5 Pointers While Buying Health Insurance Plan

Until a few years ago, buying health insurance was similar to booking a flight ticket in the 1990s –one needed contact a travel agent for consulting and booking purposes. Buying health insurance was no different either. You would reach out to a health insurance agent, who would walk you through different plan options, and with their recommendation, you bought a healthcare plan.But, the chances are that your agent may lack the required insight about your specific financial needs and may not necessarily be able to suggest the ideal product for you.

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    These days, buying health insurance online needs minimal assistance. Rather than relying on an agent, you can research and buy the best health insurance plan as per your needs. Since, you are the one who has to make the decision you should know what important factors should be considered:

    1. Decide on the Coverage Amount Wisely

    When deciding on the coverage amount, you must have a long-term view of your health costs. Think about both your medical and financial requirements–from coverage amount to monthly premiums, co-payments (a share of claim that you have to pay from your own pocket), and deductibles (an amount you pay for health care services before your insurer begins to pay). It’s a good idea to assess your needs and identify your priorities so you know what to look for in a plan.

    Let’s understand this with the help of an example. Avinash Sharma, a Delhi-based professional who had undergone a minor surgery in a private hospital received a bill of Rs. 1.4 Lakh. His insurer covered only Rs. 50,000 of the cost, as his insurance cover was not enough. Healthcare costs are rising at a fast rate and what looks like an adequate cover may not be enough in the coming years. Plan wisely, so you will not have to face such monetary crisis in future.

    Read Also-: 6 Easy Steps To Buy The Best Health Insurance

    2. Consider if You Need a Family Floater Plan

    You also need to be clear whether you want to buy an individual cover or a family floater policy. An individual cover will only focus on you whereas a family floater policy will cover the entire family.The premium for family floater plan may be higher as compared to the individual policy, but the premium per person works out to be lower. It’s a calculated risk you can safely take because it is unlikely that all the members will require hospitalization in the same year. However, if any family member has health issues, it would be sensible to look for an individual cover for them so that the premium does not increase.

    3. Compare Hospital Room Rent Capping Clause

    Health insurance policies have room rent capping clause, which means that you are eligible to claim expenses only up to a room costing below this threshold. In case you opt for a room above this cap, you will have to bear the additional expenses. Let’s say, as per your policy your room rent limit is Rs 4,000 per day. Now, if you get hospitalized and choose a roomwith rent of Rs 10,000, then you have to pay the extra Rs. 6000 from your own pocket.

    4. Look for Treatment-Wise Limits and Co-Pay

    Most of the health insurance policies have treatment wise limits on the amount you can claim for specific treatments such as cataract or cardiac treatments. Such limits would cap your claim, even when you have a large sum insured under the policy. You need to weigh this in, before you sign up.

    Another factor that has to checked while buying the insurance plan is co-pay. Co-pay is a fixed amount of the total medical bill that you pay from your own pocket in the event of the claim.For instance, if the approved claim is Rs 1 lakh, and you agree to co-pay a ratio of 10%, you will need to shell out Rs. 10,000, while the insurer chips in with the rest.

    5. Check for Cashless Mediclaim Facility

    Before buying an insurance plan, check whether the insurer provides cashless mediclaim facility. Cashless mediclaim service offers you the benefit of availing medical treatment at your insurer’s network hospitals, without you having to pay from your own pocket. Ideally, while choosing a plan you should look for the ones that have more number of network hospitals in your city.

    Since there are many insurers offering health plans, it is a good idea to do your homework before selecting the best and most suitable health policy. These above-mentioned pointers should surely help you buy the best health insurance plan.

    Written By: PolicyBazaar - Updated: 29 July 2021

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