How to choose the right health insurance plan

Choosing the best health insurance plan which best fits a person’s requirement is an important decision not just for the person but also for the family.

While choosing a health insurance plan, it is important to keep in mind that the type and size of the plan varies from person to person. The needs of a healthy young single person are quite different from the needs of a family person.

10 key points to remember when choosing the best health insurance policy

Here are the 10 Key Points one should consider while comparing health plans:

  1. Insurance Coverage:

    Besides the regular coverage features like in-patient hospitalization, pre and post hospitalization, ambulance expenses, etc. one should look for other features like maternity benefit, list of Day Care treatments etc. Accordingly one should choose the most comprehensive plan that best suits one’s needs. There are many types of health plans ranging from basic hospitalisation and critical illness to disease-based, top-up and daily cash. Buying a basic hospitalisation policy should be the priority. Others such as critical illness and disease-specific ones can be added as the next level of protection.

  2. Room rent:

    This is covered under the in-patient hospitalization category, where the cost of the hospital room is covered. All polices cover room rent but a few polices have a limit on the coverage. It would be prudent to check the limit mentioned in the chosen health plan and find out if it is at par with the choice of room one chooses to be admitted in. Otherwise, one has to compromise on the choice of hospital room or pay the extra rent from own pocket.

  3. Deductions and other limits:

    There is a concept of co-pay, where one has to pay a part of the claim from own pocket while the remainder is paid by the insurer. A higher limit may prove to be a financial strain in future. Other limits are those on ambulance expenses, certain surgeries etc. These restrict the amount of claim allowed under the plan. It is advisable to opt for a plan with a higher upper limit, so that maximum amount of claim can be availed.

  4.  Waiting period:

    If a person is suffering from a pre existing disease at the time of buying the plan, coverage for such illnesses will be provided after a waiting period of a few years. This is applicable in all health policies without exception. It is important to find out the waiting period for pre existing illeness.

  5. No claim Bonus:

    All health plans generally gives a reward if no claim is made in the previous year. This reward is called a No Claim Bonus and accumulates for every year when there were no claims. Most of the insurers allow an increment in the amount of Sum Assured for every claim-free year up to a certain limit. Others give discount vouchers, discount in premium paid for the next year or other benefits.

  6. Network hospitals:

    Hospitals which have a tie-up with the insurer can provide a cashless claim settlement facility, which involves a hassle free claim settlement compared to reimbursement. The health insurance plan’s network hospitals should be suitable enough in terms of location, services and trustworthiness. Normally network hospitals provides a cashless settlement at the time of claim and this helps in hassel free and quick way to get reimbursement of costs incurred.

    7. Claim settlement ratio:

    This ratio indicates the proportion of claims settled by the insurance company against the total claims raised. The higher the ratio, the better are the chances of the claim being honoured.

    8. Cost

    The premium for the health insurance plan should be in proportion to the features it offers because paying a high premium for limited coverage is really not worth it.

    9.Indemnity or a benefit plan:

    While indemnity plans cover hospitalisation expenses such as room rent, doctor's fee etc, benefit plans pay a lump sum on diagnosis of the disease.

    10.Can the coverage be extended and Is the policy portable?

    As a person’s responsibilities grow one may have the need to increase the sum insured. This has to be confirmed with the insurer as to what extent it can be done.

One has to confirm if the policy can be ported. This means a person can transfer the policy to another insurer without losing continuity benefits such as coverage of pre-existing illnesses after completion of four years.

As health insurance needs of individuals have evolved, insurance companies have been quick to innovate by launching better plans offering a range of options. A few of the notable Health Insurance Companies in India are mentioned below

(Source: http://customerkart.com/top-health-insurance-companies-in-india)

  1. Apollo Munich Health Insurance

Apollo Munich is one of the rising companies in this sector. Apollo Munich has provided best of features and benefits in their policies and received Health Insurance Company of the Year award in the year 2014. This Company offers cashless treatment above 4000 hospitals across the country. There are various health policies such as Optima Cash, Easy Health, Optima Super and Energy.

  1. Star Health & Allied Insurance Company Limited

Star Health Insurance company recommends wide variety of health insurance products at affordable prices for making health insurance every human being’s right. A few of the policies are Family Health Optima Insurance Plan, Senior Citizens Red Carpet Health Insurance Policy, Super Surplus Insurance Policy, Star Comprehensive Insurance Policy etc.

  1. Max Bupa Health Insurance Company Limited

Max Bupa Health Insurance Company Limited is an Indian assurance firm and it is a joint venture between Max India Limited and Bupa Finance Plc UK. This company offers health insurance products to persons as well as corporations. The list of health insurance products consisting Heartbeat, Health Companion, IMEP, Swasthya Pratham and Swasth Parivar. The Minimum age for covering is 3 months for children and maximum age is of 65 years.

  1. Reliance General Insurance Co. Ltd.

Reliance General Insurance Company Limited was founded in the year 2001 and it is an Indian Insurance company. The Minimum age for covering is 3 months for children, maximum age is of 55 years and for policy renewal Maximum age is of 75 years. In India, The firm is amongst the foremost general insurance companies with private sector market.

  1. ICICI Lombard GIC Ltd

This Company is biggest private sector general insurance company with Gross Written Premium of Rs 71.34 billion. The Minimum entering age is of 5 years and maximum is of 65 years. This Policy can be renewed till the age of 70 years only.

 

Debalina Roy Chowdhury- Para Planner

Dilzer Consultants Pvt Ltd

 

Sources

http://www.businesstoday.in/moneytoday/cover-story/tips-on-how-to-choose-the-best-health-insurance-policy-2015/story/215066.html

https://www.coverfox.com/health-insurance/articles/8-things-to-consider-while-rating-your-health-insurance-policy/