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Top 5 Ways to Get the Most Benefits From Health Plans

Health insurance is slowly but surely gaining popularity in India. Given the rising cost of health care, it only seems like the logical choice for people falling in the low, middle and upper middle income bracket. Since a bulk of the population belongs to that category, a broad variety of insurance products from different insurers are available on the market, each offering a different set of perks, greater coverage or access to a wider health care service network.

However health insurance, being a relatively new product for the burgeoning populace, is something quiet a few subscribers and non-subscribers remain unfamiliar with. Ask an insurance agent and he is most likely to give you the coverage basics which you can anyway glean off the policy wording with a casual glance.

However, when you buy into a health care policy, you shouldn’t limit yourself to simply knowing what benefits are available to you. It literally pays to go a little deeper, do some homework and make the most out of your health plan. Let’s look at some of the ways you can manage to achieve:

1. Have a secondary health insurance policy in place.

In most cases, as is common for a lot of salaried people, employers generally provide health insurance to employees as a part of company norms. As an individual, you will be covered under this policy to the extent of the sum assured per year. You can additionally supplement this by buying another, more comprehensive policy. If you find that your medical bills are only being covered to an extent by the full limit of one policy, you can invoke your secondary policy to take care of the rest. Just remember to disclose the details about each of your insurers to the other since that’s a mandatory requirement.

2. Some policies guarantee preventive care so you should take full advantage of them.

Preventive care includes things like mammograms, vaccines, GYN appointments and annual physicals and are usually conducted free of charge through network care providers under the terms of the policy. The advantages of opting for preventive care is twofold – first off you don’t have to pay anything out of pocket for services rendered, and second, preventive care means that you are much less likely to meet a serious condition down the line which will end in a claim, in turn raising your annual premium.

3. Stay within the service provider network that your health policy subscribes to and know what exactly is covered under your plan.

Going to a non-network care provider will mean that you will have to pay the medical bill out of your own pocket. Moreover, going for drugs and procedures not covered under your policy also translates into paying out of pocket. Remember that insurers will also refuse to cover you for any medical procedures performed which did not have any connection to the actual underlying condition.

4. See what riders are offered by your insurance carrier.

Riders sometime come cheaper than additional coverage and the extra premium you’ll need to pay against it will generally be much more affordable than buying into a separate plan for a specific coverage. Critical illness cover riders are especially beneficial since they offer lump sum pay outs in case a claim is made based on its condition. Some insurers also offer prescription drug riders which cover the cost of a wide spectrum of both generic and brand name drugs outlined in the policy.

You May also like to Read: Top 5 Health insurance Riders

5. Use cash and pay out of pocket for charges which do not amount to significant medical bills.

Each claim free year entitles you no-claim bonuses calculated against the sum assured by the policy. These bonuses can range from 10 percent to as much as 50 percent and is usually paid up as discounts on premium and renewal or is topped up on the sum assured. Ergo, making claims against small medical expenditures cost more in the long run than what you can gain from a claim free year.

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