5 Things To Check While Getting A Health Insurance Plan

Finding the best health insurance plan for your family can get tricky. It involves carefully picking out the features that fit your needs in the long term. An unplanned decision today may act up as a useless investment tomorrow. Ending up with a health plan that doesn’t solve its purpose in times of need is not favourable. Hence, it is essential to be careful about getting health insurance.

But the road to finding a befitting health plan for yourself and your loved ones is paved with arduous labour. However, you can choose smart work over hard work by making a checklist for keeping track of important details. So let us look at some of the most essential things to check while getting a health insurance policy.

1. Policy With Adequate Sum Insured

The first thing to check while getting health insurance is the total sum insured of your plan. It is the total amount up to which an insurer covers the medical expenses incurred through hospitalisation. Choosing a health insurance plan with a high sum insured is a must. These days, a health plan with a sum insured of ₹ 3-5 Lakh might not suffice anymore, considering the current medical inflation and surging healthcare expenses. As the cost of medical procedures, surgeries and apparatus rise, it is advisable to choose a plan with at least ₹ 15-20 Lakh sum insured. Nowadays, there are plans that provide a cover of 1 crore at affordable premiums as low as ₹ 1200.

2. Insurer With Simple Claims Process

When getting a health insurance policy, it is important to find out about the claim settlement process of the insurer. Make sure that the insurer you plan to choose has an easy and convenient claim process. Not having a quick and hassle-free claim process can prove to be a major setback for you during an emergency. It may act as a stumbling block in dire times for you and your family. Therefore, always check the claim settlement rate of the insurer before getting a plan. The higher the claim settlement rate, the better the insurer. It is advisable to opt for an insurer with over 90% of claim settlement ratio.

3. Policy With No Co-payment Clause

While buying health insurance carefully read the related clauses to check for a co-payment clause. Under a Co-payment Clause, the policyholder has to pay a certain per cent of the claim, while the remaining is paid by the insurer. So, if buy a health cover with ₹ 10 Lakh sum insured and 10 per cent co-pay, and claim for a hospitalisation costing ₹ 3 Lakh, you will have to pay 10 per cent(₹ 30,000) of the amount while your insurer will pay 90 per cent(₹ 2,70,000) of the amount. Hence, it is advisable to go for a plan with a 100 per cent claim on hospitalisation as medicare costs are always uncertain.

4. Waiting Period For Illnesses

All health plans have a specific waiting period for specified critical illnesses. While buying health insurance, it is important to check the waiting period attached with critical illnesses. It will help you figure the treatments for which you can file a claim from day one from the ones that have a specific waiting period. If you want to cover illnesses such as the coronavirus infection from day one, you will have to invest in disease-specific plans that offer coverage from the first day.

5. Cashless Hospitals Network

The cashless treatment benefit offered in health plans can only be availed at network hospitals. Hence, be sure to check the list of the cashless network for your convenience and quick access. Make sure that the cashless hospital closest to you is in your area, and can provide adequate medical attention during emergencies. Furthermore, ensure that your insurer has cashless tie-ups with a renowned cashless hospital in the city that you often visit. Information related to the cashless facility should be available on your insurer’s website.