Step 1: Finding the Right Insurance Company
Here are some factors that you can use in deciding on the right health insurance company –
1. The Range of Plans Offered
Check out the different types of plans that a company offers as well as the plan USPs. Some companies offer a range of products to suit the varied coverage requirements that you have. Choose a company with a diverse range of plans so that you can find the right policy suiting your needs.
2. The Network of Hospitals
The network of hospitals is extremely important for availing cashless claims. The wider the network that an insurer has, the better it would be. This would allow you to locate the nearest cashless hospital with ease.
3. Claim Settlement Ratio
The claim settlement ratio points to one thing – what percentage of claims did the company settle in a financial year. A higher ratio indicates that the company is steadfast in settling its claims. A factor that works in favor of the insurer.
4. Claim-Based Loading
Some companies tend to increase the renewal premium if you made claims in the previous years. This converts to higher premium expenses. As such, avoid companies that follow this practice.
5. Premium Rate
Pricing policy is how much premium the company charges vis-à-vis its competitors. You can check the pricing policy by comparing similar plans across different companies.
For instance, the Aarogya Sanjeevani policy offers uniform coverage features across all insurers. Its premiums, however, depend on the insurer’s pricing policy. Compare the premium of the plan across insurers to find the insurer that charges the least. Chances are, its pricing policy would be fair across all its plans.
6. Ease of Claim Settlement
Insurers have revolutionized their claim process and made it simpler. The following concepts are gaining traction:
- AI-enabled claim processing
- WhatsApp intimation
- Digital documentation
- Quicker approvals
- App-based claim intimation and tracking, etc.
Such facilities speed up the claim process and make it hassle-free. Thus, look for insurers that provide such facilities for quicker claim settlements.
7. Reviews
Lastly, don’t ignore customer testimonials and reviews. Most insurers showcase their customers’ reviews on their websites. You can check them out. Alternatively, you can talk to your friends and relatives about their insurers. If they have made a claim, find out their claim experience to know which company follows the best practices.
Finding the right plan
Once you have zeroed in on the right insurance company, the next, and also the most important, step would be to select the plan. With multiple insurers offering multiple plans, you have a lot of choices. However, choosing the right policy is important.
As such, here are some factors that would help you with the same –
1. Coverage benefits
The first thing that you need to check is the coverage benefits that are offered by different plans. While most plans offer the basic coverage benefits, look for plans that have unique features.
First, assess your coverage needs and then look for plans that offer those. For instance, if you are planning to have a child in the near future, look for plans that offer maternity coverage. Alternatively, if your family is complete, skip such plans.
Second, look for other additional features that might enhance the scope of coverage. For instance, sum insured restoration, high no claim bonus, value-added benefits, annual health check-ups, etc. are some of the features to look for.
Choose a plan which has the most comprehensive scope of coverage. This would minimize your out-of-pocket expenses during claims and give you better financial security.
2. Customization option
Look for plans that allow you to customize the coverage features as per your requirements. This is possible through add-ons that health insurance plans offer. The add-ons help you to opt for additional coverage features as per your needs and make customization possible.
3. Premium Amount
Of course, the premium amount is important. Check the premium charged vis-à-vis the coverage offered. To get a better idea, compare. Compare the premium across other plans of different insurers that have similar coverage benefits. See if the premium is competitive or inflated given the coverage.
Choose a plan with the most competitive premium rate for the same coverage benefits, even if it means selecting another insurance company.
4. Sub-Limits
Health plans might have sub-limits on different expenses like room rent, ICU room rent, AYUSH coverage, domiciliary treatments, etc. These sub-limits limit the scope of coverage and might result in out-of-pocket expenses. As such, choose a policy that has no sub-limits so that you can enjoy the maximum possible coverage.
