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Factors to Consider Before Getting a Health Insurance Policy

Rashmi Ghosh Rashmi Ghosh 24 May 2019

Want a clear idea of the checklist of factors that you need to evaluate while looking for a health insurance policy? Look no further. We’ve got it all covered for you in this article.

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There are innumerable factors that can be considered when you are searching for a health insurance plan. However, priorities differ and, therefore, what is relevant for, say, Mr. Malhotra might not be so for Mr. Prakash. But, wait a minute! It isn’t as complicated as it might appear to some. However, there are certain factors that remain constant, irrespective of your objectives behind buying a health insurance.

Here’s jotting them down for you.

Policy Coverage

Your sole objective of getting a health insurance is to be eligible for health benefits at the most affordable cost possible, isn’t it? So, the factor that should be topmost in your checklist should be the features and benefits being offered by a health insurance policy, and whether it meets your unique needs. The following will give you a sneak peek into the major types of health insurance policies that you can choose from as per your requirements:

  • Individual Health Insurance Policy: As evident from the name, this type of plan will be apt for you if you are looking for a health insurance policy only for yourself. Such policies generally cover the individual from expenses arising out of the list of critical and regular diseases, as specified in the policy document. The premium eligibility is based on parameters like sum insured, age, gender, life style habits, location, etc. of the individual planning to purchase such a policy. Some other highlights of this policy are that it includes cashless hospitalization and ambulance expenses.

  • Family Health Insurance Policy: Searching a health policy that not just covers you, but also your family? Consider a Family Health Insurance. Family members that are covered are spouse, dependent children and dependent parents. A family floater health insurance policy is a smart option when you are looking for a comprehensive cover for your family.

  • Critical Illness Insurance: This policy covers listed critical illnesses. Some of the critical illnesses that are usually covered by such health insurance policies are cancer, heart attack, kidney ailments, paralysis, etc. It is best suited for individuals who wish to get coverage against such a critical illness or has a family history of such an illness as it offers additional coverage. You can opt for it as an add-on over your base health insurance policy that does not usually cover you against such critical illnesses.

  • Personal Accident Insurance: This policy is especially customised for individuals who need to spend considerable period of time on the road for work or otherwise. Regular long distance travel often increases the scope of accidents. This type of policy covers death, permanent and partial disability and dismemberment that may occur due to an accident.

Premium – The premium that you will pay for is determined by parameters like sum insured, age, gender, life style habits, add-ons, etc. The younger you are, the lower will be your premium. While you are researching on the available health insurance policies in the market, make sure that you check your sum insured and whether the cover is sufficient for you.

Claim settlement ratio – The claim settlement ratio speaks volumes about the efficiency of the health insurance company in settlement of claims. It gives you a fair idea about the efficiency that you can expect from the company in settlement of claims, should the need arise.

Network Hospital – Every health insurance company has a list of network hospitals where policyholders can avail cashless benefits on hospitalization and other medical facilities. When your health insurance company includes network hospitals that are in your vicinity or that you prefer visiting, it is a win-win situation for you. What can be better than purchasing a health insurance from a company that offers the advantage of cashless facilities, especially when you are in need of emergency treatment, right?

Pre and Post Hospitalization – Health insurance policies that offer this facility are an immense benefit. Though pre and post healthcare are not a part of the main treatment, they often prove to be a substantial part of the medical expenditure. And a health insurance that covers these expenses is definitely a boon for your pocket. Pre hospitalization expenses include doctors’ consultation fees, diagnostic tests, among others, while post hospitalization includes follow-up investigations, medical aftercare, etc.

No Claim Bonus – Leading health insurance companies offer the No Claim Bonus (NCB) facility on no-claims made by a policyholder during a certain policy year. This implies that you, as a policyholder, will be able to avail a discount on the premium for the next policy year or your sum insured will increase by a defined percentage for the same premium.

Free Look Period – Does your health insurance offer you a free look period? This period enables you to read through the policy document thoroughly and get a clearer perspective of the features and benefits offered by your health insurance. In case you feel that the policy does not meet what you are looking for, you can give up on the policy and claim a refund for the premium paid till date.

Waiting Period – Is one of the primary objectives behind you looking for health insurance to cover yourself against pre-existing diseases? Then, you cannot overlook checking the waiting period while evaluating whether a health insurance is aligned to your objectives. Waiting period for pre-existing illnesses vary between 2 years and 4 years. The longer the waiting period, the lesser will be your chances of making a claim on excluded illnesses during that time period.

Now, we bet that you have a deeper understanding of the factors that you need to evaluate while selecting a health insurance that is the most appropriate for your needs. So, go on, get the policy that is the best fit for you.

Rashmi Ghosh
Written by Rashmi Ghosh
Digital enthusiast, dreamer with a colourful mind and shares her soul with canines. She survives on coffee, and food and travel feature among her topmost priorities.