10 Important Things to Look For In a Health Insurance

Are you planning to purchase a health insurance plan for your family but not sure about which plan is best and which insurance company is best. Well for a new bee who has no idea about the health insurance sector in might be a tiring task to choose the best plan out of several plans available in the market. 

With the recent incidence of the Coronavirus effect, awareness about the need for health insurance has witnessed a spike. Added to this many health insurance providers also started offering plans online without much hassle provided you are within the age limit of the risk-free zone.  

So, what are the important things to consider as deciding factors to choose the health insurance that covers your family? Let’s have a look – 

Network Hospitals to avail Cashless treatment

Every health insurance company will mention a list of network hospitals it has tie-up with. It is important to choose such hospitals to get treatment because you can avail of a cashless facility at these hospitals. The insurance company will clear the payment to the hospital directly or through its TPA. In contrast, if you select a non-network hospital, you would be paying the hospitalization bills and claims the same later with the insurer. That is the main reason to choose network hospitals to avoid the hassle.   

Claim Settlement Ratio

The claim settlement ratio of an insurance company is calculated based on the number of policies the company has sold and the number of claims it has settled in a policy year. This ratio is used as a deciding factor to choose the insurance company. Generally, the insurance company mentions its claim settlement ratio on their website. One can also cross-check these details in the IRDAI website. IRDAI releases an annual report that contains this data which is accessible to the general public. 

Pre Hospitalization and Post Hospitalization Cover

Many health insurance plans cover the expenses incurred before and after the actual hospitalization also. Choose such plans for more cover, as there will be expenses incurred in some health conditions that require many visits to your doctor for consultation and after discharge also there may be follow up visits and medication bills, and diagnostics expenses. 

Minimal or No Co-Pay

Some health insurance companies mention the Co-pay details in their plans. Co-pay is the percentage of the amount among the hospital bills you would be paying. The remaining amount would be paid by the insurer. If the actual hospital bill is very high chances of you paying a high amount out of your pocket is more. If you would like to avoid this situation you can select the plans with zero co-pay. 

Waiting Periods for Pre-Existing Diseases

Some Health insurance policies come with a waiting period ranging from 2 years to 4 years during which the insured person is not eligible to claim the health insurance if there are any pre-existing diseases by the time of purchase of the plan. Apart from this, there would be some list of treatments and diseases with a minimum waiting period of 2 years. The insurance company would mention these details in their product brochure. Spend some time to check the details so that you are aware of which conditions and diseases are not covered for certain initial policy years. 

NCB (No Claim Bonus) 0r Renewal Bonus

No claim bonus is an additional amount of coverage that an insurance company would give if there are no claims in a policy year. This additional cover limit would be added in the next ear of coverage. Selecting plans with high NCB would be a great choice as that would increase your coverage at the same cost of the yearly premium as a bonus if there is no claim in a policy year. Some health insurance plans offer this feature ranging from 5% 100% NCB. However such plans cost a little more comparatively. 

Restore Benefits

Restore benefit in health insurance is, if you have exhausted a partial or full amount cover provided by your insurer in a hospitalization, then the insurer would recharge it to the full limit again free of cost. But in general, this applies to a different health problem in case of the same person joining the hospital. If you are purchasing a family health insurance plan, this feature can be more beneficial in case if two are more persons covered in a family health insurance plan get hospitalized in the same year

Day Care Treatments

Due to advancements in the medical field, some treatments may not require the patient to stay at the hospital for more than 24 hours, and some even less. But at the same time, some such treatments would be expensive. That’s why health insurance companies include few such treatments in the eligible treatments in their plans. Check them before purchasing the plan. 

AYUSH Treatment

AYUSH means Ayurveda, Unani, Siddha, and Homeopathy. Some health insurance plans even cover the expenses incurred for such treatments. If you are willing to take any of such medical treatment methods that come under AYUSH, then you have to check if the plan offers this option. 

Home Hospitalization

Some health insurance plans cover the expenses incurred in home hospitalization if the insured person is not able to be moved to the hospital for treatment and if the treatment at home extends certain days as mentioned in the policy documentation. In the case of the elderly if you are purchasing a health insurance plan for your parents or based on the need you could select certain plans with such benefit. 

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