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Seven critical factors to compare various health plans in India

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Mr. Suresh Nair decided to buy a health insurance policy to insure the health of his entire family. He checked all the available health insurance plan options, but he got confused as there were various options in the market. He found the entire process of buying a health insurance policy baffling and time-consuming.

Mr. Suresh is not the only person who faces problems in choosing the best health insurance policy. The availability of multiple options sometimes makes things difficult for people. As it is about your health, you can’t take a risk with it. Therefore, we have come up with some important factors that you should consider at the time of buying a health insurance plan. You can use these factors to compare health insurance plans in India.

Age limit :

As the chances of falling ill are higher at an older age; It is necessary to go for the maximum permissible age limit. It is necessary that a health insurance policy continues to offer coverage even when you cross the age of 65 because, at an older age, it is daunting to buy a fresh insurance policy. Also, if you want to go for a family floater policy and add parents under the plan, it is advised to go for lifetime renewability plans.

Network Hospital:

Insurance companies offer cashless hospitalisation in case you get admitted to any of the listed network hospitals. Before purchasing a mediclaim policy, it is necessary to look for the list of the network hospitals. The hospitals in your proximity which are offering good medical facilities should be on the network hospital list of your intended insurer so that you can get cashless hospitalisation. In the case of planned hospitalisation, a distance of hospital from your home may not be important, but in the case of a medical emergency, it would be sensible to go to the nearest hospital. On top of it, if it is in the network of the insurer, then you can get cashless hospitalisation. To know, the list of network hospitals, you can also check the insurer’s website.

Waiting Periods:

Waiting for something or someone is a most boring task, and when it is waiting to get the benefits of a health insurance plan, then it becomes more annoying. All health insurance policies come with a waiting period, which is the prohibited time wherein you can’t claim for any benefits under the policy and the insurer will not settle your claim. All health insurance companies have different waiting periods for different benefits. Most common waiting period clauses are:

• Initial waiting period: Once you BUY A HEALTH INSURANCE PLAN, there comes a waiting period of say, 30 or 60 days, during which the insurer will not accept your claim, except in case of accidents. This waiting period ensures that people don’t take unnecessary advantage of the policy.

• Pre-existing conditions: Most of the insurers have a waiting period ranging from two to four years for ailments which you had before buying the policy. It means, ailments which you already had before purchasing the health insurance policy do not get immediate coverage from the insurer.

• Maternity benefits: Nowadays, many insurance companies cover maternity expenses after a waiting period of 9 months to 3 or 4 years.

Sub-limits:

Though, under a health insurance policy, you are covered up to a certain sum insured, the insurer doesn’t offer the complete coverage. The insurer can limit the coverage in certain cases with the help of sub-limits. It means, the insurer covers expenses only up to a particular limit and the amount above this limit has to be borne by the policyholder itself. The clause is employed by insurers to lower their claim outgo and is mainly restricted to ailments like cataract, hernia, sinus, kidney stone, etc. If you don’t want any unpleasant surprises later at the time of claim, go through the sub-limit clause and choose the policy which doesn’t have any such clause.

Day care surgeries:

Due to advancement in the medical field, there are many such treatments which do not require 24-hours hospitalisation. The treatment is performed in a few hours, and the patient is discharged on the same day. Such types of treatments are known as day care. Every insurer has their list of day care surgeries which they cover. It is necessary to understand the detailed specifications before taking a plunge.

Additional features:

In today’s time when medical costs have reached a new height, it is essential to think beyond the basic mediclaim policy. You should choose the insurer that offers various riders and add-ons to expand your medical coverage.

Riders:

These are the additional benefits that you can add to your basic health insurance cover to expand your medical coverage as per your requirement at nominal rates. Some of the common riders are maternity cover, room rent waiver, and hospital cash.

Add-on cover:

It safeguards you against unknown medical emergencies which involve higher medical expenses. Some of the common add-on covers are top-up/super top-up policies, personal accident cover, and critical illness cover.

Exclusions:

While it is important to know what your health insurance policy covers, it is equally necessary to understand what it doesn’t. There are certain medical conditions or events which are not covered by health insurance companies. You should carefully compare different health insurance policies to ensure that your medical condition or treatment is not excluded from the policy. Take a close look at your health insurance policies to know the exclusion list before finalising the policy.

Usually, you compare health insurance plans on the basis of premium rates. Many people avoid taking individual health insurance policies due to premium rates. However, it is indispensable to understand that health insurance policies cover your health and therefore, it is important that it should be sufficient. Therefore, to find the best health insurance policy, the premium should be the last thing to watch for, and terms and coverage should be given more importance.

The above mentioned features may have their impact on the premium of the policy too. So, to choose the right policy, carefully understand and compare health insurance policy features first and then look at the premium cost. Also, the claim settlement ratio is an important factor that should be considered after filtering in the health insurance policy with the aforementioned features.

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