The Simple Guide To Buying Health Insurance

Buying health insurance can sometimes prove to be a daunting task. So many options, so many riders, so many conditions. What do you do? Worry not – here are some tips to help you pick the right product for you.

Don’t Cut Corners On Your Cover

A typical hospitalisation, a surgery, or critical illness can easily set you back by several lakh rupees. Therefore it’s absolutely important your health plan is large enough to cover the largest part of your medical expenses. Often, people try to buy health covers by weighing only the premium costs. This may prove unwise. Based on an assessment of your health risks – both real and perceived – opt for the best possible cover you can afford with your income. Any time you’re in a financially stronger position, you should upgrade from this basic cover.

Check Local Coverage

There’s a good chance that if you ever use your health coverage, it will be in your own city. Therefore, when you buy your health plan, look at the hospitals networked with the insurer. It would be convenient for you to go with an insurer that has networked with hospitals near you. This would also help you get cashless treatment and avoid cumbersome paperwork. If you opt for treatment at a hospital that’s not in your insurer’s network, you’ll have to bear the burden of settling your own bills before filing an application for reimbursement with your insurer.

Check Room Rent

A typical health plan would have limits on what kind of hospital room you would have access to, and how much you can spend on it daily. Make sure your plan allows you access to a room you would like during hospitalisation. For example, you may prefer a private, executive room rather than a twin-sharing room.

Check Your Co-Pay Costs

Co-paying is a way with which you can reduce your premium costs. In it, you’ll have to agree to pay a percent your hospital bills – 10%, for example – while the rest is borne by the insurer. The higher you opt for co-pay, the lower your premium costs will be since you’re agreeing to split your medical costs with your insurer.

Save Costs With Floater Cover

If premium costs are a concern, you can bring your immediate family members under a single plan with shared benefits. This is called a floater plan which would typically cover your spouse and minor children. For example, if you are a 30-year-old adult looking for a cover of Rs. 500,000, your annual premium would range between Rs. 4500 and Rs. 10,000. But if you took the same cover for your spouse and two dependent children, your premium costs would range Between Rs. 9,000 and Rs. 18,000. The benefits of a floater cover can either be shared without limits or up to a fixed limit.  

Check For Exclusions

A good health plan should cover you in most medical crises. Your hospitalisation costs, surgery costs, and treatment for critical illnesses should be covered. Always give a close reading to what your insurer is not going to cover. 

For example, most insurers would not cover non-medical expenses, or hospitalisation for a cosmetic treatment. Pre-existing diseases may be excluded during a waiting period of a few years. Check for these exclusions and avoid unpleasant, last-minute surprises. 

Ask For Restoration

Some health plans have restoration of benefits in case you exhaust your coverage within a financial year. For example, you have spent your full limit of Rs. 500,000 during treatment in April. In November, you undergo treatment for another illness which costs you Rs. 500,000 more. If your policy has a restoration benefit, your coverage will be fully restored. Restoration can also happen in floater plans where the full cover is available to other members after one member has used the full cover earlier in the year.

Check Pre- And Post Hospitalisation Covers

Many insurers provide coverage to pre- and post-hospitalisation expenses. For example, a cancer patient may need to undergo surgery. Before the surgery, he may have undergone medication, medical tests, scans, consultations, etc. After the surgery, he may need further medical care, medication, radiation therapy, chemotherapy, etc. An insurer may, for example, cover expenses for 30 days of pre-hospitalisation and 60 days of post-hospitalisation. This proves valuable during any illness requiring prolonged treatment.

Go Online, Compare Products

Don’t settle for insurance quotes from one insurer. You can go online and access the full bouquet of insurance products available to you. You can control the levers of your product search and pick one that best matches your needs and fits your budget. 

Additional Benefits You Should Check For:

Some health plans will:

1)      Cover your ambulance charges up to specified limits.

2)      Cover free health check-ups at least once a year.

3)      Cover dental treatments.

4)      Provide you petty cash daily during the hospitalisation, up to specified limits.

5)      Provide you convalescence benefits – compensating you for loss of income during hospitalisation.

6)      Cover your OPD expenses, up to specified limits.

7)      Cover alternative medication such as homeopathy and Ayurveda.

8)      Maternity expenses within limits after a waiting period.

9)      Cover your organ donor’s medical expenses in case you need a transplant.

10)   Provide you a critical illness cover – a lump-sum payment upon the diagnosis of a listed critical illness.

BankBazaar is your one-stop shop for your personal finance needs! Visit our website to search, compare and apply for financial products in your city. 

(An abridged version of this article appeared in The Finapolis.)