Planning to get a health insurance? 10 tips to make this easier for you

By: Pavitra Sampath | | Updated: March 20, 2015 5:38 pm

Most people do not realize the importance of a good health insurance policy till they get stuck in circumstances where they need it the most. And some of you who do have one, the credit goes to your company s group health insurance policy. Unfortunately, most people don t know how to choose the right health insurance policy suiting their financial budget. However, if you still haven t got one and are planning to get one this year, here are few things you need to consider. Also Read - Health is a fundamental human right: Healthcare schemes in India you must know about

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1. Choose your insurance company wisely Also Read - PMJAY may not cover cataract operations: Official

Generally, companies that offer health insurance are either general insurance or life insurance companies. Experts say that it is better to pick a general insurance company over one that offers life insurance. This is because a company that provides life insurance is invested in policies that will reimburse the family members of the deceased, and will not be focused on health insurance. Another reason is that the policy usually costs more when taken from a life insurance company. Here are 5 to-dos for using your health insurance well

2. Plan according to your future needs

One of the most important things to consider while choosing a life insurance plan is to think of the needs that might arise in the future. If you have a family with ageing parents or are newly married and are planning to start a family in the near future, your bet has to be on the policies that will cover aged parents or possibly cover maternity costs.

3. Make an informed decision about the type of health insurance

Read all that you can about the various options your health insurance company is providing you. Ask questions. Generally, if you have a family it is advisable to opt for a family floater plan. It is more economical and effective in the long run. Similarly choosing a cashless policy over a reimbursement type of policy may suit some but may not be beneficial to all. Are you aware of these ten questions you should ask your health insurance company?

4. Choose the right amount as sum assured

Sum assured in simple terms is the maximum amount that a person who is insured can be reimbursed or covered for in one policy year. Basically, it is the base for all your future medical claims. Before you choose the sum assured, take into account the rising medical costs. At the same time, the amount shouldn t be so high that it would be difficult for you to pay the premium.

For example, an insurance company assumes that the cost of a hospital bed for one day is one percent of the sum assured. Therefore if your sum assured is one lakh, hospitalization should cost you thousand rupees per day. If you were hospitalized for seven days and the hospital charges more than a thousand rupees per day, you will be left paying the difference. Hence, choosing the right amount as sum assured is imperative. Read about health insurance FAQ for cancer patients.

5. Check the empanelled hospitals

Every insurance company has empanelled hospitals, with whom they have a tie up. These hospitals are instructed on how to settle the claims of a patient who has a particular company s cover. Therefore it is best to check which hospitals are under the insurance company. Checking for their specialty, reputation and distance from your home is important. This is because in case of an emergency you are most likely to visit a hospital closest to your home.

Another consideration is that there should be hospitals with varied specialities under the insurance company it is better to have a choice when it comes to certain illnesses rather than going to the same hospital that may not provide you with appropriate care.

6. Understand the premium calculation process

A premium is the sum you pay to the insurance company while buying an insurance policy. Although the formula to calculate one s premium usually has a common formula, there are a few factors that may change while charging a premium. Some of the main factors are the sum assured , the number of times you have used the policy and for how much. Talk to your insurance agent about the amount of premium you will have to pay per year and how the company will charge for various services. Go through a dummy s guide to calculating health insurance premium.

7. Read the fine print (clauses)

A health insurance policy has a number of clauses what could be called the fine print . Reading them well is very important. And if you do not understand them, do ask questions. For example: Read clauses related to the renewability of an insurance policy. This means that the policy will no longer hold good after a person attains a particular age. This could mean that you may not have a health insurance at the age of 70 or 75, when you need it the most. Here, choosing a policy that will cover you for life rather than one that will expire when you need it the most is adviceable.

If you have a pre-existing disease (for eg: diabetes), policies can be used only after a stipulated time period decided by the company. Also, if you are planning to start a family, ask the company about their maternity clause. Many companies do not cover costs of delivery or of any complications arising from that.

8. Go through reviews and compare policies

In the case of a medical emergency, it is important that you and your family have complete peace of mind when it comes to finances. Therefore, talk to your friends who might have the same policy, or read reviews about the policy you are about to buy. Another good tool is to compare policies. Knowing that the company takes care of your finances seamlessly is important for a smooth stay at the hospital and a stress free recovery. Here s what you should about cashless mediclaim.

9. Check flexibility of the policy

In the case of an illness, it is important that the company allows the insured person to have some flexibility in paying the premium for the amount used. A premium is recalculated at the end of a policy year and is increased depending on the amount the policy has been used. Therefore, it is important that the policy you choose allows you the leeway of paying older premium amount for some time, after which you can start paying the increased premium without interest or other charges levied on it.

10. Check if the company offers a no-claim bonus or discount

If you haven t claimed any insurance in the policy year, some companies offer either a bonus amount or a discount on the premium in the next year. This is called a no-claim bonus or discount. This is a good feature and also an incentive to keep yourself fit and healthy.

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Published : February 2, 2015 3:37 pm | Updated:March 20, 2015 5:38 pm

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