By Tempail 
We all desire optimal health for ourselves and our loved ones, seeking a health insurance policy that not only offers robust features but also provides maximum benefits to shield against unforeseen events affecting us and our families.
Amidst numerous options available, choosing the best plan can be a challenging task. To aid in this process, Forbes Advisor India has compiled a comprehensive guide to assist you in selecting the most suitable plan for you and your family.
Why Do I Need a Health Insurance Plan?
The increasing prevalence of lifestyle diseases, coupled with escalating treatment costs, underscores the importance of choosing a health insurance plan. Medical inflation in India, estimated at around 15% per annum, necessitates comprehensive health insurance to cover exorbitant expenses and safeguard the well-being of yourself and your loved ones.
A health insurance policy not only addresses hospitalization expenses but also provides immediate coverage for accidental injuries and various health-related contingencies. This prevents potential financial strain or the need for loans in the absence of a health insurance policy.
10 Tips To Help You Choose The Best Health Insurance Policy
1) Wide Coverage
Before purchasing a health insurance policy, thoroughly assess its coverage. Opt for comprehensive coverage to ensure adequacy in times of need. Comprehensive coverage should encompass hospitalization expenses, ambulance costs, daycare procedures, regular health check-ups, pre-and-post hospitalization expenses, critical illness coverage, alternative treatment options, automatic restoration, cumulative bonuses, second medical e-opinions, and minimal sub-limits on the plan. Read the policy documents carefully to understand inclusions and exclusions.
Pro Tip: Choose a family floater health insurance policy for comprehensive coverage addressing the health needs of each family member under a single plan.
2) Sum Insured
The sum insured denotes the maximum amount an insurance company can pay in a particular year for medical emergencies and hospitalization expenses. It is crucial to choose the right sum insured amount, ideally at least 50% of your annual income. Adjust the sum insured as life stages progress, ensuring coverage for evolving needs, such as maternity costs.
Pro Tip: Consider a “Top Up” policy to enhance coverage once the basic sum insured is exhausted.
3) Flexible Plans
Select a health insurance plan with flexibility to add family members like your spouse, parents, parent-in-laws, or a newborn. This flexibility reduces costs compared to obtaining separate policies. Ensure that short-term and temporary needs are accommodated, and flexibility extends to premium payment terms.
4) Waiting Periods
Understand waiting periods, the time during which no claims are accepted. Opt for health insurance policies with minimal waiting periods for pre-existing diseases, specific health conditions, and maternity. This allows prompt claims within a short period.
Pro Tip: Choose policies with low or minimal waiting periods for quicker claim processing.
5) Co-Payment Clause
The co-payment clause involves a percentage of the amount borne by the policyholder along with the insurance company in case of a medical emergency. Assess policies with low co-payment clauses or consider policies without co-payment clauses. Choosing a co-payment clause can lower the premium but requires out-of-pocket contributions.
Also Read: Health Insurance: 8 Tips to choose the Best Medical Insurance
6) High Claim Settlement Ratio
Select a health insurance plan from an insurance company with a high claim settlement ratio (CSR), indicating a greater likelihood of successful claim settlements. CSR represents the percentage of settled claims to total claims received.
7) Compare Multiple Health Insurance Plans
Compare various health insurance plans based on parameters such as sum insured, benefits, add-ons, premium quotes, and network hospitals. This comparison aids in understanding the coverage offered at the best rates.
8) Lifetime Renewability
Check for lifetime renewability, a crucial factor for uninterrupted coverage in later stages of life when health risks increase. Verify the policy’s validation period and confirm if it offers lifetime renewability.
9) Room Rent Limit
Choose a health insurance policy with fewer restrictions on room rent. Policies allowing selection of private, semi-private, or shared hospital rooms provide flexibility based on individual preferences.
10) Networked Hospitals
Before purchasing a health insurance policy, confirm coverage of important or nearby hospitals. Optimal coverage of preferred hospitals facilitates cashless claims, streamlining the claims process without direct involvement.
Bottom Line
Consider these tips when purchasing a health insurance policy for yourself or your family. A well-chosen health insurance policy can save on various healthcare expenses, providing financial security. Thorough research and consideration of the points mentioned will enable an informed and prudent decision.
Frequently Asked Questions (FAQs)
How to select the right sum insured amount in a health insurance plan?
Choose the sum insured based on age, dependents, income, medical history, and lifestyle. Adjust the sum insured as life stages progress.
What are the consequences of not picking up an ideal health insurance policy?
While not mandatory, not having a health insurance policy may lead to financial strain due to the rising costs of healthcare, requiring full payment out of pocket.
What challenges might one face while picking up a health insurance policy?
High premiums in India may necessitate coverage adjustments. Policyholders might need to opt for sub-limits, co-payments, or voluntary deductibles to manage premium costs
What kind of health insurance plans can I opt for?
Depending on factors such as age, lifestyle, family size, and dependents, individuals can choose individual health insurance plans or family floater plans. There are also plans covering parents-in-law, dependent siblings, and extended family members