11 Important things to keep in mind before buying a Health Insurance plan in 2025

Health insurance is essential for financial security during medical emergencies. With rising healthcare costs, choosing the right health insurance policy is more important than ever. If you're planning to buy health insurance in 2025, here are 11 key things to consider before making your decision.

1. Coverage Amount (Sum Insured)

Choose a policy with sufficient coverage to handle medical expenses, including hospitalization, surgeries, and critical illnesses. A higher sum insured is beneficial, especially in metro cities where healthcare costs are high.

2. Type of Health Insurance Plan

There are different types of health insurance plans, such as:

• Individual Health Insurance
• Family Floater Plan (for the entire family)
• Senior Citizen Health Insurance
• Critical Illness Insurance (for serious diseases like cancer or heart disease)
• Group Health Insurance (offered by employers)
• Select a plan that suits your needs and budget.

3. Cashless Hospitalization

Check if the insurance company offers a cashless treatment facility at network hospitals. This allows you to get treated without paying upfront, as the insurer settles the bill directly with the hospital.

4. Waiting Period for Pre-Existing Diseases

If you have existing health conditions (like diabetes, hypertension, or thyroid issues), check the waiting period before your coverage starts. Some policies have a waiting period of 2–4 years for pre-existing diseases.

5. Claim Settlement Ratio (CSR)

The claim settlement ratio indicates the percentage of claims an insurance company settles. A high CSR (above 90%) means the company is more reliable in paying claims on time.

6. Inclusions and Exclusions

Read the policy details carefully to understand:

1. What is covered (hospitalization, surgeries, OPD expenses, maternity benefits, etc.)
2. What is not covered (certain diseases, cosmetic treatments, waiting period exclusions, etc.)

7. Premium and Affordability

Choose a policy that offers good coverage at an affordable premium. Compare different plans online and use premium calculators to find the best deal.

8. Co-Payment and Deductibles

Some policies have a co-payment clause, which means you need to pay a part of the bill from your pocket. Check if your plan has co-payment or deductibles and how they affect your claim.

9. Lifetime Renewability

Opt for a policy that offers lifetime renewability so you can stay covered even in old age without worrying about policy expiration.

10. No-Claim Bonus (NCB)

If you don’t make any claims in a year, many insurers offer a No-Claim Bonus (NCB), which increases your sum insured without raising the premium.

11. Additional Benefits (Add-Ons)

Some insurance policies offer additional benefits like:

• Maternity Cover (for pregnancy-related expenses)
• OPD Cover (for doctor visits and medicines)
• Critical Illness Rider (for diseases like cancer, stroke, or kidney failure)
• Room Rent Capping Removal (so you can choose any hospital room without limits)