How to Choose Your Health Care Plan?

Health care insurance has become a need in today’s world, where medical treatment costs are rising at a rapid pace. Any medical emergency such as sudden sickness, accident or critical illness can result to hospitalization that can leave you financially distressed. Your lifestyle choices make a difference in your health, and the stage of your life, you are in also brings different health challenges that may require immediate health care.

Here comes the need for a health insurance policy. A Health plan provides you a financial guard against hospitalization expenses arising due to any illness, injury and other medical condition. With a health plan, you don’t need to worry about medical expenses while availing quality treatment.

Also, you can’t just pick any health insurance plan. It is imperative to choose a right health insurance plan that suits your health care needs.

You need to go through the tips that will help you choose a health care plan.

Assess Your Health Needs

When you are looking to buy a health policy, it would be a smart move to assess your health needs such number of members to be included in the plan, number of children or seniors, their medical/hereditary problems. It gives you a fair idea about how much cover you need and then, you can easily choose an adequate Sum Insured that can cover all your or family’s health treatment expenses.

For example, If you have a family of 2 Adults & 1 Child (age of eldest member is 35 years) and looking to get a health cover to meet medical expenses incurred on hospitalization of any one or all the members, you just need to assess the health needs. In a general sense, getting a cover of around 7 to 10 Lacs is enough, if residing in a metro city.

Coverage of Illnesses

The illnesses covered may differ from one plan to another and thus, it’s quite essential to scan through the coverage available under a health plan, you are looking to buy. You should also check the exclusions, so you can get an idea regarding illnesses not covered under the policy.

For example, you have opted for Max Bupa Heartbeat health plan and in case, you are hospitalized due to diabetes and claim to reimburse expenses, but as the diabetes is not covered under this plan, you cannot get the claim.

So, if your family has some hereditary medical condition or other critical condition, such as cancer, heart stroke, or diabetes, it is recommended to buy a plan that covers those illnesses.

Check Sub-limits

Sub-limit puts a cap on the claim amount for a specific disease or treatment procedure. In some cases, it is a percentage of the sum insured or a pre-determined amount as specified by the insurance company. Sub-limits are available on several medical procedures such as cataract removal, tonsils, sinus, hernia, piles, etc. Health insurance policies also put sub-limits on hospital room rent, ambulance charges, physicians’ consultation fees, operation theater charges and many others.

For example, if you have opted for a health policy with a sum insured of Rs 5 Lacs, you can stay in a room which is charged at 5000. And, in case you want to stay in a more expensive room in a hospital, you will need to pay from your own pocket for a proportion of daily room rent that goes beyond Rs 5000.

Assess Coverage for Pre-existing Diseases

Health policies put a waiting period for several pre-existing diseases/illnesses and thus, you need to check out which pre-existing diseases are covered and don’t ever forget to read the terms & conditions relating to the coverage of pre-existing illnesses, so your insurance company don’t have to deny the claims.

For example, you have opted for Max Bupa Heartbeat health plan and in case, you are hospitalized for hernia after 1 year of issuance of the policy, but as the hernia is covered after 2 years, you cannot get the claim. In this case, you can get the claim for hernia if hospitalized after completion of 2 years of the policy.

Hospital Network

When opting for a health policy, it is recommended to go for a plan that has a wide network of hospitals and it would be far better, if some of the super specialty hospitals included in the list are located in a nearby location. You should also check whether the network hospitals cater to emergency health care needs.

For example, you have bought a health plan that has various hospitals included under the network, but when you searched for a hospital in case of a medical emergency, you did not find any hospital within a radius of 3 to 5 kms from your residence and you had to go to the other end of the city to avail medical treatment. So, it’s better to choose a plan that can help you access medical treatment at the closest to your location.

Tenure of the Health Plan

Prior buying a plan, you should understand about the tenure of the health plan and don’t forget to check whether it is offering a feature of lifetime renewability, so you can renew the plan through your entire life. Typically, the health plans are available with 1, 2 or 3 years policy tenure with renewability option. You need to pick a plan that offers convenient renewability options.

For example, you have bought a health plan that is available with 3 years policy term with renewability option. So, with this plan, you only need to renew it once in 3 years and upon choosing a large policy tenure, you will get premium discounts as well.

Check Claims Efficiency

Don’t forget to know about the Claim settlement ratio (CSR) and turn around time the insurance company, as the one having higher claim settlement ratio signaling the chances for ease in settling the claims. So, it is imperative to pick an insurer that has a high claim settlement ratio.

For example, Bajaj Allianz General Insurance has 97.50 claim settlement ratio, Reliance General Insurance has 97.06 claim settlement ratio, Tata AIG General Insurance has 99.97 claim settlement ratio.

Compare & Buy

When you are looking to buy a right health insurance policy, it would be a smart move to first compare plans online. For comparing plans, it is advisable to approach an insurance web aggregator that will help you compare plan benefits, features, its inclusions & exclusions and plan premium as well. After comparing plans, you can buy the Best Health Insurance Policy in India. By buying plans online, you can also avail premium discounts in a range of 5% to 20%.

For example, Star Health offers a discount of up to 12.5% on buying policies online. Every insurer offers an online discount depending on the plan chosen.

Best Health Insurance Plans in India

Health Plans	Sum Insured	Pre/Post Hospitalization	No Claim Bonus	Pre- Existing Diseases	Add-on Covers
Religare Care	Rs 3 Lacs to 75 Lacs	30/60 days	Max up to 150% of Sum Insured	Covered after 4 years	Everyday Care- Wellness Package & No Claim Bonus Super
Bajaj Allianz Health Guard	Rs 1.5 Lacs to 10 Lacs	60/90 days	Max up to 50% of Sum Insured	Covered after 4 years	Not Applicable
Future Health Suraksha- Indivdual Plan	Rs 50,000 to 10 lacs	60/90 days	Max up to 50% of Sum Insured	Covered after 4 years	Not Applicable
ICICI Lombard Complete Health Insurance Plan	Rs 3 Lacs to 50 Lacs	30/60 days	Max up to 50% of Sum Insured	Covered after 2 years and 4 years	Hospital Daily Cash, Convalescence Benefit, Donor Expenses, Critical Illness Cover, Personal Accident Cover
Cigna TTK ProHealth Protect Plan	Rs 2.5 Lacs to 10 Lacs	60/90 days	Max up to 100% of Sum Insured	Covered after 4 years	Critical Illness

 

To summarize, Choosing a right health insurance policy provides you an adequate health cover, so you don’t need to pay the medical bills from your own pocket. There is no dispute over the need for health care plan. It gives you the coverage against rising medicare costs. You just need to read through the tips that would help you to buy a Health Insurance Plan fitting on you or your family’s health care needs. Making a well-informed and thorough researched decision always helps you get the optimum coverage with the Best Health Insurance Policy in India.