thing that this pandemic has taught us is that we need to be prepared for the unforeseen, especially when it comes to the health and wellbeing of our families and ourselves. In times of medical emergencies, finances should never stand in the way of you getting the best treatment and hence having a good health insurance policy is a must. But how to choose the right health insurance for your family? What should you be weighing while browsing through the numerous policies offered by all the insurance companies? We try to answer all these questions about Health Insurance today.

Health Insurance Plan Checklist:

You can never be sure when you might fall sick, but what you can be sure of is that you pick the right insurance policy so that in times of need, you don’t have to chase the insurer to get the claim settled. Just picking any insurance policy with a premium in your budget is not the right way to go, being informed while choosing a health insurance is a must, and here is a checklist to becoming an informed insuree:

Eligible Hospital Room

The policy will tell you what kind of room (private/ shared etc) can be booked at a hospital under the health insurance. So ensure that your preference falls in line with the insurance you buy.

High Claim Settlement Ratio

A high claim settlement ratio shows that most of the claims that are applied for to the health insurance company are settled. This shows lower conflict rates, a more transparent policy and is a must for every health insurance policy to avoid conflict at the time of emergency. Anything above 95% is usually considered good for the policy.

No Claim Bonus

Most companies will offer a no claim bonus ( benefits if no claims are made under the policy in the given year). This is to attract clients and make the policy more lucrative for them. Make sure to check this out for each and every policy you take into consideration.

Complimentary Health Check ups

An annual health check up is recommended for everyone, and fortunately many health insurance policies offer this at a minimal or no addition to the premium, making this an offer you should not ignore.

Waiting Periods on Prevailing Illnesses

Almost all insurance policies do not insure you for prevailing ailments at time of buying the policy, instead they have a waiting period after which the cover for that ailment starts. This ranges from 1-5 years depending on the cover, premium and type of health insurance policy, so make sure to take this into consideration while picking the right health insurance for you.

Cashless-Claim Network

This is one very crucial point where going with a more reputed company might play in your favor. That is because bigger companies tend to have larger hospital networks of easy cashless claims which are very important in making your interaction in these crucial times fast and seamless. Picking a slightly more expensive policy if it gives you more cashless network hospitals is most certainly worth it.

Dental, Psychiatric and Cosmetic Cover

Many policies don’t cover these three claims. Make sure you check the policy terms if any of the above three are potential claims for you or your family.

Pre and Post Hospitalisation Cost

Your policy will tell you the cost for the number of days it covers for days before and after any type of hospitalisation. Make sure to get the longest time frame available for this.

Family Floater

Your policy will tell you how many family members can be added to the policy. Ensure you get a health insurance plan that is able to include and cover your entire family.

Now that we have covered the list of things to check in, the next question many people have is why pay the premium and potentially lose all the money when you can pay the bills upfront if and when the need arises. The answer to this depends on 3 main situations;

1. Healthcare costs in the location of your residence:

While healthcare may be affordable in places like India, if you live in a place like the US where bills can potentially bankrupt you, having an insurance covering you is logically a given

2. Your Age and Health Condition:

If you are young and healthy, chances of you falling sick and needing health Insurance claims is relatively lower and in such a case you can choose to not buy a policy but pay your bills upfront. This option while risky, can make much more economical sense in your case. However, if you are older, there is a higher chance of a medical need arising, this combined with added responsibilities due to age make it a wiser decision to just invest in a good health insurance policy.

3. Likelihood of Claim:

If you or your family members tend to fall sick, your family consists of children or senior citizens, or you have some pre-existing condition that might need medical attention, health insurance is a recommended investment for you.

Health Insurance – Frequently Asked Questions

1. Is there a tax benefit to getting health insurance?
Yes, as per Section 80D of the Income Tax Act, premium paid towards Health Insurance plan is deductible from the taxable income. The upper limit for this deductible amount is Rs. 25,000 and extends to Rs 50,000 for senior citizens.

2. Are vaccinations covered under health insurances?
Yes, Some policies do cover vaccinations as well. This is beneficial especially for families with children so do check this out before buying your policy.

3. What happens if the bills exceed the insured amount?
While most Health plans cover only uptil Sum Insured, there are some plans which have Restoration benefits. This means Insurance companies will restore the entire Sum Insured, in case there is another claim by the same customer. This is applicable for any related or unrelated illness also.