Health & Car Blog

With Federation of Indian Chambers of Commerce in India (FICCI) and Insurance Regulatory and Development Authority (IRDA) pushing health insurance hard to people, it becomes important for all of us to understand the importance of health insurance and buy one to safeguard our health.

Thanks to the various advertising means, we get to know of the companies (insurers) available in the market, but the confusion arises when all the companies together throw a diaspora of health plans at us. To help you cherry pick one, here are tips to help you decide what should you look before buying a health insurance policy…

1. Co-payment can be a deciding factor

Co-payment is the portion of the claim that policyholder agrees to bear in every claim. It is different for different insurer, insurance policies and may also vary on case to case basis. The co-payment can range anywhere from 0-30 per cent.

With some companies, copayment can be reduced to zero with the payment of additional premium. Hence, before going for any one health one, make sure how much you will be comfortable paying as higher co-payment may result in lowering premiums.

2. Coverage of pre and post-hospitalization expenses

Different health plans cover pre and post hospitalization in the different way. Some plans incur 60 days’ expenses before hospitalization and 90 days after hospitalization; however, others such as Apollo Munich cover expenses incurred 30 days before hospitalization and 60-90 days after hospitalization. There are still others, which offer a percentage of pre and post hospitalization expenses.

Here, before buying a plan, you need to gauge your treatment requirements and decide which plan will be best suited for you.

3. Take domiciliary treatment if you are old

Domiciliary treatment facility is useful for patients who are unable to move to hospitals for treatment. This facility pays for treatment in home, at such times. Most of us take this facility along with a health insurance plan, irrespective of the need, resulting in large premiums. Most of us require domiciliary treatment in old age and critical illnesses; hence avoidable in young age.

4. Consider renewal age and other conditions

Most plans differ on their renewal age, limiting the opportunity for an individual to get cover till maximum age. Generally, maximum renewal age vary from 60 years to entire life of the insured.

As health insurance requires renewal after every year, most insurers increase the premium in case you make huge claims and you might want to get insured from the different company giving lower premium polices. Hence, it becomes important to look at finer points before going to a particular insurer.

5. Watch out of sub-limits

Sub-limit is the upper limit of an expense covered, which is equal to a fixed percentage of the sum insured. For example, day care treatment will be covered up to 20 per cent of the sum insured, limiting your share of sum assured for day care treatment. In addition, policies with different sub-limits are complex to handle. Here, you must compare the policies in regard to their sub limits, and take the one with minimum or no sub-limit.

6. Watch out for caps on treatments

In addition to the caps on sum assured for certain expenses, health plans also cap on the number of days, for which expenses was allowed. It includes daycare treatments, hospitalization, etc. In addition, some policies also cover non-allopathic treatments such as Ayurvedic, Unani, etc., while others do not. Here as well, one must look for his/ her requirements and ensure that one does not end up with taking all benefits, making premium too high to afford.

7. Tax benefit and loyalty bonus

Bonus is available with most insurers for renewing the policy with the same insurer. Most of the health insurance policies need to be renewed every year; whereas there are others, which are renewed after two years. Here, you need to check on the tax benefit available under the plan. Most of the one-year health insurance policies offer tax benefits; however, two-year policies offer tax benefits in first-year only.

Apart from all these pointers, additional benefits are available in the form of free health check-ups after every 4 claim free years, refund of initial health check-up cost on acceptance by insurer, different waiting periods for OPD expenses and other services, allied accidental death insurance, daily cash benefits, etc. One must assess the needs first before buying a policy.