What to Check Before Purchasing Health Insurance Policy?

Before considering opting for a Health Insurance, it is highly recommended that the decision of buying a Health product should not be only based on the premium.

In addition to the factors like price, ease of purchase and renewal, servicing etc. Here are a few things you should definitely look which selecting a health insurance product.

We have heard since the beginning from our parents and elders that “Health is wealth”.

In contemporary times, where lifestyle diseases are on the rise in the same pace as serious life-threatening critical diseases and the young population of the country is also under the grip and getting diagnosed with a variety of illnesses.

Even in their teenage years, health insurance becomes necessary for undergoing timely and quality medical treatment.

Add on covers

Many health insurance products offer necessary to add on covers which may prove very beneficial for insured and his family in times of distress.

So that you need not to buy a separate policy for covering required risks and gets seamless comprehensive coverage with your single health insurance policy.

Critical Illness Add-Ons

Pays the sum insured as a benefit amount for listed critical illness Like First heart attack of specified severity, cancer of specified severity, permanent paralysis of limbs, open chest CABG, Open heart replacement or repair of heart valves, coma of specified severity, kidney failure, Bone marrow transplant, multiple sclerosis, motor neurone disease etc.

The number of Critical illnesses covers may vary from product to product and requires attention while making purchase decisions.

Other additional covers generally available with health products are Personal accident cover, Hospital cash etc. which you may opt as per your needs and get a seamless comprehensive cover at a payment of an extra price.

Waiting Period

The insurer is not liable for any treatment which begins during the waiting period except in case of an accident.

Generally, there are 30 days waiting periods for all claims except you had one year of continuous coverage.

Outpatient treatment, Mother and child care benefits, listed illness and treatments, Pre-existing disease coverage all have specified waiting periods after which coverage comes into the picture.

You need to heed to these waiting periods as in cases it may vary from insurer to insurer, product to product and Plan to plan.

Cumulative Bonus benefits

Health insurance policies generally have this feature in which sum insured is increased by a specified percentage for every claim free year up to a specified maximum percentage.

The same ranges from 5% to 10% per year to 100% of sum insured maximum.

In case of a claim, the increased sum insured (base sum insured remains unchanged) gets reduced by a specified percentage amount. You would like to see that if this feature is present in your Mediclaim policy and if it is at what terms.

AYUSH Treatment

Ayush Treatment

AYUSH stands for Ayurveda, Yoga, Unani, Siddha, and homeopathy.

The popularity of this alternative form of treatments is increasing by leaps and bounds not only in India but abroad as well.

Inpatient treatment of AYUSH is covered by most health insurance policies with no sub-limit. Have a look that if your health policy covers for the same and do not forget to check for the applicable sub-limits if any.

OPD Coverage

Some health insurance products offer Outpatient treatment which does not require hospitalization of 24 hours with a waiting period of specified years through a network medical practitioner.

Coverage is for general consultation, diagnostic tests, dental treatment and spectacles/contact lenses/hearing aids. Terms may vary from product to product and you should have a closer look about availability and terms of OPD coverage.


One more area where you should have a detailed look are sub-limits, which are coverage wise limits placed by insurers on the overall sum insured that will be payable if the coverage triggers.

Some of the common sub-limits placed are on Room rent, ambulance charges, outpatient treatment, maternity charges etc. Some insurers also provide discounts for opting sub-limit options.

Wellness and value-added benefits

Most health products offer wellness benefits like vouchers for availing discounts at gym and other health care centers.

As prevention is always better than cure a customer should select a product which has to tie up with branded and reliable wellness centers and offers services at affordable discounted prices.

The range of value-added services like telephonic or doctor consultations, health newsletter, and library, specialist consultation with follow up sessions, second opinion etc. Research a bit and choose a product which provides a range of standard and reliable value-added services.

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Network Hospitals

For your convenience and better treatment, you must have a look at the network hospital list of the insurer and select an insurer who has cashless tie-ups with reputed hospitals in the vicinity of your place.

Discounts and Loading’s – Have a look at the discounts and loading’s offered by the insurer and select a product which offers more discounts like a family discount, long term policy discount, E-Policy discount, Lifestyle discounts, treatment in tiered network and others. Loading’s for adverse features like tobacco consumption should also be looked upon.

Other important features and coverage’s – Other features you may look in a health insurance product are whether health checkups, convalescence benefits, Vaccination charges for post-bite treatment, daily cash for accompanying an insured child, Maternity coverage, Restore benefits, cover for people living with HIV/AIDS, Global coverage etc.

In total, you should after careful consideration on the above factors select a health insurance policy which meets your risk and budget requirements and provides comprehensive protection to you and your family.

Also CheckExclusions in a health insurance policy – Why you should pay attention before purchasing the policy?

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