Although life expectancy has improved dramatically generally, it is also true that the number of diseases affecting us is increasing. These days, medical inflation and the nation’s growing healthcare costs can be quite costly and have a big effect on your financial well-being. Purchasing health insurance is one method to be financially ready for unforeseen health risks.
In order to make an informed choice when buying a health plan, we discuss in this article the five stages you should take when doing your research.
Let’s first clarify what a health insurance policy is, though.
Health insurance: what is it?
In a health insurance plan, the policyholder pays the insurance company a premium, and the insurer covers the insured’s medical costs, such as hospitalization, daycare, post-hospitalization, and pre-hospitalization, among other things. After paying the bills, the policyholder may receive reimbursement from the insurance. In contrast, if he or she chooses a cashless service, the insurance company will pay the hospital immediately in the event of hospitalization. However, different insurers may have different terms.
Steps to take when opting a health insurance plan
1. Purchase Health Insurance Grounded on Your utmost Important Needs
- Over the once ten times, health insurance in India has significantly changed, offering a variety of insurance plans with colorful features and specifications. These days, there live health plans that are applicable for seniors, youthful families, couples, scholars, those with diabetes, heart complaint, and indeed those who have formerly entered a cancer opinion. With so numerous options, it’s easy to come confused. thus, the original step is to determine what your top need is. Do you have a pre-existing medical condition that requires content? Or is it the motherliness and parturition insurance?
- Or is it because overseas treatment is available? You can choose the type of coverage you require after you have a thorough understanding of them.
Pro-Tip: A minimum coverage of six times your pay is a decent practice, while there isn’t a hard-and-fast rule. Therefore, you should get coverage of at least Rs 3 lakh if your monthly wage is Rs 50,000. Additionally, this can cover up to Rs 5 lakh.
2. Locate a Cashless Hospitalization Network that serves the city’s best hospitals.
- You can receive medical care without having to pay for it yourself if you use a cashless service. The insurance company will pay the hospital immediately for the medical expenditures. Not all Indian hospitals are included in the cashless network of insurers, despite the fact that all of them provide cashless services. In fact, insurers provide cashless networks to 4,000 to 8,000 of India’s 50,000 private hospitals. Each insurer has a different cashless network. Therefore, be careful to check the cashless hospital list provided by your insurance to see if the best hospitals in your location are included.
- Don’t forget to include the city’s top hospitals rather than just the overall number of hospitals. Since 90% of hospital stays are scheduled, you should choose the facility that provides the greatest medical treatment.
3. Look for the Specific Coverage Provided
To find out exactly what coverage you are eligible for, read the fine language of the health insurance. In essence, policy coverage consists of five essential elements.
1.Coverage for inpatient hospitalization:
Staying in the hospital for longer than twenty-four hours for medication or treatment is known as in-patient hospitalization. For inpatient hospitalization, all insurance carriers offer high coverage/limit, meaning up to 100%. Choose a plan that offers you the most coverage for inpatient hospital stays.
2.Daycare treatment coverage:
In a hospital, some procedures might be finished in less than a day. For instance, tonsils, cataracts, chemotherapy, etc. Choose a plan that covers a lot of childcare treatments as a result.
3.Allowance for room rent:
According to the selected plan, it is the hospital room allowance. While some plans provide a specific proportion of the sum assured to be used as room rent, others have no cap on the amount. Therefore, if you have a 1 percent room rent cap on a Rs 3 lakh policy, you will only be eligible for a maximum of Rs 3,000 in rooms, which may not be enough.Knowing the maximum amount for a hospital room is helpful so that you may adjust your insurance requirements.
4.Coverage of pre- and post-hospitalization costs:
This is the payment of any pre-hospitalization and post-discharge expenses that are directly related to the disease or injury that led to the policyholder’s hospitalization. Eligibility usually lasts 30 and 60 days before and after hospitalization, respectively. However, the amount of coverage is limited by certain plans. Choose a plan that covers the greatest amount of pre- and post-hospitalization costs.
5.Sub-limits for specific costs or therapies:
- A sub-limit is the maximum amount that a policyholder may be reimbursed for a specific service or expense. A sub-limit of a specific percentage of room rent, for instance, was observed. Sub-limits on specific procedures are also present in some plans. Maternity services will always have a sub-limit, with a specific cap on normal birth and a different one on cesarean delivery, much like cataract surgery may have a sub-limit for each eye.
- Your coverage revolves around these five components. When purchasing any type of health insurance policy, you should carefully review these. In general, health plans provide a number of additional benefits, such as companion benefits, daily allowance, physiotherapy allowance, and domiciliary hospitalization. However, since these aren’t precisely essential coverage, we have set them aside.
4. Review the exclusions, co-payment, and waiting period of the plan.
To comprehend the waiting period, co-payment, and exclusion clauses that are included in your coverage, go over the health plan’s fine print once more. No claims will be accepted during the waiting time, which is essentially a hibernating period. This provision only applies if you already have a medical condition. The duration of hibernation may range from two to four years. Generally speaking, the shorter the waiting time, the better.
Furthermore, keep an eye out for the co-payment provision, which specifies the portion of the claim that you are responsible for paying out of pocket.Co-payments are generally set up in programs for specific requirements or elderly individualities. also, take into account the rejections, which are ails or medical costs that your health plan does n’t cover. This implies that you’ll be responsible for these costs.thus, before copping health insurance, it’s pivotal to study the policy language.
5. Determine Advantages That Increase Your Sum Assured
Given the rising expenditure of medical care, it makes sense for us to search for health insurance programs that gradationally expand content. There are two ways to do this. The no- claim perk comes first. Restoration comes in alternate.
No-claim bonus to increase the amount guaranteed:
The no claim bonus, or NCB, is a method used by insurers to enhance the amount of sum assured from 5% to 50% at the same premium level in exchange for policyholders who have a claim-free year. In this manner, you will be able to accrue enough NCB to raise your total insured by up to 100%. Various insurers have varying NCB regulations.
Repair for extra protection:
Under this benefit, the insurer would add more coverage without charging you more if you used up your whole insured amount while in the hospital or receiving treatment and still needed more. Similar to NCB, different insurers have varying restoration guidelines. For a deeper understanding, carefully study the policy’s wording or seek ETMONEY’s assistance.
Choose insurance with good restoration benefits and a good NCB.
Read our blog post on How to Choose the Best Health Insurance for Your Family if you’re looking to purchase health insurance for your family.
The bottom line
You will be able to easily identify a powerful health plan that satisfies all of your requirements if you base your research on these five stages.
However, OPD costs, global coverage, wellness services, health examinations, and in-house claim settlement are among the benefits that did not reach the top five list. These may be significant in certain situations, but they only enter the debate after the first five factors have been taken into account.
Additionally, visit the ETMONEY app’s health insurance section to purchase a paperless health plan from leading insurers.
