What should you look at while buying a health insurance policy?

Health insurance was not a familiar term to many before the COVID-19 pandemic. After the pandemic, people are rushing to purchase various health insurance policies as they now understand the significance of health insurance in their life. Health emergencies can hit any time and put undue stress both emotionally and financially. Insurance companies are also revamping their existing policies or introducing new policies to gain the attention of the customers. But very often the complex insurance jargon makes health insurance buying decisions difficult for buyers.

Here we are going to mention things to know before buying health insurance it will help you to choose the right health insurance plan.

What to consider when buying health insurance

Here are the 9 major factors you need to consider while buying a health insurance plan as mentioned below:-

1. Age Criteria
2. Sum Insured
3. Premium and Coverage
4. Claim Process
5. Critical Care Policy and General Health Policy
6. Cashless Network Hospitals
7. Claim Settlement Ratios (CSR)
8. Check Customers Review
9. Inclusions and Exclusions

1. Age Criteria

While purchasing a health insurance policy, consider the age of the family members for whom you are going to purchase the policy. Age plays a pivotal role in your health insurance. For a family floater policy, health insurance premium rates depend on the age of the eldest member. Moreover, when purchasing a health insurance cover, check out health insurance family plan age limit documents. Many health insurance products come with a minimum entry age limit of 91 days and a maximum of up to 60 years. Some health plans also cover people with a minimum age limit of 25 years and a maximum of up to 60 years. Many policies don’t have any restrictions in terms of age.

2. Sum Insured

Don’t forget to consider healthcare inflation whenever purchasing a health insurance policy. Always go for a policy that offers a higher sum insured amount. Earlier, people used to purchase a health policy of Rs 3-5 lakh. But now, this amount won’t be adequate because of the sky-high price of healthcare, medical procedures, equipment, and surgeries. At present, the cost of heart surgery is nearly Rs. 3-4 lakh. But if you consider medical inflation, then the same will be going up to Rs. 10 lakh in the next few years. Therefore, always choose a plan that offers a higher sum insured amount. Always choose a plan considering the healthcare inflation.

3. Premium and Coverage

While purchasing a health insurance policy, don’t just focus on the premium amount rather go for a policy that offers maximum benefits. You may get tempted to buy the policy that comes with the lowest premium but a low premium plan may not offer extensive coverage. Check whether your policy comes with additional clauses like co-payment, sub-limits, deductibles, etc. If your policy includes these clauses, then you would need to pay some part from your pocket for the medical expenses incurred. Discard a policy that comes with these clauses. Always go for a policy that is budget-friendly and offers you adequate coverage, without tampering with the benefits.

4. Claim Process

Choose a health insurance company that comes with a simple claim settlement process and the claim settlement ratio is healthy. Apart from this, easily reachable and efficient customer support should also be a factor while choosing a policy for you. Never ignore these factors if you want a policy to meet your requirements at the time of a medical need.

5. Critical Care Policy and General Health Policy

Critical ailments like kidney failure, cancer, tumors, stroke, etc., require special medical attention and care.  The costs of critical illnesses expenses are also quite high and your general health policy may not offer coverage for these costs. Sometimes, these treatments may absorb the sum insured of your regular policy, and still, you need to pay a humongous amount from your pocket. As a precaution, it would be a wise decision if you purchase a critical illness policy. This type of policy is beneficial for you if you have a medical history of critical illness in your family.

6. Cashless Network Hospitals

Always look for the best cashless medical insurance in India. All insurance companies have a tie-up with hospitals (network hospitals) where you will get cashless treatment facilities for your medical ailments. In the case of any healthcare emergency or hospitalization, you must take admission to these hospitals. Insurance providers usually settle your medical bills directly with these hospitals. Purchase health policy from an insurer that comes with a high number of network hospitals.

7. Claim Settlement Ratios (CSR)

A health insurance policy will assist you at the time of hospitalization. You will never want your claim to get declined by the insurer or only a small amount of the claim to get approved. Here enters the claim settlement ratio that determines the loyalty and legitimacy of an insurance company. By visiting the website of a company, you can check its CSR value. All details including the total number of claims settled, how many days it takes for the company to settle a claim, the number of the pending claims, etc. will be mentioned on the website.

8. Check Customers Review

Before committing to any policy, don’t forget to check the reviews of customers online. There are many online forums and social media platforms where customers tell about claim settlement procedures, reasons for claim rejections, time taken to settle claims, and how efficiently the insurance provider handles the claim. Check these forums thoroughly and make a wise decision.

9. Inclusions and Exclusions

Read the fine print of your policies i.e. terms and conditions of the policy. The list of inclusions and exclusions is mentioned in the policy documents. Most health policies have some common exclusions like STDs, HIV, AIDS, dental treatment, obesity treatment, self-injuries, sports injuries, etc. So before signing any contract, check what you are getting against your policy and what treatments are not covered under the policy.

When purchasing medical insurance, look into these parameters. When investing in health insurance, always try to find the best deal. If required, compare various policies and identify the most suitable one that meets all your healthcare requirements.