10 Key Factors to Consider Before Buying Health Insurance

Top 10 factors to consider in Health Insurance: 

So, while you go hunting for the best plan that suits you, consider  that the plan you choose ticks these crucial pointers listed below:

1. The Criteria of Age  

Consider which stage of life you are in before you decide on an insurance plan. If you are starting a new family a comprehensive plan with a family floater having an entry age as low as 91 days would be apt for you. If you want coverage for chronic or lifestyle diseases, you should look for a plan with pre and post-hospitalisation coverage. If you are buying health insurance coverage for your parents or even grandparents, separate plans for senior citizens would be a better way to go.  

2. Good Blend of Premium and Coverage  

It is just a habit to go for a cheaper premium at the first instinct. But not at the cost of the insurance coverage. If you happen to find all required coverages at a cheaper premium, do go for it. But always delve deeper to find out why the cost of coverage is low. There may be additional charges for extra coverages in the form of riders and clauses of co-payments, deductibles and ceilings on coverage payments for specific diseases.  

You should go for a balanced plan which provides you with wholesome coverage at an affordable cost rather than blindly going for some cheaper premiums. It may so happen that you end up paying more at the time of the actual claim. Ensure that the sum insured can cover your family size, your city’s healthcare costs and any pre-existing health conditions.  

3. The Clause for the Waiting Period 

Certain pre-existing conditions are covered by health insurers after a wait time which usually ranges from 2 to 4 years, post which you are eligible for a payout of the insured amount. Medical conditions like high blood pressure, diabetes, thyroid, and hypertension are usually covered with a waiting period. The tenure though varies from insurer to insurer and some may offer a lower waiting period. So be sure to look out for the list of such diseases covered, the tenure of the waiting period and options for buyout which lets you reduce the wait time. 

4. Renewal Benefits and Facilities for No Claim Bonus   

Most health insurance providers offer no claim benefits in the form of bonuses and renewal discounts. The no-claim bonus gets added at the year-end if you do not file a claim within the policy year. This way your sum insured is increased for the next year. Some policies even retain no-claim bonus facilities after a minor claim. Some even offer cumulative bonuses for consecutive claim-free years.   

For instance, if the sum insured of a policy is 5 lakhs and the company declares an NCB of 10 % for every claim-free year with a maximum of 50%, Rs.50000 will get added to your sum insured every year till it reaches the amount of Rs. 7,50,000 (which is 50% of initial sum insured of 500,000/- =2,50,000/-+ Sum Insured of 500,000/-). 

5. Cashless Benefits and List of Network Hospitals 

Would you not be relieved if someone could take care of your finances while you focus on your or your loved one’s recovery during medical exigencies? A cashless benefit is just what you need. Every health insurance company has a list of hospitals with whom they have tie-ups for direct payments. It saves you from the arduous paperwork required for hospital admission and claim. Moreover, you have access to the best doctors and facilities without sweating about your expenses. Hence checking the list of hospitals along with the process to access cashless benefits while buying health insurance can save you a lot of stress. 

6. Critical Illness and Additional Riders 

Standard and regular health plans may not cover terminal illnesses like cancer, cerebral strokes, or kidney diseases. To have enhanced coverage for these long-term diseases, you should consider policies with additional critical illness riders. 

Added to these, there may also be accidental disability cover, hospital cash benefits or personal accident insurance. 

7. Preventive Health Check-up and Co-payment Clauses 

Nowadays health checkups may also eat into your savings as they need to be regular and are quite expensive due to the usage of modern technologies. Regular MRIs, Ultrasonograms, screenings, ECGs and EEGs are sure to pinch your pockets hard. Look for this preventive coverage when you are buying health insurance plans for your family.  

The co-payment clause simply means the amount that you will need to contribute at the time of claim, and the restof the  amount will be reimbursed by your insurer. In case you want a plan without a co-payment clause buy a plan without sub-limits.  

8. Maternity Cover and Newborn Cover 

Preparing yourself in advance for maternity expenses will be a good piece of wise advice to consider. Usually, maternity benefits have a waiting period of 2-4 years, so you should plan in advance when you decide to start a family. You should go for plans that have coverage for newborn babies along with normal and C-section deliveries without charging extra premiums.  

9. Pre and Post Hospitalisation benefits 

When you are admitted for treatments, it is not only those days that your expenses soar but also before and after them, you continue to pay for multiple other activities associated with your recovery. Repeated medical tests, doctor consultations, post-operative care at home, medicines, physiotherapies etc. are to name a few. Ensure your health care plan is well-equipped to cover them without you being worried about finances. 

10. Claim Settlement Process  

This is a very crucial point to consider as it will be a blessing at the time of settling health claims. No one wants to be hassled about money when your near and dear ones are suffering in a hospital. Hence do check client reviews, choose a reputed brand as your provider and read about their claim settlement process in detail before going all in.