Health insurance: Top things to look for when buying a health cover

By: |
July 17, 2020 6:12 PM

The number of choices and complex jargons make buying a policy difficult. To avoid any misinformed decision making, one should look for certain points in a health insurance policy.

Coronavirus lockdown, Covid-19 pandemic, health insurance, Covid-19 insurance cover, IRDAI, Corona Kavach planWith increased digitalization, buying a health insurance plan today is extremely easy.

Till a few months back none of us was aware that such a major pandemic will strike the world. Experts say that more than ever before, people are now realizing the importance of having a health insurance cover. Rakesh Goyal, Director of Probus Insurance, says, “With healthcare emergencies on the rise, insurers are now stepping into the market with newer and better products. In fact, for most people buying health insurance is a challenge in itself.”

Hence, the number of choices and complex jargons make buying a policy difficult. To avoid any misinformed decision making, one should look for certain points in a health insurance policy. Such as long term duration of the waiting period, benefits of the policy, cashless hospitalization benefits, co-pay, room rent limitations, etc.

Here are the things you should look for when buying health insurance;

– Individual or Family Floater: When opting for a health insurance policy, one has the option of choosing from an individual and a family floater plan. In an individual plan, the sum insured is meant only for the policyholder. Individual plans can be also be bought for each family members having the same or different sum insured. So, to make sure every family member is covered under a health plan, one has to opt individual plans for each of them. The other option is to cover the whole family under a floater plan, which will cover you and your family members in a single plan. In the family floater, the total sum insured is shared between the family members. Many insurers do offer family floater plans with restoration benefits too, which restores the coverage when exhausted in the policy year due to incurred claims.

Goyal says, “As the old saying goes, ‘better safe, than sorry’, investing in a health insurance plan is a great way to stay financially secure in adverse health emergencies. With increased digitalization, buying a health insurance plan today is extremely easy. You can scan and upload your documents and save a copy of your policy on your email. Make sure you have a financial shield to meet the medical treatment expenses.”

– Cashless Hospitalization Benefits: Health insurers have a tie-up with hospitals as part of their ‘network hospitals’, to offer cashless hospitalization and settle claims. With these network hospitals, policyholders can avail cashless treatment by submitting their policy details. This not only saves time but also cuts down the tedious paperwork. It is a quicker process as the insurer pays the sum directly to the hospital. Hence, review your list of network hospitals and filter the ones around you before zeroing down on a health insurance plan.

– Age Criteria: When it comes to deciding the right product for a health risk cover, age is a critical factor. Most health policies have a well-defined age depending on the product type. Even though most products cover individuals from 18 years to 60 years, they can vary. Additionally, keep in mind the premium amount is directly related to age. In the case of a family floater policy, the premium cost is calculated on the basis of the age of the oldest family member.

– Duration of Waiting Period: The waiting period of a policy is the time duration when claims made against specific or pre-existing illnesses cannot be processed. Pre-existing illnesses such as thyroid, blood pressure, diabetes, or any other conditions that an individual is suffering from, along with treatment for chronic illnesses like arthritis, varicose veins, cataracts also fall under the waiting period clause. On average, the waiting period is about 48 months.

Goyal says, “Typically there is a waiting period of 30 days before making a claim for other than pre-existing illnesses. However, newly launched COVID-specific products, have some relaxations with the waiting period. It is best to know the waiting period beforehand to avoid disputes during claim settlement.”

– Premium to Coverage Ratio and Room rent: Most buyers often choose the lowest premium rates while buying a policy without paying attention to the coverage amount. Experts say this is due to the lack of awareness. Most choose a health plan that does not disrupt their monthly budget. However, lower premium rate policies usually have limited coverage.

Goyal says, “In order to strike the right balance, it is recommended to look for a good premium to coverage ratio. Remember to compare the plans or speak to an expert before buying. Also, pay attention to co-payment structures and other claim related clauses.” Note, a higher but with limitations on the room-rent can also surprise you at the time of claims. The medical treatment expenses including doctor’s fees are charged based on the room rent. Before buying it is advisable to check the room rent allowances. When buying a health insurance plan, a good rule of thumb is to look for long term benefits, co-pay, and room rent limitations.

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