Things to Consider Before Getting Family Health Insurance

Things to Consider Before Getting Family Health Insurance

In life, it is essential to safeguard your loved ones from financial upheavals caused due to unforeseen medical conditions. A secure way of doing the same is by getting a family health insurance plan. However, choosing the right plan for your family can be a daunting task. Therefore, you must conduct thorough research and consider a list of things before getting a family health plan. Some important points to consider while getting family health insurance are as below:

Is the Sum Insured adequate for your family?

The first thing you need to consider while getting health insurance for your family is if the Sum Insured can cover the entire family’s medical needs. For this, you need to check factors like the age of your family members, their pre-existing ailments, etc. If your parents are also part of your policy, you might need a higher sum insured as medical expenditure increases with old age. Ideally, a cover of Rs 20-25 lacs for a family living in an urban area is considered adequate. Nowadays, plans as high as Rs 1 crore are available at a much affordable price.

What is the Waiting Period of the plan?

Usually, insurers have a waiting clause in case of pre-existing illnesses. The waiting period mostly ranges from 2-5 years. During this waiting period, you cannot make a claim related to such ailments. If there is an elderly in your family, it is advised to buy a plan with a shorter waiting period.

Does the Insurer have an extensive Hospital Network?

It is very important to check the number of network hospitals included in your policy before making a purchase. Choosing a plan that offers the maximum number of network hospitals is beneficial. This will make it easier for you to leverage cashless treatment in a wider area. This feature is a major advantage with family health plans as the family members do not have to worry about the expenses in an already crucial circumstance. In such situations, the insurer deals with the hospital regarding medical bills and unburdens the family financially.

Check for Room Rent Capping

During the process of health insurance purchase, it’s essential to check the room rent capping of your plan. It is the limit of hospital room expenses that is supported by your insurance provider. This capping is either a figure that determines the amount of room rent expenses to be paid by the insurer or a specific percentage of the sum assured. Therefore, if a plan’s capping on room rent is set at Rs 5000, then you can claim only Rs 5000 as room expenses on it. However, if you choose to go for a health plan with no room rent capping then you’re entitled to select any room as per your preference, without having to adjust within a prescribed bracket.

Check for Sub-Limits

While looking for a health plan, it’s essential to be vigilant about sub-limits. It is an additional limit to a health plan’s coverage that is set for certain medical expenses. These medical expenses are covered under the original policy coverage limit or the sum insured. Insurers provide sub-limits on hospital room rent, doctor’s consultation fee, ambulance charges, and a few pre-planned medical procedures. Health plans with sub-limits are comparatively more affordable than those without sub-limits.

Does the plan include Daycare procedures?

Sometimes you may need to be hospitalized for less than 24 hours. However, several insurers only give coverage for hospitalizations that last over 24 hours. Despite this, many medical procedures like dialysis, CT scans, etc. only require certain hours of hospitalisation. This benefit comes under the daycare procedures. Hence, always check if your health insurance provides daycare procedures while getting a family health plan.

Does your Insurer have a good Claim Settlement Ratio?

It all boils down to how seamlessly your insurer can process your claim settlement procedures. For this, you can check the insurer’s claim settlement ratio. It is the indicator of how successfully your insurance company settles its claims. It is calculated by dividing the total claims paid by the number of claims filed. You must choose an insurer with a high settlement percentage to rest assured in your time of need and to have your medical bills reimbursed without any hassles.

Remember, there is no one standard health insurance that fits everyone’s needs the same way. So feel free to customise your plan, depending upon the needs of you and your family. You can even opt for add-ons at a fair price that extends the coverage of your policy. It’s crucial to choose an insurer with good customer care service. So consider the above points and make a sensible decision that benefits your loved ones at the right time.

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