Comparing health insurance plans? Check these facts before you buy a health cover

With multiple health insurance plans available in the market, it may sometimes become little daunting to choose the right one to buy for oneself.

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Do not merely go by the premium as it will differ depending on the features available in the various plans.

Selecting the right health insurance plan amongst several plans available in the industry is making the comparison task difficult for buyers nowdays. Most of us are aware that buying a health insurance policy helps in meeting the hospitalisation costs. However, when it comes to choosing the right health insurance policy, it becomes a slightly trickier task. Comparing health insurance plans need to be done to choose the right policy. After all, there are different health insurance plans available with different insurance companies. Even with the same insurer, there are different versions or variants of the same policy. “With multiple health insurance plans available in the market, it may sometimes become little daunting to choose the right one to buy for oneself,” says Amit Jain, President, Personal Lines, Bancassurance & Affinity and Marketing, Liberty General Insurance.

But, the numerous features and versions should not deter you to avoid buying a health insurance plan, especially if you are in the pink of health. “One should buy a health cover while one is disease-free and healthy, in order to avoid premium loading or rejection of the proposal, in case of any adverse medical condition,” says Shanai Ghosh, CEO Designate, Edelweiss General Insurance.

Even before you zero-in to the right policy, there are other issues to take care of. Buying a health cover with an adequate sum insured is important. The right amount of sum insured in a health insurance policy will largely depend on the city where you reside. In big cities, cost of hospitalisation will be more compared to a relatively smaller city or town. Also, a higher sum insured should be opted for in case you or any family member has a family history of any ailment.

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While selecting the right plan for you, it’s important you consider the features also according to your age. Ghosh makes it simple for you to decide. “Age is also an important element to be taken into account. For customers between 0 days to 18 years, hospitalisation cover is important; however, if you are a senior citizen, you need to consider age, hospitalisation cover, reload of critical illness coverage, AYUSH benefits, Sum Insured restore benefits etc., would be more ideal. For adults, maternity benefit and personal accident covers, are also of importance along with basic hospitalisation,”

Simultaneously, you need to decide whether to take a Family Floater plan or an individual plan. “If unmarried or single, one can opt for an individual sum insured plan and take a separate floater policy for parents. If married, we recommend a family floater policy, which can cover self, spouse and children (if any) in a single policy, where the sum insured can be utilized by all insured in the policy,” says Ghosh. Remember, most insurers cover family members up to the age 25 in a family floater policy and one may add or remove a member’s coverage from it.

Now, comes the important part of selecting the policy. Most insurers have more than one variant of the same policy such as Basic, Silver, Gold or Executive, Premium etc. While selecting a health insurance policy, start with the most standard or basic version and see its features. Find out what all is included and excluded in the policy. This gives you a fair idea as to what to expect in higher variants. Now, see if the advanced versions offer features that you find to be essential or not. Accordingly, see the difference in the premium between the the two variants and decide. “The plans can be compared on the basis of policy features, premium and claims servicing of the company. With numerous plans available in the market, it is very important to identify the exact need of the family,” informs Jain.

There are some important features that you may consider while comparing health insurance plans. “One should look at products with no room rent capping, no sub-limit and no co-payment in it to have no liability in the future,” says Jain. Sub-limits is applicable on almost all hospital cost-heads and any expense above that will have to be borne out-of-pocket by the health insurance policyholder. Ideally, opt for plans with no sub-limits else you will have a cap on the room rent.

For more evolved buyers, looking at the financial soundness of the insurer also helps. Even though claim ratio and other financial keep changing for the insurer, one may apply them while deciding on the insurer but need not rely entirely on them. “Insurers who have minimal claim rejection ratio and lesser customer grievance along with high solvency margins are suggested,” informs Vikas Mathur, Head – Health Marketing, Universal Sompo General Insurance.

Do not merely go by the premium as it will differ depending on the features available in the various plans. “ It is important for customers to check for coverage offered in the policy vs the premium charged for coverage to make an informed choice,” says Ghosh. Finally, disclose all material information including your medical history and current medications, if any. Letting the insurer know about pre-existing diseases is equally important as any non-disclosure or wrong information may result in a repudiation of the claim even if they are covered after four years of the policy. Jain sums up, “Determining the right cover at the right price is the most critical point to evaluate in choosing a health cover. The lifestyle of the family, family history of any specific ailment and any pre-existing disease in the family should be the key factors you should consider while selecting the right health insurance plan.”

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