How to Choose the Best Health Insurance Plan?

12 Tips to Choose the Best Health Insurance Plan

Here are a few smart tips to select the best health insurance plan for you and your family:

1. Pick a Plan Type As Per Health Needs

   If you want medical coverage for yourself, you must opt for an individual health insurance policy. But if you want to cover your family, go for a family floater health insurance plan instead of buying individual health plans for each member. Family floater plans are more affordable as they cover all family members on a floater sum insured basis. Similarly, elderly people aged 60+ years must buy a senior citizen health insurance policy.

2. Choose an Adequate Sum Insured Amount

   When purchasing health insurance, make sure to choose the sum insured that you actually need. While a higher sum insured will increase your premium, a lower sum insured will be insufficient to cover all your medical expenses, leading to increased out-of-pocket expenses. Moreover, you must consider the age of all family members, your city of residence and future medical inflation while selecting the right coverage amount.

3. Opt for a Plan Closer to Your Desired Coverage

   While buying medical insurance, pick a plan offering your desired coverage. Analyze the health needs of your family and choose a plan that offers you the right coverage. Ideally, you must go for a comprehensive health insurance policy that covers beyond hospitalization expenses, including OPD treatments, home care treatments, teleconsultations, non-medical expenses, modern treatments, etc. Moreover, plans with specific coverage, like maternity insurance benefits for newly married couples, should be considered.

4. Prefer Plans with No Sub-limits/ Co-payments

   At the time of choosing the best health policy, look for plans without any sub-limits or co-payment clauses. While sub-limits restrict the maximum amount you can claim for a treatment/procedure, co-payment is the share of the claim amount you agree to pay during claim settlement. Since sub-limits and co-payments increase your out-of-pocket expenses, avoid buying plans with these clauses and evade any financial burden during claim settlement.

5. Choose Plans with a Lower PED Waiting Period

   While choosing medical insurance, especially for parents or senior citizens, prefer plans with a lower pre-existing disease (PED) waiting period. The PED waiting period is the time period after which you can raise claims for pre-existing diseases. Although most plans offer a PED waiting period of 1 to 3 years, some plan offers PED coverage from day 1 for diseases like hypertension, diabetes, etc. Since elderly people have age-related issues, a lower PED waiting period shortens their wait time for filing claims.

6. Go for Plans with Restoration Benefit and Annual Health Check-ups

   To choose the best health insurance policy for yourself, make sure to consider plans with restoration benefits and annual health check-up facilities. The restoration benefit recharges your sum insured before renewal if the original amount is partially/completely exhausted. On the other hand, the annual health check-up benefit pays for your preventive medical tests every year. These benefits are useful to enhance your coverage quality and, thus, should be preferred.

7. Pick Plans with Wider Pre & Post-Hospitalization Expenses Coverage

   A good medical insurance policy covers pre & post-hospitalization expenses for a longer duration. While pre-hospitalization expenses cover medical expenditures incurred before hospital admission, post-hospitalization expenses cover those incurred after hospital discharge. Thus, make sure to go for plans that offer 60/90 days of pre-hospitalization and 120/180 days of post-hospitalization costs.

8. Check the Policy List of Exclusions

   Every health plan comes with some standard and some specific exclusions. It is essential to check exclusions in a health insurance plan to know what your insurer will not pay for. So, if you seek coverage for a specific treatment/disease, make sure to pick a mediclaim policy that does not put them under their list of exclusions.

9. Opt for Plans with Desired Riders and Add-ons

   Riders or add-on covers can enhance the coverage of a standard health insurance plan on payment of an additional premium. You can consider add-on covers, such as critical illness cover, personal accident cover, inflation shield, etc., and riders like hospital cash rider and global cover rider to extend your policy coverage. For instance, senior citizens can opt for a PED waiting period reduction rider to claim their PED expenses early. Therefore, prefer plans that offer your preferred add-ons or riders.

10. Go for an Insurer with a High Claim Settlement Ratio

    While buying a mediclaim policy, go for an insurance company that enjoys a high Claim Settlement Ratio or CSR. The CSR is the ratio of the total claims settled against the total claims received in a year. A higher CSR indicates that the insurer settles most claims it receives. Thus, if you opt for an insurer with a high CSR, you have a higher chance of your claim getting settled.

11. Check the Reputation of the Insurance Company

    Before you purchase a health plan, make sure you check the reputation of all health insurance companies in India. Doing so can help you get an idea of the after-sales services and how quickly the insurance company settles the claim. You can check reviews of insurance companies online to get the real picture.

12. Compare Multiple Health Insurance Plans

    One of the best ways to pick the right health insurance plan is to compare various available plans on the basis of coverage, benefits and premiums. Comparison helps you to find the plan that offers the best coverage within your budget. You can easily compare health insurance policies online on websites like Policybazaar.com to get the best deal.

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