9 Pillars of Health Insurance You Must Consider!

We live in a world that is full of uncertainties. One of the uncertainties are medical emergencies which can hit you anytime in your life. The daily increase in the cost of healthcare in our country can hit a big dent in your finances. Therefore, it is best to buy a health insurance policy just to keep yourself & your loved ones safe.

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    Now, once you decide to buy a health insurance policy, it is impossible to decide as there are too many options available in the market. It gets confusing as you need to find the best health insurance that will suit your needs. Well, you don’t have to worry anymore. We have simplified this decision for you. Here is a look at the important things you need to know before you buy a health insurance plan or you can term them as the pillars of health insurance:

    Pillars of Health Insurance

    Buying the right health insurance depends on certain factors, which include:

    • Age Criteria

      When you decide to buy a health insurance, age is one the most crucial factors. When you purchase a medical policy, you need to know the age of all the family members who you want to be insured. It is more important for a family floater policy as the price of the premium will always depend on the age of the eldest family member.

      Make sure you check the age criterion before you decide on a particular health insurance. Many health insurance policies have an entry age limit of just 91-days which goes to a maximum entry age of 60-years. Some plans have a maximum age limit of 50 years only while some have an age limit starting at 25 years. However, there are many health insurance plans that don’t have any kind of restrictions on the entry age which means you can choose your options accordingly.

    • Combo of Premium & Coverage

      It can be very beneficial for you to buy a policy that has the lowest premium. However, like a coin, there are 2 sides of it. A policy that gives a wide coverage for an affordable premium is a good offer. The other side is a premium which is as close as the cost of an insurance coverage. The best method is to find the reasons why there is a lower premium. Make sure that there aren’t any hidden clauses of sub-limits, deductibles, co-payments, etc. which you would have to pay when you claim anything. An important thing to remember is that you should an insurance policy which suits your needs and not negotiating any benefits along with an affordable premium.

      You May Like to Read: Health Insurance Premium Calculator
    • Cashless Benefits

      There is a network of hospitals that have tie-ups with Health Insurance providers. This is where the insured persons can easily avail the cashless benefits in case of an emergency treatment. Health insurance companies this way help you in saving a lot of paperwork which is required at the time of admission and at the time of claim. Furthermore, the hospital is directly paid by the insurer. This allows you not to arrange any kinds of funds or claim a reimbursement. It is best to check with the insurance provider you are choosing for the list of hospitals they have in their network. This will allow you to check which hospitals are in the network close to your place of residence.

    • Hospitalization Coverage

      As there are many health insurance plans in the market, the majority of them cover the medical expenditures that happen during the period of hospitalization. Make sure you buy a health insurance cover that not only covers your expenditures during the hospitalization period but also that for the expenses that occur before & after the period of hospitalization. This will help you save expenses on medical tests, medicines, ambulance charges, doctor fees, etc.

    • Maternity Expenses Coverage

      One of the most common mistakes that people do in a health insurance policy is to ignore the benefits related to maternity. Day by day, the cost of maternity as well as delivery is exploding through the roof. It is best to purchase a health insurance policy that covers the expenses of delivery and maternity care. The usual waiting period before anyone can claim the benefits is 2-4 years. In case you are planning to start a family, then a plan with a waiting period of 2-3 years will work for you. Some plans also cover new-born baby’s medical expenditures along with the delivery expenses. Always ensure that you check any limitations attached to the maternity insurance policy.

    • No Claim Bonus

      No Claim Bonus means the discount that an insurance company offers for all the years you do not file a claim. This means your coverage amount is increased by the insurer for all the claim-free periods at the time of your policy renewals. Many insurance providers give you a ‘No Claim Bonus Limit’. Any increase in the insured sum depends on the limit specified by the insurer.

      Let us see how this works with an example. If you purchase a health insurance policy of Rs 6 lakh and the insurer is giving you a 10% of NCB for every year you don’t file a claim with up to a maximum of 50%, then the below table shows how the ‘No Claim Bonus’ affects the sum of your insured amount;

      No-Claim-Bonus

      Claim Free Year

      Sum Insured

      1st Year

      6,00,000

      2nd Year

      6,50,000

      3rd Year

      7,00,000

      4th Year

      7,50,000

      5th Year

      8,00,000

      *The above amount is subject to change as per the insurer’s terms and conditions

      The maximum amount insured capping in the above table is 8 lakh (50% of 6 lakhs). Always ensure you check the policy’s wordings of the No Claim Bonus clause.

    • Clause of Co-Payment

      At the time of purchasing a health insurance policy, lots of people find a term that confuses them which eventually they ignore. It is known as ‘Co-Payment Clause’. This means that there is a set percentage of amount which is to be paid by the insured at the time he/she claims while the rest is paid by the insurer or insurance company. Before you purchase a new health insurance policy, do check if there is a clause as such which would later impact your finances. It is best to not have any sub-limits as such. However, there are a majority of insurers that keep this clause if a certain age is crossed or the insured has a pre-existing medical issue.

    • A Preventive Health Check-Up Facility

      The cost of many preventive health check-ups has gone up. These include cancer screenings, MRIs, cardiovascular diseases, etc. If you are purchasing a health insurance plan then it is best to have it covered. This will help you same money rather than make a hole in your wallet. Do check if the insurance policy has a coverage limit of preventive health check-up.

    • Process Related to Claim

      Always go through all the wordings and the claim process of the insurance company before purchasing anything. It is always beneficial to have a smooth claim process at the time of settling your claims. Always do a lot of research on your own which includes customer-reviews on the web and then select the best health insurance provider.

    In a Nutshell

    Buying health insurance is an important decision to make so that you and your loved ones do not have to fear about any financial emergency, especially in India, where the cost of medical care is rising day by day. These important points explained above will help you choose the best health insurance plan. So, what are you waiting for?

    Written By: PolicyBazaar - Updated: 30 July 2021

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