10 Points To Consider Before Buying A Health ...

10 Points To Consider Before Buying A Health ...

Major Benefits Of Having A Health Insurance

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10 Points To Consider Before Buying A Health Insurance Plan

Fri, Mar 31, 2017

img By Heena Bathla Editor at Quickbima

Having a health insurance plan has almost turned into a necessity in this day and age given the rising cost of medical treatments. If you do not have one, you may end up shelling out quite a bit from your pocket during medical emergencies. The only way to be prepared for when such a situation arises is to have a health insurance plan for you and your family members. Now if you are planning to take out an insurance cover, you need to take a few factors into consideration to help you find the right plan.

1. Co-Pay - Co-payment is a common feature in many health insurance plans. Most of the leading health insurance companies have the co-pay clause in their insurance policies. In co-pay, you as the insured have agreed to pay a specific percentage of the claim whenever you undergo any medical treatment. The co-pay percentage generally tends to be fixed.

For instance you have a health insurance plan that has a 10% co-payment clause; so if you are hospitalized and your claim amount is Rs. 1,00,000 then your insurer would be liable to pay Rs. 90,000 (90% of Rs. 1,00,000) and you would have to pay the remaining 10% i.e. Rs. 10,000. When you are comparing the different insurance policies in the market, it is better to opt for one that either has no co-payment clause or the lowest co-pay amount.

2. Premium - The premium amount, which is paid annually, is one of the most important factors to be taken into account when you are considering which health insurance plan to buy.  Premiums will differ depending on the type and amount of insurance coverage.

A common mistake made by policyholders is that they blindly go ahead with the plans that have the lowest insurance premiums. Usually when a health insurer offers you very low premiums, they will find out some other ways to make up for it. So you must make sure to study all the benefits, features and terms of a plan to protect yourself from falling into any trap. Visit to compare the top health plans. We suggest going for the plans which offers best value for your money.

3. Network Hospitals -
Network hospitals are hospitals that have a tie up with your health insurer. Such hospitals will have an agreement with the insurer to providing you cashless treatment.

When you file a claim, you have the option of going for cashless facility. You do not have to settle the bill amount upfront with the hospital, rather the health insurer, through a third party administrator, will pay your bill to the hospital. When you are looking around for health plans, it is ideal to opt for one that has a wide network of hospitals in your city.

4. Pre and Post Hospitalization Expenses - A pre-hospitalization cover generally covers the charges you have incurred 30 days prior to your hospitalization. Consultation fees, blood tests, X-rays etc. fall under this category.

A post hospitalization cover generally covers all the expenses incurred by you for 60 days from the day you have been discharged from the hospital. Some health insurance companies offer post hospitalization cover for more number of days. It is advisable to look for health plans that cover you for the maximum number of days for both pre and post hospitalization.

5. Reputation of the Health Insurance Company - We are typically inclined to opt for health plans that our near and dear ones suggest. However, it is important to note that what works for another person may not necessarily work for you. Keeping that in mind, it has been noticed that the market is flooded with products and marketing strategies by health insurers aimed at luring in more customers.

It is thus necessary to conduct your own research before settling in on which plan and which health insurer to go for. Look into how a particular insurance company has settled previous claims and the time taken to do it. You can judge a health insurer’s efficiency based on the same.

6. Maternity Benefits - The expenses incurred during pregnancy can be quite high. It is therefore important that women check to see if their insurance policy offers maternity coverage. The insurance cover for maternity generally takes care of :

  • Pre and post hospitalization expenses
  • Expenditure related to caesarean or normal delivery
  • Room charges and surgeon charges.

Before you take out a health cover, look into the waiting period for claiming maternity expenses. Also, check to see if the health insurer will cover outpatient expenses.

7. Exclusions - Another aspect people generally tend to overlook when they compare health insurance policies is the list of exclusions. Some health insurers exclude coverage for pre existing diseases or sometimes only provide cover for such diseases after a waiting period.

You must see to it that the insurance plan you are purchasing covers any disease that runs in your family. In case you or your family member requires treatment for a condition that is not covered by your health insurer, you could end up spending a big amount.

8. Claim Settlement - Before taking out a health insurance plan, check the process by which the claims are settled - whether it is through a third party administrator or directly by the health insurer. Usually when the insurance company directly settles the insurance claims, there is a high chance of getting the entire claimed amount.

Besides the involvement of third party administrator, you must also look into the claim settlement ratio and settlement time. A high claim settlement ratio indicates that the health insurer settles genuine claims.

9. Renewal of Policy - The policy renewal option is among the crucial things to check under the terms of your health insurance plan. Policy renewal basically means the age till when you can renew your health insurance cover.

Some health insurers limit it to 65 years, while others go up to 85 or even 90. When you are shopping around for health plans, shortlist insurance policies those that are renewable even after the age of 65. Remember, the longer the period, the better.

10. Day Care Procedure - A short term hospitalization procedure is termed as day care procedure. An example of a day care procedure is when you have to undergo a minor operation that would not require you to stay in the hospital for more than a day.

Not many health insurers cover day care procedures since hospitalization of at least 24 hours is mandatory for making a Mediclaim. Thus it is important to look out for health insurance companies that will cover day care procedures as such treatments can be quite costly.

Keep the above mentioned points in mind when you are shopping around for health insurance plans. Pay close attention to the features and benefits mentioned under each insurance policy before buying a health insurance plan. Opt for one that covers a wide variety of medical treatments so that you will not be weighed down by any financial concerns. For more information about the various health insurance products in the market visit our website


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