5. Co-Payment Clause
Health insurance plans might have co-payment clauses for different reasons. Co-payments mean that in every instance of a claim, you are supposed to pay the specified part of the claim from your pockets. For instance, a co-payment of 10% means that 10% of every claim would be borne by you. Common co-payment clauses are applicable in the following instances:
- If the insured is aged 61 years and above at the time of buying the policy
- If you buy the policy in a city belonging to a lower Tier and avail of treatments in a city in a higher tier
- In the case of specified illnesses and/or treatments
Look for health insurance plans that do not have the co-payment clause. Even if the clause is unavoidable, like in the case of senior citizen plans, opt for plans with a lower co-payment rate.
How To Find the Right Coverage Amount?
An optimal sum insured is important to ensure that your health plan sufficiently covers your medical expenses. A low sum insured defeats the whole purpose of investing in health insurance and is a strict no-no.
Selecting the right sum insured is easier than you think. You just have to consider the following factors:
- The number of members being insured under the policy
- Whether you or any other member suffers from any pre-existing condition
- The basic cost of hospitalization and medical treatments
- The rising medical inflation
Most insurers help you calculate the ideal sum insured based on your income, expenses, existing coverage and members to be insured. You can also estimate the optimal requirement through a simple formula which is as follows:
Sum insured = 50% of your annual income + total hospitalization costs incurred during the last 3 years
For instance, say your annual income is INR 15 lakh and in the last three years you have incurred a hospital bill of INR 5 lakh. In this case, the optimal sum insured would be calculated as follows:
50% of INR 15 lakh + INR 5 lakh = INR 12.5 lakh
Step 4: How To Afford a Health Plan
The premiums of health insurance plans are affordable. Moreover, insurers offer you the facility of installment premiums wherein you can pay the premium monthly, quarterly or half-yearly. This makes the health plans affordable.
Furthermore, if affording a high sum insured poses a challenge, you can opt for super top-up health plans. Super top-up plans help in enhancing the coverage while keeping the premium low.For instance, say you want coverage of INR 15 lakh but the premiums are unaffordable. In such cases, you can opt for a comprehensive health plan of INR 5 lakh or INR 10 lakh and add a super top-up plan of INR 10 lakh or INR 5 lakh respectively.
The super top-up plan would help you enjoy an aggregate coverage of INR 15 lakh. However, the aggregate premium would be lower compared to buying a health plan of INR 15 lakh.
How To Purchase A Health Insurance Policy Online?
- The simplest way to purchase a health insurance policy via online mode which can be done in minutes with a paperless process and no physical signatures.
- All you have to get is full detailed information on various health policies as per your needs and requirements.
- Review the best health insurance policies and compare them further and as per your needs and requirements to finally select the best one. Research them online to know more about the coverage, benefits and premium quotes at your convenient place and time.
- Once you have finalized the policy, read the policy document carefully and complete the documentation process.
- Once the documents have been uploaded, it is the time to make the final payment which can be done by credit card, debit card or by net banking. Insurance companies generally take seven to ten days to complete the full process and then handover the policy document to you.
Things To Avoid While Buying A Health Insurance Policy
Rushed Into Buying A Policy : Do not buy a health insurance plan in hurry. It is advisable to do proper research and then select the best health insurance for you or for your family. You can do your own research and compare the premium quotes online, before choosing a health insurance policy.
Choosing Insufficient Coverage: The premium cost is a major consideration while buying a health plan. Do not choose insufficient or restricted policy coverage in order to save premium cost. Rather go for a comprehensive coverage plan with considering the family size, medical history and your financial situation.
Hiding Health-Related Details: While purchasing a health insurance plan, disclose all the necessary details about your health, lifestyle habits or and pre-existing diseases. Hiding relevant medical history can cause major damage as insurance claims can be rejected on the basis of undisclosed medical information.
Not Buying A Separate Health Insurance Policy: Do not rely completely on medical coverage provided by your employers as it has only limited coverage. Also, when you leave the organization, the contract will be terminated on an immediate basis. It is crucial to buy a separate health insurance plan where the quantum of coverage is more and it will not be affected by the terms and conditions of your current employment.