Today, science has growth to treat for major illness unlike past provided you can afford the treatment. With the prices of treatments skyrocketing and several specialized treatments heavily priced, it makes sense to purchase a health insurance plan.
So, what is the ideal sum insured that you should opt for? The health insurance cover will differ based on income, age, family size, city of residence, previous medical history, family medical history, preferred hospitals, etc. While it may not sound very pleasant, purchasing critical illness cover is absolutely necessary today. Having a top-up plan will provide you and your family with that extra cushion in case of any untoward incident.
Five tips for buying a health insurance plan
- Room Rent Capping
Room rent capping is a condition that puts a limit on the daily room rent. If your medical insurance plan puts a cap on per day room rent at Rs 3,000, and if you select a room that has per day rent of Rs 6,000, then your reimbursement will be only 50 per cent, and you will have to pay the rest. The room rent capping is decided as 1 per cent or 2 per cent of the cover amount.
E.g., if you have health insurance of Rs 5,00,000, then your room rent cap at 1 per cent will be Rs 5,000.
Tip: The reimbursement is based on the rate of capping, so it is essential that you consider health insurance that offers a No / lower percentage of capping and higher room rent.
- Pre-existing Conditions
Pre-existing conditions are defined as diseases or conditions you already have while purchasing the health insurance. The insurer will have a waiting period of 24 to 48 months before you can avail treatment for existing conditions under the newly purchased health insurance. It is also possible that some existing conditions could be co-pay, meaning you pay a certain portion and the insurer pays the rest for the treatment.
Tip: It is essential to understand the waiting period and carefully study the existing conditions that are covered. Choose a health insurance policy with the least amount of waiting period and minimum or no co-pay for pre-existing conditions.
- Restoration Benefits
Today, family floater plans are purchased by many against individual health insurance for the cost-effectiveness and the huge cover that it offers. Chose plan with ‘restoration benefits’.
Tip: It is essential to ensure that the policy offers restoration benefits. This will ensure that even if you have used a certain amount or even the entire amount of the health insurance coverage for treatment, the policy is restored and available for another hospitalization of the same person or anyone else in case of family health insurance plan.
- Network of Hospitals
Health insurance is purchased so that it can be availed in time of the need. So, it is vital to check if the health insurance you plan to purchase covers hospital near your vicinity along with multi-speciality hospitals.
Tip: Health insurance plan with a larger network of cashless hospitals should be preferred as it will ensure that you do not have to pay the bills and wait for reimbursement later.
- No-Claim bonus
No-claim bonus is a benefit offered by your insurer if there are no claims made during the entire year. These benefits will result in an increase in the sum insured without any change in the premium. The cover is usually increased 25-50 per cent in case of no-claim bonus.
Tip: The no-claim bonus offered by the insurer is an effective tool that will help you increase the amount of coverage without the burden of additional premiums
It is wise to not always fall for the lowest monthly premium plans as these tend to lower the cover. Purchasing a health insurance plan is a vital step for the safety of your loved ones. It is vital for you to understand all the terms and conditions before zeroing on any health insurance policy.