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Top 10 Things to Consider Before Buying a Health Insurance

October 13, 2022
in Uncategorized

  1. Sum Insured: With the rapid increase in the cost of hospitalization and medical treatments, it is important to have an adequate cover. Sum insured should be decided based on the city of residence, existing disease and the number of family members to be covered under the policy.
  2. Age Criteria: Different policies come with different age limits; some policies have a minimum age limit of 91 days while others might have an entry age limit of 25 Years, and most policies have a maximum age limit of 60 years.
  3. Policy Premium & Coverage: The premium will depend on the coverage sought for, the more comprehensive coverage the policy offers higher will be the premium. Just to buy a cheaper policy, it is not advised to compromise with the coverage.
  4. Waiting Period: It refers to a time when no claim can be raised against the health insurance policy. Pre-existing diseases and maternity benefits are typically included. It can range from 9 months to a few years, depending on the insurance company and the plan that you want to buy.
  5. Cashless Hospitalization Benefits: Typically, health insurance companies partner with network hospitals so that the insured can receive cashless treatment at the time of a health-related emergency. It saves you from the time-consuming documentation required during admission and claim. Additionally, the insurance pays the hospital directly with the insured amount. Therefore, at the time of admission, you are not required to first arrange funds before requesting reimbursement. It will be beneficial if you check with your insurance for a list of empanelled hospitals and are aware of all network hospitals in your area. In addition, determine whether the insurer has a wide range of hospitals where you can receive cashless treatment. As a result, you’ll need to pay substantially less for medical care.
  6. Claims Settlement Ratio: The claim settlement ratio is another crucial aspect that every policyholder should understand. It is the percentage of claims that an insurance company settles in a year out of total claims. It acts as a measure of their reliability. The insurer is more dependable if the ratio is higher. So, before selecting an insurance company, conduct basic research.
  7. Pre/post-hospitalization Coverage: Any tests, treatments, doctor visits, etc. done before or after hospitalization are considered pre and post-hospitalization. Pre- and post-hospitalization terms and conditions vary among insurance companies. Ensure that your policy includes this coverage.
  8. Exclusion of Co-payments & Sub-limits: One of the most important factors to consider when purchasing insurance is clauses such as co-payments and sub-limits. The co-payment clause requires the insured to pay a percentage of the total hospital charge, with the insurer covering the balance. The sub-limit clause is an additional clause that requires attention. If your policy contains a sub-limit clause, then in case of hospitalization a specified % of the sum insured will be borne by the insurer remaining needs to be paid by you. Both of these clauses act as detrimental for the insured.
  9. Cap on Room Rent: Although the cost of a hospital’s room rent may seem insignificant, it can be expensive depending on the facility. If the patient is admitted to a room that costs more than the allowable limit, the cost of the treatment may increase. The maximum amount of room rent coverage permitted is specified by the room rent limit in a health insurance policy. The insured would be required to pay a proportionate amount of the total hospital bill if he chose a hospital room with a higher rent.
  10. Global Cover: Healthcare expenses incurred outside of India are referred to as global cover. According to experts, it’s important to understand the cover limits, terms, and circumstances, such as the requirement for proof of diagnosis in India only. You might also need to consider the countries covered by the policy and the payment method, for example, whether it is cashless or based on reimbursement.
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    About Us

    MyGoalMySip is an Online Mutual fund investment platform powered by Prudent Wealth. As an investor, it might be hard to find the perfect investment opportunity; therefore, we’re here to help you make an informed decision.

    Our goal is to educate people and make them financially literate, and at the same time guide you in your investment journey, in short MyGoalMySip is your investment buddy.

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