In-order to buy the right policy you may want the best health insurance tips. Buying a health insurance plan is a process which involves a lot of planning else you may end up investing in a plan which does not offer the best available coverage nor pertain to your particular requirements and needs.
There are high chances that you may end up buying a health insurance plan which may offer a basic coverage and also not cater to your requirements.
Basic guide for health insurance
1) Choose the right amount as ‘sum insured
What does sum insured mean ?
Sum insured is the maximum money that your insurance company will promise to pay if you are hospitalized(in case you claim).
You must keep a note of today’s healthcare cost while you plan to freeze on a sum insured value.
If you reside in a 1 or 2 tier city or any rural areas you must aim to have a cover that ranges between 3 to 5 lakhs(at least) and if you are from a metropolitan city then you should look at a cover ranging between 7 to 10 lakhs(at least).
2) Don’t rely completely on the health insurance policy provided by your company
Many corporate companies will offer you health insurance plans but having an individual plan for yourself is mandatory for the following reasons -
- Sum insured may not be as per your requirement
- Corporate cover will cease if you plan to leave your job or retire
3) A plan with no or minimal sub limit is a must
Be very careful of the plans which offer a cap on -
- Room rate
- ICU charges
- Maternity charges
- Certain medical procedures such as cataract, knee replacement etc
Sub-limits means that your insurance company specifies a limit for an expense and anything above that needs to be borne by you.
4) Understand all the benefits of a policy
Doctor’s fees, ICU room rent, pre and post hospitalization, ambulance charges, these are common benefits which you will come across in all the plans. You have to also check whether a plan covers other benefits like -
- Domiciliary expenses (treatment at home)
- Organ donor expenses
- OPD expenses
- Cost of alternate treatments like Ayurveda, Homeopathy, Unani, maternity coverage etc
5) Freebies are also beneficial
Make sure that the plan offers a free medical check-up every year. Please note, this does not affect the premium when policy undergoes renewal.
6) Be honest and transparent while you finalize a plan
Many claims just get rejected because of non disclosure.
You have to be transparent about the following -
- Any surgery or treatment that you have undergone since birth
- Consumption of any medicines on regular basis
Please disclose the above listed points in your proposal form.
7) Include maternity planning in family planning :)
Now a days married couples focus a lot on family planning; clearly modern day intelligent thinking. This thinking is completely intelligent if you also plan for an insurance plan for pregnancy as well. Medical cost for pregnancy have gone up exorbitantly and it is crucial that women should have health insurance plan that covers maternity benefits as well.
8) Restore benefit :
With this kind of benefit, insurance company will restore upto 100% of the sum insured in a year. Please do note that in effect, you have a coverage of the double the sum of your basic cover size.
Please read the following example for better understanding -
A patient falls ill in the first policy year and then make a claim of Rs. 2 lakhs. This claim will be settled by the insurance company. Now, the balance claim amount is Rs. 3 lakhs.
After a few months, there is another claim of Rs.4 Lakhs. Plans without restoration benefit would settle Rs.3 lakhs i.e the balance claim amount of Rs. 3 lakhs and the pending amount of Rs.1 Lakh have to be paid from your wallet/pocket. In this case Restoration benefit plans helps you and offers a restoration benefit where you will get the entire claim of Rs. 4 lakhs.
9) Cumulative bonus :
Look for insurance companies who would offer a cumulative bonus in the form of percentage increase in the sum insured or discount the premium payable if you don’t have claims for one policy year. This bonus can be accumulated year after year.
10) Pre/Post hospitalization :
Pre-hospitalization expenses usually incurs before a patient is admitted to a hospital for treatment. For your information following expenses may be considered as pre-hospitalization cost/expense in a health insurance plan -
- Doctors fee
- Medical tests
- Medicines and vaccinations
Post-hospitalization expenses incurs post treatment. This cost is unavoidable during a patients recuperation phase.
It’s ideal that you have a plan which reimburses the money you have spent on pre and post hospitalization expense.. Every penny counts!
Types of health insurance plans
- Individual plan
- Family floater
- Senior citizen plans
- Special health insurance plan for diabetic patients, critical illness insurance plan and personal accident cover
Reasons why you may struggle to choose the right health insurance plan?
- Pool of insurance policies by multiple broking companies
- Frightening phrases and idioms which otherwise are called as policy wordings. A serious challenge to laymen
- Lack of knowledge
Though it sounds very petrifying to boil down to the right required plan, having an insurance policy is very important. A right move means that you have secured your future and this can be achieved if you understand the health insurance guide or tips properly.
Guidance from TEAM AFS. Your health insurance advisors!
Above basic health insurance guide will help you getting into any unwarranted situations and you can avoid any possible blunders.
You can always contact us for any health insurance advice or guidance.
If you have an existing policy, we can always help you with a second opinion which will help you understand the knitty gritty of your policies. Let’s not be a victim :)