With the epidemic COVID 19 spreading like a disaster throughout the world, contemporary time emphasize the importance of old saying “Health is wealth”. The need of safeguarding our health with good habits like proper diet and daily exercise is need of the hour. Also, to prepare for future uncertainties regarding the healthcare costs which are rising steep and seen almost doubling in previous years, need to be heeded.
To mitigate this effect India has suitably chosen the tool of health insurance which is evident from its rising demand over the years. Health insurance products come in different varieties with a range of add on covers and the nuances of terms and coverages are sometimes not well understood by the common public.
With the common pursuit of choosing the best health insurance policy for self and family, public sometimes gets confused and thus making the purchase process difficult for them. In this article we will discuss that how to choose a best health insurance policy in India in order to make the purchase decisions smoother.
Sum Insured: Choosing an apt sum insured is probably the first and most vital step while purchasing a health insurance product. Sum insured must be chosen in such a way that is sufficient in future for self and family in case of complicated medical emergencies. Some benefits to be looked for to be included in the policy is mentioned herein.
Restoration benefit reinstates the entire sum insured in case of complete exhaustion of the same during a policy period. No claim bonus increases the sum insured by a specified percentage every year in case of a no claim upto a maximum amount. In some products the sum insured gets doubled in as less as 2 years in case of a no claim. So even if we select a lower amount initially say, 5 lakhs of sum insured but the aforementioned benefits present in our health policy, it can go higher every year in case of no claim till a maximum amount and be fully reinstated if we exhaust the same completely.
Network hospitals: Before purchase we should be sure that the health insurance, we are to buy covers all good hospitals with best of medical facilities in our neighbourhood and the city we reside in. Some of products covers particular or emergency medical treatments anywhere in the world, we can look out for such a policy depending upon choice and budget. In some products, getting treatment in a non network hospital may impose restrictions or invite a co-payment.
Wellness benefits: Many people neglect the importance of this particular benefit but should keep in mind that “Prevention is better than cure”. Regular health check-ups, gym memberships, health coaches, second opinion and other wellness benefits are very effective. Some products give rewards like stay active benefits for practising marathon, regular walking, yoga among others which can act as a motivation to stay fit and save money on health insurance renewals.
Claim payment Ratio: Higher the claim payment ratio of the insurer, the lesser is claim rejection chances. Most insurers publish this data on their website and its better to have a look at the same.
Co-payment: Some products may have co-pay for all claims, some for treatment in non-network hospitals, and some for every hospitalization for senior citizens. We should properly understand and opt for a policy imposing lesser co-payment restrictions. Kindly note that in some cases co-pay, if opted, may help you to save on the premium. So, we should take a rational decision in such cases as per our pocket and requirement.
In addition to the points discussed above in details, we must also see availability of the below general factors in a health insurance product before making a purchase decision
- Life time renewability (Some products stipulate a maximum renewal age, which should not be there because at old ages and upon survival we will be unable to procure a fresh health policy)
- No cap on room rent (Some policies may have a restriction)
- Lesser waiting periods (Common is 2 years for pre-existing illnesses, some policies have high waiting periods of 4 years, some products may impose a waiting period for common surgeries like kidney stone removal, stomach ulcer etc.)
- Maternity benefit and cover for new born babies (requisite for people planning marriage or family in near future)
- Outpatient coverage and Pharmacy expenses (offered on selected products)
- Dental cover and hospital cash (may be available as add-on)
- No geography-based co-pay or sublimit
- Cover for dependant children (look for the years till dependent children are covered)
- AYUSH treatment availability (Very helpful in some cases to have it covered)
- Long term policy discount (may be opted for saving a few bucks)
- Family floater discount or discount for adding other family members in an individual policy (may save on premium)
We should also look for an online policy purchase discount as many of the insurers pass on the benefit of lesser acquisition costs to the policyholders. Although, we have tried to list out major benefits which should be present in standard health insurance product, it is advisable that a prospective buyer can take the help of comparison sites which compares the premiums and benefits to help purchasing decisions.
We should remember that more benefits come at a higher premium, people need to decide that what all benefits and add on are extraneous and should opt for a comprehensive health insurance product which is not too costly.