One of the things that the pandemic has taught us in recent times is the importance of health insurance. Opting for any insurance seems easy given the number of organisations seeking to lure the customers, however, there are a few factors that one often neglects at the time of selecting a policy and ultimately pays a heavy price when there’s a medical emergency.
Here’s a list of the 5 most important details one should look for before taking a medical policy from any insurer:
a. Hospital network
Always ask for the list of network hospitals in your city (and the one you prefer) from the insurer, and also in cities, you often travel to. Look for the insurer that has the highest number of hospitals with cashless bill settlement option so that the insurer settles the bill directly and you (or your family members) are not hassled with the bill settlement task at the time of a medical emergency.
b. Pre/post-hospitalization
Always choose an insurer that covers your pre and post-hospitalization expenses such as doctor’s fees, medical tests, medicine expenses, and not just the expenses at the time of hospitalization.
c. Co-pay and sub-limits
These are the two conditions (co-pay and sub-limits) that are often overlooked while considering a health insurance plan. Which ultimately leads to uncomfortable situations at the time of settlement of the bill. For example, if there’s a 20% co-pay condition in the policy, the policyholder has to pay 20% of the medical expenses. Also, a condition of sub-limit puts a cap on many things such as expenses on certain treatments, room rent in case of hospitalization, beyond a limit. One should downright ask for the list of exclusions in the proposed plan.
d. Waiting period and pre-existing disease clause
To avoid unethical practices of non-disclosure of ailments by the party while availing a policy, many insurers have a clause that requires a waiting period before the party can gain the benefits of full cover or a list of ailments begin to get covered in the policy. One should be fully aware of these clauses and should not buy a policy under the presumption that he/she would get the benefits immediately after taking up a plan for a pre-existing health condition.
e. No claim bonus and lifetime renewability
While taking any health insurance plan one should enquire about a ‘no claim bonus’ feature in the plan which ranges between 5% to 100% of the basic sum insured and adds additional cover in your existing plan in case of no claim in the particular year. Higher the bonus better as you won’t need to take more cover every year. Also, choose a plan that offers lifetime renewability as the chances of catching an illness is higher as you grow old.
One should also remember to take tax benefits for the premium paid under Section 80D of the income tax act and renew the plan before expiry. Most of the companies provide a free health check-up at the time of renewal of the policy. This should be availed by the life assured to keep track of their health.
Besides the above-mentioned details, there are a few things that one needs to remember about health insurance. The earlier the better. Health insurance taken at an early stage in life can offer relief during difficult times. Since the policy taken at an early age requires no medical check-ups, provides easy and hassle-free renewals, and has a lesser chance of rejection due to health issues.
Another important aspect to note is the sum assured. One should take adequate cover depending on their age and income, which can take care of any medical emergencies without burning a hole in one’s pocket as medical expenses come unannounced.
Lastly, always consider taking a plan from an insurer with the right credentials, and opt for a family floater plan instead of separate plans for each of the family members.