Medical emergencies come unannounced. They can eat into all your savings if you are not adequately insured. Healthcare costs, too, get higher from time to time. In order to be on top of such situations, you need the right health insurance policy for yourself and your family. And to pick the right product among the array of options available in the market, you must ask yourself the following questions.
Individual health insurance plan or a family floater?
Insurance companies offer both individual health plans and family floaters depending on your needs. While an individual plan covers all members in a family separately, a family floater protects everyone under an extended plan with the same terms and conditions. Relationships covered in a family floater varies from company to company. While most schemes cover individuals, spouses and children, there are some that take care of the parents and parents-in law.
“A family floater allows a higher cover than an individual policy and costs comparatively less. However, the policy premium is determined on the basis of the age of the oldest member included in the plan. Therefore, a family with the oldest member less than 50 years of age stands to benefit more from a family floater. If you have aging individuals in your family who are more prone to illness, you must opt for individual health plans,” says Adhil Shetty, CEO, BankBazaar.
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What are the inclusions and exclusions?
Diseases and ailments covered under a health policy vary from company to company and plan to plan. For example, a company may not cover maternity expenses under a basic plan, but may include it in a higher plan. Every health plan has a list of exclusions and a list of ailments that have an associated waiting period. “An ideal plan would cover the maximum number of ailments with minimum waiting period. You must read all terms and conditions carefully before you opt for a policy, so that you’re not in for a rude surprise when you need to use it during a health emergency,” informs Shetty.
Are there sub-limits?
A health insurance policy may cover multiple ailments, but with a cap or sub limit imposed on the expenses. Health plans often come with fixed sub-limits for room charges, doctor’s fees, ICU charges, attendant daily expense, ambulance charges, etc. You must look for the minimum number of sub limits and make sure that the sum assured is sufficient for treatment in a good hospital.
Is there cashless coverage available near you?
These days all health insurance companies have tie-ups with a large number of hospitals, ensuring cashless mediclaim facility. If you get treatment from any of the hospitals in the insurance company’s network, you don’t have to pay out of your pocket. “However, in case of a hospital which is not in the insurance company’s list, you will have to make payment in that instant and submit necessary documents claiming reimbursement. Therefore, ensure that you have a cover with a wide coverage in the area you live,” says Shetty.
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Is there a no claim bonus?
Most health insurance companies today offer cover enhancement to the tune of no claim bonus for every year you don’t make a claim. For example, if you have not made any claim in the first year of buying the cover, you will get a no claim bonus of 10%. So, if your basic cover was worth Rs 5 lakh in the first year, you would get an additional cover of Rs 50,000 in the second year without making any extra payment. If you do not make any claim in the second year, your cover would be enhanced further.