In an individual plan, each individual is insured for a specific amount, whereas in a family floater plan, the whole family is insured for a fixed sum assured. In the case of the family floater, when the primary person dies or reaches the exit age, the policy is closed and other younger members can’t renew the policy. But in an individual plan, an individual remains insured on an individual sum insured basis even if the eldest member of the family attains the exit age or dies during the policy tenure.
2. Sum Insured (Coverage Amount):
Whilae choosing the coverage amount or the sum assured, it is recommended to take various factors, such as rate of inflation, surging healthcare cost, etc., into consideration. Moreover, if you’re living in any metropolitan city, the costs of hospitalisation will be way higher than in rural areas. Likewise, if you cover your loved ones also in the policy, you might want to opt for a higher sum insured.
3. Co-payment Option:
Various mediclaim plans come with a co-payment clause. Co-payment is usually a percentage of the claim amount that the insured has to bear while raising a claim before the insurance provider settles the remaining amount. The co-payment can range from 10% to 30% based on the insurance provider. Thus, check for any co-payment under your mediclaim policy before buying.
4. Exclusions:
There are a few medical expenses that are either covered after a certain time or not covered at all under a mediclaim policy. For instance, HIV infection, drug or alcohol addiction, etc. are not covered under the mediclaim policy, but specific diseases like removal of kidney stones, gall bladder surgeries, etc. are covered after a certain waiting period. You must check the exclusions carefully before buying the policy.
5. Network Hospitals:
One of the most important benefits of choosing a mediclaim policy is the ease of the cashless settlement of hospitalization expenses at network hospitals. Every insurance provider has network hospitals where cashless hospitalisation can be availed. Therefore, you must check the network hospitals list of the insurance company near your area before you purchase the policy.
6. Renewability Age:
Some policies come with a lifetime renewability option allowing you to renew your policy irrespective of your age. This is essential for older people because it is tough to get insurance at that age. Therefore, you must check the renewability option of your policy before buying a mediclaim policy.
7. Pre-existing Disease:
Almost all insurance companies cover pre-existing diseases after a waiting period. While buying a mediclaim policy, you must check the pre-existing waiting period as the best mediclaim insurance plan will cover pre-existing diseases as soon as possible.
