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.

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      Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. For complete list of insurers in India refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in

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      *We will respond in the first instance within 30 minutes of the customers contacting us. 30-minute claim support service is for the purpose of giving reasonable assistance to the policyholder in pursuance of the claim. Settlement of claim (including cashless claim) is the responsibility of the insurer as per policy terms and conditions. The 30- minute claim support is subject to our operations not being impacted by a system failure or force majeure event or for reasons beyond our control. For further details, 24x7 Claims Support Helpline can be reached out at 1800-258-5881.

      *Product information is authentic and solely based on the information received from the Insurer. Policybazaar is acting only as a facilitator and claims settlement shall be at the sole discretion of the Insurer. Policybazaar does not provide any medical or surgical advice or diagnosis and is not responsible for your interactions / treatment by a medical practitioner/hospital. Please consult a registered medical practitioner for any medical or surgical advice. The Information that you obtain or receive from Policybazaar, and its employees, or otherwise on the Website is for informational purposes only. As per the Insurance guidelines, you are allowed to cancel the policy with-in 30 days from the date of Issuance of policy.This option is available incase of policies with a term of one year or more.

      *All the health insurance plans cover hospitalization expenses including COVID-19 treatment cover up to the specified limits. You can also buy specific COVID-19 health insurance policies such as Corona Kavach Policy and Corona Rakshak policy.

      **All savings and online discounts are provided by insurers as per IRDAI approved insurance plans. #Tax Benefits are subject to changes in tax laws. GST Exemptions depend on fulfilment of qualification criteria and submission of relevant documents.

      *₹1748/month is the starting price for a 1 crore health insurance for an 18-year-old male, with no pre-existing diseases. Discount on renewal premium is subject to the number of wellness points earned in the health insurance policy. For more details about the plans, please read the sale brochure carefully to get upto 100% discount on renewal premium.

      *₹400/month is the starting price for ₹ 5 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹541/month is the starting price for ₹ 10 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹762/month is the starting price for ₹ 1 Crore Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹243/month(₹ 8/day) is the starting price for a 5 lakh health insurance for a 20-year-old male, non-smoker, living in Bengaluru with no pre-existing diseases

      *₹2020/month is the starting price for ₹ 1 Cr Health insurance for a 50 year old male & 50 years old female, living in Bangalore with no pre-existing diseases rounded off to nearest 10.

      *₹390/month (₹13 per day) is starting price for 1 cr. Health insurance for 25 years old male, with pre-existing diseases, residing from tier 1 city rounded off to the nearest 10.

      *No medical tests are required unless requested by the insurer’s underwriter. In-case of pre-existing diseases relevant medical proof would be required as per the terms and condition of the policy opted.

      *The values taken for effective cost calculation are indicative values and may change as per the selected plan.

      *Coverage upto double the amount of Sum Insured is available on certain covers for a minimum plan of Rs. 5 Lakh on the first claim only to an individual of upto 45 years of age with no pre-existing diseases. The benefit is available with or without extra cost depending on the plan chosen.

      *Coverage of pre-existing diseases is provided by insurer as per their underwriting policy.

      *The scope of coverage may vary from plan to plan.

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