A health insurance plan is the best way to secure your healthcare costs. It is one of the insurancecovers that you need to avail even if you do not have any dependents. Health insurance plans for individual as well as family are available, and you can choose according to your requirements in the best possible manner.

If you have already purchased a health insurance plan without doing much research or just to avail tax benefits, you need to ensure whetheryour health policy has the “key features” to be the perfect plan for your requirements. If not, you can still avail certain benefits by opting for facilities like super top-ups, etc.

Some of the features that you must recheck in your policy are as follows:

1. Co-pay& Deductible

The first and foremost thing to check is whether your policy includes the clause of co-pay and its percentage. Co-pay refers to the percentage of the total claim that you will have to bear in case of hospitalization or illness, after the payment of which the insurer will be liable to pay the rest of the amount.

For example, if the total claimableamount forhospitalization is INR. 100,000, and the co-pay is 10%, then you will need to pay INR. 10,000out of your pocket. Provided that the total amount is less than the sum assured of your plan.

Deductible however is given as a fixed amount, say INR. 5000 for each year. In this case, health insurance will only step in if your expenses exceed INR. 5000.

2. Sub-limit

Sub-limit refers to the limits that the policy sets in case of specific illnesses. For example,A plan might set up a limit of INR. 1,50,000 for a particulartreatment like cataract surgery. So, even if the sum assured is INR. 15,00,000, you will only geta benefit of INR. 150,000for cataract treatment. A room rent capping is also a part of sub-limit.

Policies come up with different room rent caps.A room rent cap refers to the percentage of sum assured beyond which you cannot avail the room you wish, or you will have to bear the extra expenses yourself. For example,if the room rent cap is specified in your policy of INR. 5,00,000 as 1% or INR. 5000/day whichever is less, you will have to bear the extra expenses of the room in case you wish to take a room with a higher room rent.

3. No Claims Bonus

It is not every year that you need to avail the benefits of your health cover, until and unless you suffer from certain major diseases like cancer. So, you need to check if your policy offers a no-claims bonus.

A no-claims bonus refers to the benefits you can avail at therenewal of the policy if you have not made a claim in the previous year. Insurers will likely increase the total sum assured of your health plan or offer discount in the premium costs. So, if you already have a policy, check whether you are being given this benefit by the insurance company.

4. Super Top-ups

You can add to your total sum assured by top-ups and supertop-up schemes. A top-up plan is an extra sum assured that will pay the expenses of a single hospitalization if it crosses the base limit.

A super top-up is an amount over and above the base policy that can be availed multiple times in a yearto cover the increased requirement as a result of inflation.

Many insurance companies provide this benefit to people who live in the metro citiesand have chances ofincurring higher healthcare expenses. Such super top-ups are also added in the existing policy plans for specific diseases like cancer etc.

5. Hospital network

Insurance companies nowadays work in partnership with individual hospitals to make the hospitalization process easier for you. If you decide to get admitted to a hospital that is in your insurer’s network, you need not worry about the paperwork. The insurance company will pay the expenses directly.

However, you need to check in such a case whether there are goo hospitals included in the network of the insurer. If the hospitals of your choice are not in the network,you may still get the benefit of the insurance, but it will be in the form of reimbursement.

Thus, if after reviewing your existing policy, you feel that you have compromised on several of the above key features that could have made it better for you, you must rethink and try to either change the insurer or the health insurance policy, whichever is feasible for you at this point.