Choosing a Health Insurance plan can be very easy if you keep some pointers in mind. Here’s help.
Cheap is a very relative term, especially when it comes to Health Insurance. It’s no secret that hospitals today charge room tariffs that can make 5-star hotels seem like budget hotels in comparison! And, God forbid if a small surgery is involved, your purse will feel lighter by a neat lakh or two.
Medical costs have skyrocketed so much in the recent times that it won’t be a surprise if ISRO and other space research communities start considering space technology to be cheaper. Your only option against such meteoric inflation in healthcare expenses is a Health Insurance plan.
But, choosing the right plan is as important as getting one. So, how do you zero in on the best plan? Here are the questions you should be asking yourself.
Am I adequately covered?
Getting adequate coverage is the first thing you need to consider. As you know, the more the sum assured, the more the premium will be. However, paying a slightly higher premium is better than saving on premium but paying ten times more for hospitalisation expenses. Moreover, the premium paid for Health Insurance brings you tax benefits of up to Rs. 75,000. This will apply if you buy plans for the whole family, including your parents.
So, what is the ideal sum assured? There are several parameters to consider, but as a rule of thumb, if you are young and healthy, a sum assured of Rs.5 lakhs will be a good start. As you renew the policies, take advantage of the No Claim Bonus and increase your sum assured proportionately.
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Am I completely covered?
Adequate cover and complete cover for your healthcare expenses are two different things. An optimum sum assured covers you adequately, whereas complete coverage includes other things that come within the ambit of medical expenses. This will include things like pre- and post-hospitalisation expenses, hospital room charges, nursing expenses, ambulance charges, etc.
Check if the plan you choose covers many of the related expenses. It may provide sufficient cover in terms of the amount of sum assured but may not provide for the right kind of expenses. Compare across plans to see what expenses are provided for, assuming the sum assured is the same.
Who is the best provider?
This is a million dollar question or rather a crorepati question. IRDA, insurance regulator in India, has made it mandatory to have uniformity in case of health policies. This makes it easy to choose between options in the market. Yet, there are several parameters to consider when you choose an insurance provider.
The Claim Settlement Ratio (CSR) of the company is an important parameter. This gives you an idea of the probability of your claims being approved by the insurance company when you file a claim.
Next is the list of network hospitals in which the insurance company offers the cashless facility. Having the option of cashless reimbursement can make all the difference between quick and easy settlements as opposed to the tedious process of paying the hospitalisation expenses yourself, then submitting all those bills to the insurance provider and then waiting for them to respond.
Finally, there can be slight variations in the premiums of different insurance companies, so do your research to identify providers with lower premiums and the best features.
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There are too many complex plans. How do I choose?
Apart from the basic indemnity plans, there are some benefit plans that can potentially confuse buyers. They include surgical protection plans, cardiac care covers, cancer care cover etc. that offer a higher coverage for specified conditions. The premium of such plans will be lower; about one-third of an indemnity plan, but one can make the best use of them only if an expense related to those specific conditions arises.
For instance, since surgeries are the most money-draining part of medical treatments, getting a special cover for it and a lower overall premium is the right thing to do. But, if you decide to opt for them, take them in addition to a basic plan, as most of them might not cover other regular hospital expenses.
Should I go for any riders?
Riders are worth considering if you are likely to undergo any medical treatments. Maternity cover riders, pre-existing disease cover, and critical illness riders are three of the most popular riders in Health Insurance. While the first two can be opted for depending upon your specific condition, you can give the third one a miss if you have a high sum insured for your basic plan.
Disease-specific plans such as a diabetic care plan are an alternative to critical illness riders. But, they come with a higher premium and are not sold as standard covers. Therefore, they can be included as additional protection only if required.
Should I opt for cover for treatments abroad?
Many policies today provide cover for treatment coverage abroad. Coverage for treatments abroad will mean a higher premium. But remember, it is applicable only when you travel abroad. And moreover, in most cases, you could take a Travel Insurance policy which would cover your hospital expenses abroad. Therefore, you can save on premium cost.
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Here’s a quick cheat-sheet for buying Health Insurance:
- Go for a basic indemnity policy first. Other plans such as critical illness and disease-specific plans can be your next level of protection.
- Read the policy inclusions and exclusions carefully.
- Check the individual expense limits for different heads like hospital room rent, doctor’s fee etc. to see what is covered.
- Find out if there are any treatment-specific caps that limit the amount you can claim for some treatments such as those for pre-existing diseases.
- Check for the portability of the plan – whether the policy allows changing the provider without losing continuity benefits.
- As you grow older or as the number of dependents increases, you may need to increase your sum assured.
- Most importantly, buy plans as early as possible to take advantage of low premiums.
With these in mind, you should be able to experience 5-star comfort during your hospitalisation while your wallet feels the pinch of only a budget hotel’s charges. Get that plan right away.