Most people now understand the importance of having a health insurance policy. As per Statista research, 514 million individuals were covered under health policy schemes till 2021. This is 37% of the Indian population, which makes a big proportion of individuals having no access to health insurance facility. Thanks to govt. schemes promoting free health insurance, that we could at least achieve this much.
While opting for health insurance policy you must check that it fulfil your needs and provides desired result with full effectiveness and efficiency. Some important aspects to consider are:
1. Benefits
These days most of the policies are coming with re-store benefit. It means, if after a claim your cover gets exhausted then insurer top it up with additional cover so you don’t run out of cover.
You should check if your policy include both inpatient (hospitalization) and outpatient (medical services outside the hospital) care.
You must also see how many days of pre & post hospitalisation expenses are included in the policy.
It may also include any specialist consultation and treatment if required.
It should also have cashless feature in which medical expenses are directly settled between the insurance company and network hospital. The policyholder does not have to pay any cash.
2. Premium & Cost
Ensure that monthly/annual premium amount fits to your budget.
In the case of senior citizen, most of the companies has a policy of co-payment. In case of co-payment, you have to pay in most cases 10%-30% of the total claim amount from your pocket.
Sometimes Insurance companies also applies “Loading Charges” on premium for those applicants who might have a higher than usual risk of making a claim for pre existing disease like diabetes,hypertension etc. Loading charges may also be applied in case you have a height-weight ratio. It might indicate higher chances of you getting diseases and increased chances of claim liability for the insurer.
3. Coverage Limits and Exclusions
You must be aware of pre-existing diseases exclusion. It means, that only after completing the certain waiting period, few pre-existing ailments would be covered under your policy. It is calculated from the date of commencement of the policy.
You must check if there are any limits or capping on room rent, ambulance etc.
4. Additional Features
You may opt features like virtual medical consultations, Maternity Coverage which includes pregnancy, childbirth and postnatal care, dental and vision coverage. But these comes with an additional price which you have to pay annually.
There are policies which includes coverage of non payable items like gloves, oxygen masks, cotton etc. You may also pay some additional premium to get them included in your policy.
5. Disclosures
You must ensure to share all of your medical history, which is relevant and need to be known by the insurer.
In case of non-disclosure, your claim might be rejected
There are many features & aspects which you must take care while opting for health insurance, but we discussed the most important. You may opt for so many features and benefits under a health insurance plan, but you must also review its requirement for you. As you opt for more and more benefits, your premium goes higher, so you have to opt it wisely.
Very informative