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What are the main factors for buying health insurance?

Planning to buy a new health insurance plan? Here are a few points to consider.

Purchasing a health insurance plan for you and your family is one of the best protection options to consider. A family health insurance plan provides health coverage for all the members of your family on a floater basis. Under a family health insurance plan, you are not required to pay a premium for every single family member. The entire sum insured is available for use of all the insured members. You can also buy an individual health insurance policy for each family member, with a separate sum insured amount assigned to every individual, but it is an expensive option as compared to a family floater plan. Here are the key points to consider for buying a health insurance plan:

  • Claim Settlement Process - The claim settlement process should be fast, convenient and hassle-free. It is one of the most important factors to consider before purchasing a health insurance plan. Select an insurer which has a high claim settlement ratio. A higher claim settlement ratio implies that the insurer is generally successful in settling claims.
  • Co-Payment - This implies that the insured is required to pay a pre-defined percentage of the claim amount and the remainder will be settled by the insurance provider. Co-payment ranges anywhere between 10% to 20%. Always check the co-payment ratio before purchasing a health insurance plan.
  • Day Care Procedures - Daycare procedures are surgical procedures which do not require hospitalization for more than 24 hours. Most of the health insurance plans available in the market today provide cover for day cover procedures. It is advisable to opt for a plan which covers a higher no. of daycare procedures as certain daycare procedures can be equally expensive.
  • Network Hospitalization - Ensure that your health plan has a wide network of listed hospitals in your locality as well as across the country. This feature will facilitate easy cashless hospitalization even if you travel or move residences across cities.
  • Pre and Post Hospitalization - This includes medical expenses incurred after and/or before hospitalization. It also includes follow-up visits to the doctor, the cost of additional medicines. Ensure that your health plan provides cover for pre-post hospitalization expenses, higher the no. of days covered the better.
  • No Claim Bonus - NCB or No Claim Bonus is a feature provided by most health insurance providers. Under this feature, an insured is entitled to an increase in the sum insured at the same premium or a discount in premium during the time of renewal in case there have been no previous claims made by the insured.
  • Amount of Cover - Ensure that you purchase a comprehensive health insurance plan with a decent sum insured for your entire family. The plan should provide adequate medical cover for all the members of your family.
  • Free-Medical Checks - Purchase a health plan which comes with a free health check-up. As you grow older, you will require frequent health check-ups. Before health check-ups start to burn a hole in your wallet, it is advisable to get them covered under a health insurance plan.
  • Lifetime Renewal - Purchase a health insurance plan which can be renewed lifelong. It is easier to renew a plan during old age in comparison to purchasing a new health plan.
  • Rider Options - Many health insurance plans come with additional riders. Riders enhance the overall benefit of the base health plan at the cost of an additional premium. You can always opt for additional riders. Here a few examples of rider options - Maternity Cover, Hospital Cash, Critical Illness Cover, Personal Accident Cover, etc.

Advantages of Health Insurance

Here are the key advantages of investing in a health insurance plan:

  • Medical Cover - The primary advantage of a health insurance plan is the medical cover that comes along with it. A comprehensive health plan provides protection against high medical expenses such as in-patient hospitalization, pre/post hospitalization, ambulance charges, cashless hospitalization, AYUSH, domiciliary treatment expenses, etc.

  • Critical Illness Cover - Many health plans provide cover against critical illnesses. The critical illness cover can be part of the base health plan or taken as a rider option. A critical illness rider provides cover against life-threatening diseases and conditions such as kidney failure, bone marrow transplant, stroke, and loss of limbs, etc. In case you are diagnosed with a specified critical illness, you will receive a lump sum amount. The lump-sum amount can be utilized to meet the treatment-related costs.

  • Cashless Benefit - Under a cashless claim benefit, you are not required to pay the hospital bill out of your pocket. The insurer will directly settle the claim with the network hospital. In order to avail this benefit, you need to get yourself admitted at the insurer’s network hospital.

  • Hospital Daily Cash Allowance - Many insurance plans provide the benefit of hospital daily cash. Under this feature, an insured will be provided with a daily cash allowance for each day he/she spends in the hospital. The number of days spent in hospital is always pre-decided in the policy and may vary from one insurer to another. This benefit is ideal if you are going to be hospitalized for a long period of time.

  • Tax Benefit - Premium paid towards a health insurance plan is eligible for tax deduction under Section 80D of the Income Tax Act, 1961. In the case of an individual, it is Rs. 25,000. If the individual/spouse is above 60 years of age, the deduction available is Rs. 50,000. An additional deduction (for covering father or mother or both) is available to the extent of Rs. 25,000 if less than 60 years old and Rs 50,000 if parents are 60 years old or more. An amount of Rs. 5,000 for payment of preventive health check-up of either the individual himself or his family members which includes spouse, parents and dependent children is also allowed within the upper limits.

Change in lifestyle coupled with increasing pollution along with many other factors can have a negative impact on an individual’s health. The health toll is even greater if you are the sole breadwinner of your family. In short, it is advisable to purchase a health plan at the earliest. The earlier you purchase, the cheaper the cost of the health policy.

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