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9 Pointers for How You Can Best Utilise Your Health Insurance

Over the past years, the health insurance industry has witnessed lots of changes. Many new regulations have been introduced and the entire industry has been standardised to some extent. As a lot of policyholders bought their health insurance years ago when rules were different, they may not be relevant in today’s context.

If you’re amongst those who think the job is done once the insurance is purchased and the policy document is received, then we have some unfortunate news for you that this is not the case. There is a huge list of things to do after you insure your health with an insurer. Here’s how you can put your health insurance to some good use in 10 ways.

# 1- Don’t Delay Buying it.

The foremost thing to remember is ‘No delay’. Buying a good sufficient policy is 10 times better idea than purchasing the best health policy after 10 years. Fix it in your mind that you’re going to buy health insurance now, set your requirements first, compare the plans online and get your dream coverage.

# 2-Individual Cover or Family Floater

If you are planning to buy a plan in your 30s, consider buying family floater plan. Because at this age, either you’re already married or getting married. So, rather than buying a separate plan for each family member, you can opt for the best family health plan or floater plan that includes maximum 6 to 8 members. This way it is cheaper than an individual plan. Also, there will be a large cover shared by all the members and one can make a claim, whenever required.

But here comes the twist!

If you’re adding your parents who are more than 50 years old or have health issues, it makes sense to have separate health plans for them. Here you should not include a member with high risk as the frequency of claim is likely to be higher with time. Hence, rest of the members could be left with less or no cover to claim should they need it.

# 3-Ensure Your Family Knows About the Policy

There are many cases when the family is unaware of a plan the insured has bought. Consequently, the dependents may not file a cashless claim or there may be a delay in registering a claim, and so, they may end up bearing the medical expenses. So, it is essential to inform your spouse or family about the policy and keep a copy of policy document in a place that is easily accessible. Each member should be aware of how to go begin the claim process if need be.

No # 4- Mark the Renewal Date & Arrange for the Sufficient Fund

It is always the case that policyholders tend to pay the premium of health insurance in the nick of time or when they receive a reminder call from the insurance company. One should avoid this approach as insurers are not bound to do so. The insured should set a reminder of the due date and pay the premium timely. As the premium could be a huge chunk of your monthly expense, make sure you arrange for the same before D-day arrives.

No # 5- Avail Tax Benefit

You are a regular and timely premium payer, since you bought your health insurance. However, it may be that you lack awareness of the tax benefits that one could avail against the premium paid for a health plan. Due to this, you might not claim a tax deduction or do it the wrong way. This can be avoided by increasing a little knowledge about Section 80D of the Income Tax Act, which talks about tax deductions on the premium of health insurance.

No # 6-Intimate the Insurance Provider about Any Changes in Health History

When it comes to the insurer-insured relation, you need to be upfront, be it any claim related issue or about your poor health condition. Usually, health policies are renewable in every year and as per the IRDA guidelines, no insurer is authorised to increase premium based on claim history of the customer, during renewal. In order to maintain good faith, one should disclose everything related his/her health or any pre-existing illness so that no complications arise during a claim.

No # 7- Increase Sum Insured

In order to beat the current inflation level you will need a sufficient Sum Insured. Otherwise, your health insurance plan will prove to be insufficient when you need it the most. Hereby, it is very important to evaluate your insurance cover from time to time and during policy renewal is the best time to do so. If the insurer offers you 10% or higher increase in the cover, go for it so that your health plan keeps pace with current inflation rates. If there is no such provision, then you can opt for a top-up policy which covers you when the limit of your base health policy is exhausted.

No # 8- Add New Member

It often happens that after buying a policy, one may start a family. If this is the same with you and your baby has arrived, immediately inform the insurer without waiting for the next renewal. Add your child in the policy then and there. Usually, most health insurers cover new-born babies after 91 days. You will have to pay a pro-rated premium and the insurer will issue an endorsement. In your next renewal, your child will be covered as well.

No #9- Careful about Room Rent Capping

This is one thing that your insurer or agent may not be willing for you to know and this could single-handedly depreciate the worth of your insurance plan with inflation.

Health insurance policies have a limit on room rent that is called room rent capping. As per this, the insured is eligible to claim room rent expenses below this limit. In case your hospital room rent exceeds this limit, you’ll have to bear the expense from your pocket.

Let’s say, that you opt for a health insurance policy that sets capping on room rent up to Rs. 5000 per day. Now, when you get hospitalised, god forbid, you choose a room worth Rs. 10,000 per day. Though your policy covers you for room rent, it will pay you up to 5000 per day only. The balance amount will be paid by you. This should not be the case, right? But, in reality, it is the truth. The insured is liable to get only 40% of the actual room rent. For example, of your ICU cost is 20,000. Even if it is within the limit, you will only be paid for 40% of 20,000 that is 8,000. Conclusion is you’ll be at loss due to room rent capping 

In a Nutshell!

Though health insurance comes with lots of benefits and unique features, choosing the right plan is not less than a herculean task. Since buying the right policy is imperative yet difficult, it requires constant review and attention, even after buying the plan, so that it can be used for your best use. By making a check-list of how to track your plan timely in a right way, you can avail the maximum benefits out of your health plan. Be smart, stay healthy!