5 Things You Should Not Skip Before Finalizing Your Health Plan

Author: Ompal Rao

The health insurance plans offer financial assistance in the event of unexpected medical complications. It helps meet various health insurance demands, whether those needs are based on an individual's life stage or a particular ailment.

Before making a final decision to purchase a health insurance plan, consult our helpful guide, which focuses on the five most crucial factors to consider.

1. Coverage amount

The scope of coverage must be assessed and evaluated. Buyers may believe purchasing health insurance is sufficient to meet their healthcare needs. Buyers who purchase a health plan solely based on the premium, assuming that "affordable is wiser," may end up limiting their scope of coverage.

It is critical to have health insurance with a substantial sum insured the maximum amount that can be paid out under a health plan. Rising medical costs can be mitigated by selecting a totality insured large enough to substantiate the claim amount without requiring you to pay out of pocket.

2. Room rental caps

Before purchasing a health plan, it is critical to review and assess the restrictions or upper limits in the form of capping and sub-limits. There are some restrictions on the health insurance benefits payable from the health insurance plan coverage. Room rent is your per-day benefit when your health insurance plan's eligibility hospitalises you.

Traditionally, the hospital room rent is capped at 1% to 2% of the total insured daily. Recently, health insurance plans have included "single private rooms" or the option to "upgrade your room," and some plans have "no capping" on room rent. The latter two options are typically available in health insurance policies with a higher sum insured.

3. Network of cashless hospitals

Cashless hospitalisation is a simple procedure that makes seeking health care easier during a difficult time. You only need to show your insurance company's health card to be admitted to the hospital.

However, not all hospitals will be partnered with your insurance company to provide you with such hassle-free treatment. As a result, it is critical to review the list of cashless hospitals approved by the insurance company. It is essential to visit your preferred hospitals from the list. *

4. Record of claim settlement

The claim settlement record is an important aspect that should be considered. The amount of claims settled by the insurance company is essential because it reflects the insurance company's preference for genuine claim settlement and assures you that your claims and reimbursements will not be wrongfully withheld. *

Before purchasing a health plan from a specific insurance company, look for a consistent and healthy claim settlement ratio. *

5. Payment in part

Your co-payment is your portion of the claim amount. Co-payments are classified into two types: voluntary and mandatory. As the name implies, voluntary co-payment is one that you, as an insured, choose, whereas the health insurance plans for family or self, requires mandatory co-payment. The co-payment is calculated as a percentage of the claim amount.

The insurance company will reduce your premium if you choose voluntary co-payment because you must share the claim amount in the predetermined percentage. If you are a young, healthy person, you should select voluntary co-payment because the likelihood of claiming from a health insurance policy decreases.

Don't be fooled into thinking that opting for voluntary co-payments will reduce your health insurance plan costs. The surprise comes when you are unaware of the co-payment parameter in your health insurance premium when you file a claim. As a result, this clause must be noticed.

  • Standard T&C Apply
  • Currently, there are 2 tax regimes in India – new and old. To get the tax benefit you desire, choose the correct one after consulting an expert. You can opt for a regime change during the next financial year.
  • Visit the official website of IRDAI for further details.
  • All savings are provided by the insurer as per the IRDAI-approved insurance plan. Standard T&C apply

Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.