18 Tips to Select the Best Health Insurance You Need to Know

best health insurance Policy
Tips for Best Health Insurance

Buying the best health insurance policy should be on your priority list. In my opinion, it may be your great investment because ultimately it is for you and your family. If you have the best health insurance policy for you and your family, It will be helpful in case of medical emergencies.

Risk and uncertainties are everywhere and at every minute of our lives. Day by day the number of diseases/illnesses is increasing and road accident is also very uncertain.

The cost of medical expenses is very high and also increasing day by day. Everyone is not able to afford a high level of medical expenses. So, the best health insurance policy is the best option. Here are some important tips and suggestions which may be helpful to get the best health insurance policy.

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1- Purchase a Policy in Your Budget

You should buy the best health insurance policy in your budget from the very first moment you plan for it. Because It will be easy for you to afford and renew it on time. I am not saying that you compromise with the features and benefits. I am just saying that you should choose it with good features at a reasonable price term and within your budget that you can afford for the long-term.

budget best health insurance
Best health insurance within budget

Just imagine for a moment, that you purchased the best health insurance policy for your family last year. You paid the premium of Rs. 1 Lac. But this year you are not able to renew it because of the budget problem. Now what? Your policy may get lapsed and insurance service will get terminated.

2- Focus on Required Coverage and Avoid Unnecessary Covers

Whenever you are planning to buy the best health insurance policy, just take a pen and paper and first work out it. Note down your family members’ details and medical history etc. Now note down your requirements – Most priority, Least priority, and no requirement.

Now you search out different plans online and offline. Compare and check which one is the best-suited plan for you. Let’s see these examples.

You should maximize the features at a reasonable insurance premium but should not compromise important features because of a premium only.

3- Claim Settlement Ratio and Claim Process

The most important factor of your best health insurance policy is that you get the claim on time in case of need. You should check the claim settlement ratio of the insurance company. If the claim settlement ratio is high mean the company is good at paying claims to its customers.

But if the claim settlement ratio (CSR) is very low then you should have a pause here. It may be a signal for you to think again. Claim rejection chance is high if CSR is very low. You should have a look claim ratio before you purchase the policy.

4- Life-Long Renewal Option

Life is very uncertain and nobody knows how many years he or she will live. Nobody knows when she or will become ill. There is a higher chance of being sick/ill at an older age. Comparatively, there is a lesser chance of being sick/ill at a younger age. You should go through the renewal terms of the policy. You should prefer the policy which has no age limit for renewal.

In some plans, you may see that there is a maximum age limit to renew the policy. But you should give preference for a lifelong renewal kind of health insurance policy. Because you don’t know that a medical emergency will come at the age of 30 years or 70 years or at another particular age.

5- Network Hospital

The insurance company has tie-up with so many hospitals to provide cashless claim settlement to customers. The insurer has its own network hospital list and you should have a look at the network hospital list before buying the best health insurance policy.

In my opinion, you should prefer the insurance company which has a high number of network hospitals. But you should also check that important hospitals in your residential area/workplace are available on the list.

6- Individual or Family Floater

Suppose, I have two options 1). Sum assured of Rs. 5 Lac for each member ( four members in the family) or 2). Sum assured of Rs. 20 Lac – family floater policy ( four members in my family). Premium in both cases is almost is same.

In the above cases, I will choose the second option because here the sum assured is very high. Here, if there is any medical emergency with anyone then medical expenses can be covered up to Rs. 20 lac.

However, in the first case, you can claim up to a maximum of Rs. 5 lac. An example is only for understanding purposes actual figures may be different. If you are not a single individual and have a family then you should prefer the family floater policy. However, it is totally your decision which one you choose.

7- Check Waiting Period

Generally, health insurance plans in India have some waiting periods. Here are some of the waiting periods-

Initial waiting period: Except for accidental hospitalization, the initial waiting period may range from 30 days to 90 days. Generally, the minimum waiting period is 30 days. However, it will depend on your best health insurance policy.

Waiting period for specific disease: In the Specific waiting period, the insurer does not cover a set of specific diseases/procedures until 24 months from the policy inception. Eg. Stone, Cataract, Glaucoma, Fibroid, etc. For details refer to your policy terms.

Waiting period for pre-existing disease: The insurance companies do not cover pre-existing diseases during this waiting period. This period normally varies according to the plan. However, It may be 48 months or 36 months, or less than 36 months.

Maternity waiting period: There are some health insurance plans in India which are covering maternity expenses also. But in some cases, you have to serve a specific waiting period. Most of the plan has a maternity waiting period.

In my view, you should check all the waiting periods and their terms before you do a final purchase of the best health insurance plan. You will not be disappointed later if you are aware of it.

8- Check for Discounts

Discounts may directly impact your insurance premium. You must work out how much discount the company is offering and which one you can avail of. There may be these types of discount options on premium.

Family Discount: You may have the option to get a family discount if you cover more than two members in one health insurance policy.

Long-term Discount: Normally, companies provide long-term policy discounts also. In this case, if you purchase a policy for 2 years or 3 years then you get some extra discount respectively.

Online Discount: Some companies may offer you an online discount also. You should check all the options for discounts. You can minimize your best health insurance policy premium by availing of suitable discounts.

