Bad Health Insurance Plans? 4 Tips to Deal with it

Inadequate Cover:

A good health insurance policy cover must account for growing medical inflation. If it does not, then during medical emergencies, you may end up bearing a major chunk of the medical expenses, thus defeating the very purpose of a good health insurance plan.

Pre-Existing Medical Conditions:

A good health insurance plan must provide sufficient cover for pre-existing medical conditions. Even if this comes at an extra cost, it is worth it.

Waiting Period:

If your health insurance policy involves an unreasonably lengthy waiting period for a list of diseases before you can make a claim for them, it is time to make changes.

Stringent Limits:

Always ensure that you read your health insurance plan’s fine print in details. Some policies impose limits on expenses that can be incurred to avail adequate and good medical treatment. These restrictions could be on surgery expenses, hospital room expenses, etc. If your health insurance policy’s stringent limits subjugate its benefits – rethink.

Hospitalization Cover:

Although health plans usually provide pre and post hospitalization cover, some of them mask this benefit by offering expenses coverage only for a limited number of days. This makes the policy more attractive, as lower premiums can be offered. However, in the long run, this turns out to be an expensive affair for the customer.

Settlement of Claims:

A good reputation with regard to settlement of claims is a crucial consideration while choosing your health insurance provider. Putting forth a claim is a cumbersome, tedious and time-consuming process, hence the insurer must settle claims as quickly as possible with minimal hassles. If your insurance provider’s claim settlement reputation is not good, you could be in trouble.

If your policy has some or all of these drawbacks, it is imperative that you either change your insurer or make the requisite adjustments and/or changes as it is not a good health insurance policy.

H2: These 4 health insurance tips can help you extract the maximum benefits from your health insurance plan:

Increase the Sum Assured

You can easily increase your existing policy’s sum assured at the time of renewal, by paying an additional premium. The insurance company will approve your request based on certain qualifying parameters.

Portability

The provision of portability by the Insurance Regulatory and Development Authority of India (IRDAI) is a major development in the health insurance field in India, and for policyholders, this is truly a welcome relief. If you are unhappy with your existing insurer, you can switch to a different insurance provider and opt for a different plan. You just need to communicate your decision to your current and prospective insurer, minimum 45 days before your existing policy’s renewal date.

Pick a health plan with your prospective insurer that assures a higher sum, better benefits, no loopholes, and complete transparency. A good thing about portability is that the waiting period for pre-existing medical conditions can be carried forward from the old to the new insurer – subject to the condition that you do not take a break during policy renewal.

Top-Up Plans

If you feel your current policy’s assured sum is insufficient, you can get either a top-up or a super top-up plan on your existing policy. A top-up is an extra cover in addition to your existing health plan’s sum assured. To illustrate, let us assume that your existing policy’s sum assured is Rs.5 lakhs along with a top-up cover of Rs.7 lakhs with the deductible of Rs.3 lakhs. Now in the event of hospitalization claim in a year, suppose the total expenses are Rs.8 lakhs, then Rs.5 lakhs will be paid from your existing policy and the balance amount of Rs.3 lakhs will be paid using the top-up cover.

This feature, however, can be availed only once a year, and only after you exhaust the existing policy’s benefits. If you have a second hospitalization claim in the same year, the top-up cannot be utilized.

We can use the same example illustrated above to understand what a Super Top-Up is. If you have a second hospitalization claim in the same year, the super top up will help you with the entire medical cover, provided the amount is within the specified limits. This saves you from the extra financial burden posed by the second hospitalization.

You can purchase either of the top-up plans depending on your current sum assured and your specific medical requirements.

Get a New Policy Altogether

A good health insurance policy is meant to give you timely and adequate financial support, along with making it convenient for you to use it when the need arises. If you fail to get this and continue having issues with your current policy, purchase a new policy that meets your exact requirements, instead of renewing the old one.

When buying health insurance in India, plan as meticulously as possible, and ensure you thoroughly read the policy documents. If you or your policy happen to go wrong somewhere, then at the time of the health plan’s renewal, you can always set things right.