Buying a health insurance policy is a very crucial decision today where the medical inflation is rising at a great percentage, leading to a considerable rise in the cost of healthcare services year on year.
Given the importance of the fact of having a health insurance plan, we shall be mentioning a few points today that you should duly consider while assessing or buying health insurance.
Keep reading to learn how to make better decisions about buying health insurance.
What is the health insurance coverage amount?
This is probably the first question you should ask before purchasing a policy. A policy offering sufficient coverage – Rs.50 lakh or more, is always good to go for considering the increasing costs of treatment.
Is cashless settlement available?
Cashless service means that the settlement of hospital bills directly takes place between the hospital and the insurance company. This mitigates the need to undergo the hassle of paying a huge sum first to the hospital and then waiting for the reimbursement from your insurer.
It is hence important to check that the insurer has how many hospitals in its cashless claim settlement network. It is especially important to check how many hospitals in your city/region are tied up with that insurer for cashless settlements.
Is it asking to co-pay?
Co-pay means that the medical bill would be split between you and your insurer, and the insurer won’t be settling 100% of the entire medical bill.
This is not good for the insured person as apart from paying the premiums, he/she would now also need to pay a portion of the bill, diluting the purpose of having health insurance in the first place.
Hence one should always ask the insurance company whether they have co-pay or not. If they say yes, it would be better to look out for a better company or better plan.
Is there a sub-limit for any disease?
To explain the sub-limit, let’s say that Salim bought health insurance with a cover of Rs. 10 Lakh, and a year and a half later he underwent a surgery for the removal of kidney stones. After receiving the hospital bill of let’s say 5.5 Lakh, Salim contacted the health insurance company for settling the bill. But the company said that they could settle only up to 4 Lakh as lung, heart and liver ailments have a sub-limit of 4 Lakh in their policy.
So sub-limit basically means that despite having a cover of let’s say 10 Lakh, cover for certain ailments would be available only to a limited extent.
Asking for this clause from your insurer could help you assess the policy in a better way.
Is No Claim Bonus Facility Available?
After taking insurance if one doesn’t fall ill the entire year, then they shouldn’t feel that their premium went in vain. Hence it’s good to check that your insurer provides you with a No Claim Bonus.
This bonus simply means that in case of 0 claims in a year, the insured person would get his/her insurance cover increased by a certain percentage for the next year.
This also incentivises you to stay healthy while not feeling that your money would be wasted in case of a claimless year.
Is there any Auto Restoration Benefit?
This is a benefit that could come out to be a saviour in the case of continuous hospitalisations leading to exhaustion of insurance cover.
Restoration benefit means that once a cover is fully exhausted, the insurer would refill the entire cover without any additional cost for at least one time.
For example: If someone, unfortunately, undergoes an accident, and the treatment towards which exhausted the entire cover. 9 months later the same person was infected with COVID-19 and had to be hospitalised. If the insurance came with a restoration benefit, then despite the cover exhaustion 9 months ago, this person will be able to undergo the treatment for COVID-19 with backing from that insurance company itself.
Is the cover includes pre & post hospitalisation?
It may happen that a person has to undergo multiple hospital visits before getting hospitalized, and it may also happen that the person may have to visit the hospital multiple times after getting discharged as well.
It’s better for you to stay away from policies which only cover your in-hospitalisation expenses and ignore pre & post hospitalisation scenarios, which too could prove to be a very expensive affair for the insured.
Hence it is better to ask the insurance company whether they cover all these three cases, pre, post and in-hospitalisation.
Do note that pre & post should be for the exact ailment the person was hospitalised for.
Always make an informed decision before buying a policy. In case you’re looking for a comprehensive health insurance policy, visit Navi Health Insurance. Make sure to go through all the terms and conditions before signing up for a policy!
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Disclaimer: This article has been prepared on the basis of internal data, publicly available information and other sources believed to be reliable. The information contained in this article is for general purposes only and not a complete disclosure of every material fact. It should not be construed as investment advice to any party. The article does not warrant the completeness or accuracy of the information, and disclaims all liabilities, losses and damages arising out of the use of this information. Readers shall be fully liable/responsible for any decision taken on the basis of this article.
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