Health Insurance Fundamentals: Things to Consider While Buying A Policy

Health Insurance

Lifestyle diseases, viral infections, and accidents are hard to predict. Health issues not only cause physical discomfort but also result in financial challenges. High-quality medical care is expensive. Therefore, one needs to plan well to stay afloat in case of unfortunate events that lead to hospitalisation. All this makes health insurance a crucial part of people’s life.

Nowadays, there are a lot of options when it comes to health insurance. Several insurers are offering a variety of health insurance policies. New-age digital health insurers are making the entire process easy and quick. In this dynamic marketplace, you must research and choose a plan that is best suited to your requirements for optimal results. Here are some things to consider while buying health insurance.

Self-analysis
Analyse your current lifestyle, health profile, and family’s medical history. Evaluate your savings in the bank against the cost of treating a lifestyle disease that forces you to spend a week in a hospital. Think about the health hazards in your immediate environment – pollution, rash driving, unhealthy diet and components that add stress to your daily routine. Such introspection will throw light upon the kind of policy you should opt for.

Picking the Policy
Health insurance is a wide concept. It includes different types of policies. You have the option to buy an Individual policy as well as a Floater policy that covers your entire family under one Sum Insured. Other policies/ add ons like Critical illness, Personal Accident, Hospital Cash, Top Up, Super Top up which help you design a wide-ranging Comprehensive health insurance policy/ cover for you and your family.

Health InsuranceYou can choose to secure yourself with multiple policies. For example, you can buy a Family Floater plan as well as a Critical Illness policy. Pick the policy or policies based on self-analysis. Usually, salaried employees are covered under their employer’s group health insurance plan. If you have such a cover, go through that policy’s coverage, and decide if it is enough for you or do you need the cushioning in the form of the plans mentioned above especially when you change your employer.

Age Factor
The higher the policyholder’s age, the higher the insurance premium to buy the policy. Young people can manage with a less-expensive policy that offers a lower Sum Insured, which is the maximum payable claim amount. However, the same will not be ideal for a person above forty years of age. Therefore, it is suggested to avoid postponing the purchase of a health insurance policy. Also remember the health insurance policies have a waiting period for various ailments/ illness hence the earlier you buy an insurance cover and renew it on a regular basis the waiting period for the listed ailments/ illness cease as per the tenure of policy.

Note that in case of a Family Floater policy, the eldest member’s age will have a bearing on the premium. Also, some policies might have a minimum and a maximum age limit. In most cases, the age restrictions are relaxed.

Right Combination
Simply going for a policy that is priced less and offers a higher Sum Insured might not be feasible. You need to consider a combination of factors while buying a health policy. These factors include the premium paid, the coverage offered, and the conditions that come with it.

For example, a low-priced policy might come with a Co-pay clause, which means you must pay a part of the hospital bill. Also, keep an eye on sub-limits, for example – a limit on the insurer’s liability to pay the hospital’s room rent. Consider the waiting period (specified days before raising a claim) as well.

Finding the Ideal Insurer
Insurers offer benefits to their policyholders as a part of the value-added services. Such benefits include the cost of health check-ups and covering ambulance charges. Check if your preferred insurer offers these benefits.

An ideal insurer ensures smooth claims settlement. Several insurers facilitate cashless hospitalisation where the hospital bill is settled between the network hospital (those that have a tie-up with the insurer) and the insurance company. This way, you do not have to pay the hospital bill and then get it reimbursed from the insurer.

Online Insurance
Nowadays, policies can be purchased easily through the insurer’s websites. Such digital insurers have also made the claim process hassle-free. You can speak to people in your circle to know about an insurer’s reliability. Checking online reviews for credibility is also an option.

Read the policy’s terms and conditions before purchasing it. Engage with the insurer through email, on call, or via social media if you need clarification. Make a wise choice and pick a cover that fits your bill.

Views expressed in this article are the personal opinion of Biresh Giri, Appointed Actuary, Head of Product Development & CRO, Acko General Insurance.

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