Health insurance is no more just an option. Rather, it has become the need of the hour with rapidly rising double-digit medical inflation figures and an increase in incidents of life-threatening illnesses such as cancer and cardiovascular, lung and liver diseases.

Getting just any health insurance policy is not guaranteed to grant you comprehensive cover against rising medical expenditures. There are several factors you need to consider to make sure you choose the right health insurance plan. Let us tell you about things you should pay attention to when comparing health insurance plans.

Sum insured

The sum insured is one of the most vital aspects of a health insurance policy. According to a 2016 study conducted by Apollo Munich Health Insurance, 50.5% people across India are underinsured. Being underinsured exposes you to the risk of high out-of-pocket expenditures or even an inability to get required medical treatment.

The choice of sum insured should be governed by medical costs at the healthcare facilities you prefer to visit, the age of the insured members and the medical diseases the insured are suffering from or prone to.

Claim settlement time and claim settlement ratio

When it comes to health insurance, the moment of truth is when the policyholder files a claim. But don’t wait to find out the truth; whether bitter or sweet, for yourself. Enquire about the company’s claim settlement ratio.

Claim settlement ratio is the ratio of the claims paid by a health insurance company against the premiums earned by it. The higher the claim settlement ratio, the better.

Claim settlement time is another critical aspect of a health insurance company’s services, especially when it comes to the time taken to settle cashless claims. Delay in getting a cashless claim approved can cost an ailing person precious time.

Network hospitals

A company that has good quality network hospitals in all major cities helps ensure that you can avail quick, cashless treatment when most needed.

This is an important factor to consider as cashless treatment can be a life-saver in cases when you do not immediately have funds available and can help you avoid the hassle of settling hospital bills.

Sub-limits and co-payments

Sub-limits are limits an insurance company puts on its liability towards the policyholder for specific expenses. One of the most essential sub-limits to pay attention to is the room rent sub-limit as room rent makes up one of the major portions of a hospitalisation bill. It is advisable to look for a plan that offers minimal or no sub-limits on room rent and otherwise.

A co-payment is a pre-defined percentage of the claim amount that the policyholder is meant to bear themselves, only after which the health insurance cover comes into play.

Plans with sub-limits and co-payments are cheaper than ones with minimal or no co-payments or sub-limits. But these cheaper plans may prove more expensive in the long run when they fail to offer adequate cover.

Pre and post-hospitalisation cover

In several cases, an ailment results in hospitalisation after certain diagnostic tests and consultations with doctors. Even when the patient is discharged, expenses are incurred on outpatient treatment, involving medicinal intake, follow-up investigations and doctor consultations.

A plan that offers extensive pre and post-hospitalisation cover can help further scaffold the brunt of high medical treatment costs.

No claim bonus, restoration benefit and other discounts

Most health insurance policies now offer a no claim bonus, which leads to an increase in the sum insured at renewal, up till a specified limit, if the insured doesn’t make a claim in the policy tenure.

The restoration benefit entitles you to a restoration of the basic sum insured if you exhaust your entire cover.

Other discounts, such as a discount for choosing more than two members for an individual policy or for opting for a two-year contract with the company can help you gain more value for your money.

Exclusions

Health insurance plans tend to exclude certain diseases and procedures from the cover provided. It is essential that you study the list of exclusions carefully in order to be well-informed of what is not covered by your health insurance plan.

Health-related guidance and rewards

Ideally, a health insurance plan should not only come to your rescue when you have to rush to the hospital or get a medical procedure. A good health insurance plan takes care of your health from the word go.

Choose a policy that provides regular health tips and guidance, health-related counselling, regular health check-ups and rewards for staying active and healthy.

Health insurance can be a very beneficial investment tool if you choose the right policy. It is essential to understand the features of the policy carefully and to go through the policy wordings carefully in order to carefully understand all essential features of the plan. You must choose wisely and buy a health insurance plan as early in your life as you can to avoid high premiums and serve through the waiting periods with ease.

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