Introduction
Life is unpredictable and full of uncertainties, anything can happen at any time to anybody. And medical emergency is one of them it can come knocking anytime. Medical expenses is getting costlier every now and then. So, buying a health insurance policy can protect you from a financial blow of your savings and provide you the much-needed cushion to brave you through any kind of medical expenses such as check-ups, tests, medicines and other procedures. Through this article, you will read the things you need to know before getting health insurance.
Health insurance policy and meaning
A health insurance policy is a medical insurance that acts as a safety net for covering the medical expenses caused due to accidents, illness, or injury without shaking your financial build-ups.
Basically, it is a contract between the insurance company and the insurer, where coverage on medical expenses up to the sum insured limit is done by the company. This health plan, also offers multiple benefits, including cashless hospitalization and free medical check-ups. Plus it also provides tax savings on the premium paid to the insurance company under Section 80D of the Income Tax, 1961.
Types of Health insurance policy
Individual plans and family floater plans are the two types of health plans. Before choosing any of the two its important to understand them to make thoroughly, just to make sure you make the right and smart decisions for you and your family as well. Here a brief meaning of both two types.
- Individual plan –this plan covers only for a single individual, i.e., in whose name it is being issued.
- Family floater plan–this single plan cover the entire family members of the individual, under whom the insurance policy is being issued.
Remember your decision will depend entirely on factors such as your age, your children ages, medical history, and budget.
What are the things to know or consider before buying a health insurance policy?
With so many health insurance plans available in the market it is overwhelming to choose which is right and best for you and your family. So here are some important things to know before buying a health insurance policy.
1. The Age Criteria
Before purchasing a medical policy do keep in mind the age of the family members who need to be insured. The cost of premium would depend on the age of the eldest family member, especially in a Family floater policy. Also, check out the age limit criterion there are plans that have restrictions on the age entry.
2. The Right Combination of Premium and Coverage
Buying health insurance with the lowest premium can be profitable. However, there can be two sides to it. Firstly, policy with a lower premium can be good if it gives an extensive coverage at a premium that one can pay. Secondly, lesser premium at the cost of the insurance coverage. So, if you come across a reduced premium it is wise to look for the reasons behind it, as it should not be at the cost of the insurance coverage.
In in the process of evaluation options, look for a policy that offers adequate coverage, without compromising on the benefits and at a premium that you can afford.
3. The Waiting Period Clause
Being aware of the waiting period clause will help you make a better decision. During this time period any claim arising out of pre-existing illnesses or specific illnesses will not be accepted.
Remember different policies have different waiting period. So, compare and choose a plan that comes with the least possible minimum waiting period to be able to claim the benefits in case of a health emergency.
4. Look for Cashless Hospitalization Benefits and a network of hospitals.
Always know to check for health Insurance companies that have a wide network of hospitals with the policy. Here, the insured members can avail of cashless treatment in case of a medical emergency.
This cashless facility not only saves you from the tedious paperwork needed at the time of admission and claim. But the insurer also pays the sum insured directly to the hospital. For an individual who travel often it will be helpful to check with his/her insurer for the list of impaneled hospitals. And know what all network hospitals are available in their vicinity.
5. Pre and Post Hospitalization Coverage
Almost all health plans cover the medical expenses that are incurred during the hospitalization. But what about before and after hospitalization – Doctor consultation fees, prescription drug/medicines, medical tests, ambulance charge, etc.? Buy a plan which covers aspect of both, before and after hospitalization for a lower out pocket cost.
6. Coverage of Maternity Expenses
With maternity expenses is in its peek, it is a need to buy health plan that covers maternity cost. For maternity benefits, check the waiting period applicable for claiming maternity expenses and consider the sub-limit.
Remember to choose a plan that also covers new-born medical expenses apart from the delivery cost. And not forgetting to check the limitations that are attached to it or for exclusions related to the policy.
7. No-Claim-Bonus/No-Claim-Discount
NCB refers to the reward offered by the insurance company for all the years that you have not make any claim. Either a decrease on your insurance rate for the following year or a bigger sum insured for the same premium may be offered as the bonus.
However, the No-Claim-Bonuslimit is stated in the majority of health insurance plans. Furthermore, the growth in the insured amount would be subject to the insurer-specified limit.
So, before buying the insurance choose wisely and be sure to check the policy wordings for the No-Claim-Bonus clause.
8. Preventive Health Check-up Facility
Preventive health check-ups is way costlier than one thinks, for instance like – cardiovascular diseases, cancer screenings, MRIs, etc. So, when buying a health insurance policy makes sure the plan includes free preventive health check-up or the insurance coverage limit of preventive health check-ups.
9. Co-Payment Clause
Co-payment clause is the percentage of the amount that needs to be paid at the time of claim and the rest will be paid by the insurer. Without any co-payment , one need not make any out of pocket cost for each claim. So, before buying the medical insurance policy, check the policy documents if there is any co-payment clause applicable that might impact your claim amount.
However, if you have any pre-existing conditions or have crossed a certain age limit most insurers would have a co-payment clause. So, if you have opted for co-pay, you can choose the percentage you want to commit, i.e., right at the beginning.
10. Claim Process
The claim process and claim settlement are two major factors when it comes to selection of a policy.
- It is beneficial for the insured if the claims process is straightforward and claims are resolved quickly.
- Always have a good understanding of the policy wording and go through the health insurance claim process that is followed by the insurance company.
- Select a health insurance provider that is known for its seamless claim settlement services.
Conclusion
As you now know the in-depth information on health insurance policies, now it is your decision whether to buy a plan. And if you plan on buying what are the things you need to know. Or, keep in mind in the process of comparing the different health policy you have selected. Remember wealth is also health!
