Your Money: Select a health insurance plan that’s right for your needs

Health insurance policies come with a wide range of features and benefits.

Medical emergencies come unannounced and have the potential to ruin an individual’s physical and financial health, especially if the treatment requires hospitalisation. This makes getting a comprehensive health insurance plan with adequate coverage one of the most important things to secure to avoid draining precious savings and accumulating unnecessary debt in footing steep hospitalisation bills. And it holds true even if you’re covered by a medical plan provided by your employer that often comes with an insufficient sum insured and would not be of any help if you lose your job.

Here are a few important things to keep in mind while buying a health insurance plan.

Family floater vs. individual cover
Are you married and have two or more members in your family? If yes, you can go for either a family floater policy or an individual health policy for all the members. If the proposer’s age is below 45 years and there are young people in the family (usually less prone to hospitalisation risk), then the family floater policy can reduce the premium amount. You can also get higher coverage with a family floater policy.

However, if the proposer is a senior citizen or nearing 60, the hospitalisation risk increases due to age-related ailments. Multiple claims in a year can reduce the available coverage amount for other insured members under a family floater policy. So, senior citizens and ageing individuals should prefer an individual health policy, whereas families consisting of young members can opt for a floater policy.

How much cover should you take?
While buying a health policy, assess your present health condition, lifestyle, hereditary diseases, etc. Decide on a health policy size that can provide sufficient cover if the need arises. If you stay in a metro city, take at least Rs 5lakh-Rs 7 lakh cover due to the high hospitalisation costs there.

Exclusions and waiting periods
Exclusions are such treatments which are permanently not covered in a health policy while a waiting period is the time span during which treatment for certain ailments are not covered. For example, treatments like dental implants, HIV, vision correction, expenses on alternative therapies, pre-existing health ailments, etc., may be permanently excluded by a health insurance company. The exclusion list may vary from company to company. Similarly, a health insurance company may stipulate a waiting period for specific ailments depending on its terms and conditions. Waiting period requirements may also vary from company to company. Factor in the exclusions and check the waiting period requirements applicable to your pre-existing conditions while choosing a health insurance plan.

Premium & network hospitals
Health insurance policies come with a wide range of features and benefits. These may include pre-and post-hospitalisation cover, domiciliary treatment, critical illness protection, maternity treatment, medical check-up facility, etc. Some companies also offer benefits like reloading the sum insured after a claim is made during the policy period.

Many insurers also offer a no-claim bonus that enhances the sum assured during policy renewal at no extra cost if no claims are made during a policy year. Then there is the all-important factor of network hospitals– you should ideally go with a policy that offers cashless treatment at all the major hospitals near you.

Compare different policies and choose the one whose features and benefits best meet your needs. Some of these features qualify as add-on benefits that will increase the premium cost. However, going for the cheapest premium (and hence giving up on comprehensive protection) could be dangerous. Consider the features and benefits best suited to you and the insurer’s claim settlement ratio to make an informed choice.

The writer is CEO,

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