9- Inclusions and Exclusions of Health Insurance

If you think that you may get a claim for every medical expense in health insurance then it is not practical. Every plan has some temporary and permanent exclusions also. Generally, an insurer does not pay any claim for the permanent exclusions listed in your policy. You must check this list. So, that you may be aware that what is not covered in your policy permanently.

10- Selection of Right Sum Assured

The selection of the right sum assured is a very crucial factor while purchasing a health insurance policy. Did the sum assure of 1 lac, 2 lac, 5 lac, 10 lac, or 1 crore? Which one is best? The ideal answer is the higher sum assured is best. But it doesn’t mean that you have to buy only a sum assured of 1 crore only.

It depends on many factors to decide the best sum assured for you or your family. It should consider the following points before you finalize it:

  • In which city you are living?
  • What is your standard of living?
  • Most important, What are your income and budget?
  • In which hospital you prefer your treatment?
  • What is the average medical cost for major disease treatment and or operations?
  • How many members are there in your family?

Ideally, a sum assured of Rs. 10 Lac to Rs. 20 lac is OK for treatment in India. However, it also depends on the above factors.

11- You should Check Co-Pay/Limits and Sub-Limits

When we buy the best health insurance policy, the first thing that comes to mind is that the insurance company will bear all future medical expenses up to the sum assured. But this may not be the real picture. You must go through the details of limits and sub-limits and or co-pay.

Your plan may have some capping on room rent expenses, emergency ambulance charges, and some other expenses. Generally, in the lower sum assured plan, there may be a limit on room rent expenses like 1 % of Sum assured, etc

There may be a co-pay condition in your policy after a particular age. You must know all the limits, sub-limits/co-pay so that you be prepared for the terms.

12- Pre-Policy Medical Checkup and its Cost

Insurance companies do underwriting and analyze the risk available in particular cases and issue the policy. In some cases insurer issue policy after a pre-policy medical test of the insured.

Pre-policy medical normally depends on the age of the insured, existing symptoms, pre-existing disease, height, and weight of the insured.

The question is who will bear the cost of this pre-policy medical test? It may vary from company to company and plan to plan. Some insurance companies bear the full cost of pre-policy medical tests. But in some insurance companies and or plans policyholders bear 50% of the cost. There may be a different scenario also.

13- Provide Correct Information

What if the insurance company rejects your claim at the time of need? There will be a big disappointment and a sudden financial burden for you. If you are not satisfied, you have the option to go to ombudsmen and court. But what if there was a mistake on your side?

For example, you provided the wrong medical history at the time of filling out the proposal form. In this case, the decision may not be in your favor.

You must provide correct and complete information in the proposal form. Name, date of birth/age, medical history, symptoms if any, habits, profession, and other required details should be proper and accurate.

14- Free Health Checkup

Most insurance companies provide free health check-ups in a health insurance policy. Some insurance companies like Religare, Maxbupa, etc are providing free health checkups every claim-free year. However, it may also depend on the plan which you choose.

Some companies and plans are provided once for 2 or 3 claim-free years. You should check out before buying the policy. The number and list of tests may also vary according to companies and plans.

15- Buy Health Insurance at Early Stage

Most people and experts will suggest you take the best health insurance policy at an early age. My opinion is also the same. There may be the following points which you may consider:-

  • First, It will cost you less premium.
  • Second, You will serve the required waiting period at the early stage of your life.
  • Third, there is very little chance of pre-policy medical tests.
  • There is very little chance of rejection of your proposal form.

The chance of illness and disease is less at a younger age which is why the premium is also lower in comparison to a higher age.

16- Flexibility to Add a New Member in the Midterm of Policy

Do you have the flexibility to add new members to your health insurance policy at renewal and midterm? Companies provide you this flexibility to add a new member at the time of renewal of the policy or in the midterm of the policy. It depends on your insurer and the kind of plan you have.

Ask your insurance agent about the terms of adding a new member to the policy. If you expect your marriage or newborn baby after buying a policy then it is very important to know.

17- Cumulative Bonus or No Claim Bonus

Your insurance company provides you a cumulative bonus when you do not file any claim for the complete policy year. In some plans, you may get a claim bonus of 20% on every claim-free year. You can add this bonus maximum of up to 100% of the basic sum assured.

Some plans may provide you with a 50% bonus on the first claim-free year and again 50% on the second claim-free year. Total maximum up to 100% of the basic sum assured. There are more than 100 health insurance plans in the market and a bonus percentage depends on the plans and company you opt-in.

18- Pre and Post Hospitalization Expenses

You must check pre and post-hospitalization expenses in your health insurance policy. This is the inclusive feature that covers medical expenses incurred before admission and after discharge from the hospital.

Pre-Hospitalization: Medical expenses incurred prior to the date of hospitalization. This may be for 30 days, 60 days, or more as per the plan you choose.

Post-Hospitalization: Medical expenses incurred from the date of discharge from the hospital. It may be for 60 days, 90 days, or 180 days or else depending on the plan.

These expenses are covered in the case of inpatient hospitalization only. The expenses should be related to the disease/illness for which the insured was hospitalized. You can claim these expenses through reimbursement within a specified time.

Conclusion – Best Health Insurance

The selection of the best health insurance policy required proper attention. Whenever you plan to purchase, check all the features and benefits. There are several companies like Bajaj, Hdfc, Etc are into health insurance and you should compare at least 4 to 5 companies’ plans. This may be a very important decision for you and your family.

So, it is very important to have the best health insurance policy. All the best!

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