Health Insurance Policy: How To Make The Right Choice

By Adhil Shetty | August 23, 2017

Buying a Health Insurance plan is a complete necessity as they back you up financially during any unannounced health emergency. With medical costs rising, a serious disease or ailment can disrupt your financial stability. Even minor ailments these days can put a dent in your bank account.

Critical Factors To Look For While Choosing A Health Insurance Plan

A basic Health Insurance plan should essentially take care of the hospitalisation charges. This way you do not have to fork out money for a big medical expense and it can be met by your Health Insurance plan. You can look for more customisation in the form of increased medical cover, cover for medical tests, visits to the doctor and cost of medicines.

Broadly One Should Keep In Mind The Below Listed Crucial Points

Details Of  The Insured Members – This would include health status of the individuals planned to be covered under the policy.

Type Of Policy – Decide which type of health policy you would require- family floater or Individual. Both these options have different benefits when it comes to insuring a single person or an entire family. Floater options work well for a younger family, while individual policy works well for a family with members over 50 years of age.

Cover Amount – When buying Health Insurance, you should take into account inflation and the cost of medical treatment. Decide the amount accordingly keeping a long term perspective in mind.

Room Rent Capping – You should ensure the policy you are opting for has no cap towards the hospital room rent.

Co-pay Factor – You should go for a plan that does not have any condition of co-pay under any claim scenario. This condition levies a co-payment clause owing to which a policy holder has to share the cost of claim in the defined proportion as set in the policy.

Hospital Network –In case of emergencies, you should check whether or not a particular hospital figures in the cashless list of network hospitals.

Waiting Period Of Pre-Existing Diseases (PED) – This factor is important in case you have PED like diabetes or hypertension. Your Health Insurance plan in such case should have coverage for the same

Along with the above-mentioned factors, you could also take into account if the Health Insurance plan you are choosing includes benefits like restoration of cover amount, free medical checkups, maternity benefit etc

Benefits Of Having A Health Insurance Plan

Cashless Hospitalisation – Health Insurance companies usually partner with hospitals to make available cashless medical insurance plans. When you are admitted to one of these partner hospitals, the insuring company pays treatment expenses to the hospitals. This way not a single rupee is spent from your pocket. In case the hospital is not a partner, you pay for the treatment and later reimburse it from your insurer.

Pre-Hospitalisation Expenses – If you have spent money on treatment for an illness that you were admitted for later, the insurer will make sure that they pay for these costs too. The insurer will ideally pay for the costs that you incur 30 to 60 days before you are hospitalised. 

Post-Hospitalisation Costs – The treatment does not end once you leave the hospital. Bills add up for medicines, doctor visits, tests etc. Insurers will pay for costs 60 to 90 days after you have been discharged from the hospital.

Free Medical Check-ups – Decent policies give you the option for free medical check-ups. This ensures you stay healthy and anything out of the ordinary is caught at the right time. Most of these policies give you one free medical check-up every year. 

Tax Savings – You can claim exemptions for the premium paid for your medical insurance under Section 80D of the Income Tax Act of India. Rs. 25,000 can be claimed as a deduction annually. The premium can be for you, your spouse or your children. Senior citizens may claim up to a total of Rs. 30,000. An additional equivalent amount can be claimed U/S 80D for premium payment for parents as well.

No-Claim Bonus – If you have not made any claims over the past year then you will receive a bonus. Your premium amount may be reduced or there would be an increase of your sum assured.

Do not just focus on the cover and the premium amount to pick the best Health Insurance policy for you and your family. Focus on the sum insured limit, as you would have to pay for any amount that exceeds the sum insured. This can be deduced by evaluation your current financial situation, family medical history etc.


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About Adhil Shetty

Adhil Shetty is the Founder and serves as the Chief Executive Officer of Adhil has a Master’s degree in International Relations with a specialization in International Finance and Business from Columbia University in the City of New York, and a Bachelor’s degree in Engineering from the College of Engineering Guindy, Anna University. Adhil is an expert in Personal Finance (Car loan/Home loan and personal loan) and he majorly consults on investment and spends rationalization for the Indian loan borrowers. His guidance is number based with real time interest rate calculations and hence useful for consumer’s real time query.

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