A Comprehensive Checklist for First-Time Health Insurance Buyers

Health insurance is a financial product that protects you from medical expenses that may be beyond your means. It serves as a safety net, ensuring that individuals and families can access necessary healthcare services without facing significant financial burdens. Health insurance typically covers hospitalization, surgeries, doctors' fees, and other related healthcare costs, including day-care procedures, pre- and post-hospitalization expenses, and sometimes preventive healthcare. For first-time buyers, understanding the basics of health insurance and having a well-thought-out checklist is essential to making an informed decision that best suits their needs.

Health Insurance Checklist in India

Before entering the world of health insurance, it's crucial to follow a comprehensive checklist to ensure you make the right choice. Here's a detailed guide to help you buy the right health insurance:

• Assess Your Needs: Consider your current health status, family health history, and financial situation.
• Research Plans: Explore various health insurance plans available in the market.
• Compare Coverage: Compare the scope of coverage, including hospitalization, day-care, and pre- and post-hospitalization expenses.
• Check Network Hospitals: Ensure the insurer has an extensive network of hospitals, especially those located near you.
• Understand Exclusions: Be aware of what is excluded from the policy.
• Check Waiting Periods: Take note of waiting periods for pre-existing conditions and specific treatments.
• Evaluate the Sum Insured: Make sure the sum insured is sufficient to cover potential medical expenses.
• Review Premium Costs: Compare premiums across different plans to find one that is affordable and fits your budget.
• Read Reviews and Ratings: Check customer reviews and ratings of the insurer.
• Understand Renewal Terms: Ensure that the policy offers lifelong renewability.
• Check for Add-ons and Riders: Look for additional benefits like critical illness coverage, maternity benefits, etc.
• Review Claim Settlement Ratio: Opt for insurers with a high claim settlement ratio.

Common Misconceptions About Health Insurance

There are several misconceptions about health insurance. One common myth is that young and healthy individuals don't need health insurance. However, health insurance benefits everyone, regardless of age or health status, because acute illnesses can affect anyone. Another misconception is that health insurance policies cover all medical expenses; in reality, each policy has specific conditions and limits on what it will pay for. Additionally, many people believe that the claims process is always complicated. However, technological advancements have allowed insurers, like ManipalCigna, to streamline and simplify the claims process, minimizing complications for policyholders.

Diversity of Health Insurance Plans 

The health insurance market in India offers a diverse range of plans to cater to different needs and preferences. ManipalCigna, for instance, provides three distinct plans: 

1. ManipalCigna Sarvah Pratham 

This plan is ideal for new to health customers. It offers coverage for significant conditions like Heart, Cancer, Stroke and major organ/bone marrow transplant, making it suitable for price-sensitive customers. 

• Sum Insured Options: ₹5L to ₹300L 

• Min/Max Age at Entry (Adult): Min 18 Years, Max 65 

• Min/Max Age at Entry (Dependent Children): Min 91 Days, Max 30 Years (Floater) 

• Policy Type: Individual/Multi-Individual & Family Floater 

• Policy Tenure: 1, 2 & 3 Years 

• Renewability: Lifelong 

• Waiting Period: PED – 36 Months, Initial – 30 Days

Base Covers: In-patient hospitalization, Day Care Treatment, Pre & Post Hospitalization

Medical Expenses, Domiciliary Hospitalization, Road Ambulance, Donor Expenses, AYUSH Treatment

Value Added Covers: Tele-consultation, Wellness Benefits, Discounts from Network Providers 

Add-on Covers: Accident Hospitalization Cover, Personal Accident Cover, Temporary Total Disablement, Health Check Up, Air Ambulance, Restoration, Gullak (Guaranteed Cumulative Bonus), Sarathi (Waiving off PED waiting period for listed condition), Room Rent Modification, Surplus, Deductible, Voluntary Co-Pay, Coverage for Non-Medical Items and Durable Medical Equipment.

2. ManipalCigna Sarvah Uttam 

This plan is designed for those who are new to health and seeking comprehensive coverage. It includes a wide range of hospitalisation benefits with infinite power to ensures you receive unlimited medical care when you absolutely need it, offering unparalleled protection and support for you and your loved ones

• Sum Insured Options: ₹5L to ₹300L 

• Min/Max Age at Entry (Adult): Min 18 Years, No Limit 

• Min/Max Age at Entry (Dependent Children): Min 91 Days, Max 30 Years (Floater) 

• Policy Type: Individual/Multi-Individual & Family Floater 

• Policy Tenure: 1, 2 & 3 Years 

• Renewability: Lifelong 

• Waiting Period: PED – 36 Months, Specific – 24 Months, Initial – 30 Days 

• Base Covers: In-patient hospitalization, Day Care Treatment, Pre & Post Hospitalization Medical Expenses, Domiciliary Hospitalization, Road Ambulance, Donor Expenses, AYUSH Treatment.

• Value Added Covers: Tele-consultation, Wellness Benefits, Discounts from Network Providers.

• Add-on Covers: Personal Accident Cover, Temporary Total Disablement, Health Check Up, Air Ambulance, Restoration, Gullak (Guaranteed Cumulative Bonus), Maternity & New Born Hospitalisation Expesnse, Sarathi (Waiving off PED waiting period for listed condition), Room Rent Modification, Surplus, Anant (Unlimited Sum Insured for any hospitalization related to Cancer, Heart condition, Stroke or Major Organ/ Bone Marrow Transplant) ,Deductible, Voluntary Co-Pay, Coverage for Non-Medical Items and Durable Medical Equipment.

3. ManipalCigna Sarvah Param 

This plan caters to customers who are new to health or have Health Insurance with other Insurance Company, including existing policyholders with other insurers. It offers full hospitalization coverage with instant coverage (no waiting period).

• Sum Insured Options: ₹5L to ₹300L 

• Min/Max Age at Entry (Adult): Min 18 Years, No Limit 

• Min/Max Age at Entry (Dependent Children): Min 91 Days, Max 30 Years (Floater) 

• Policy Type: Individual/Multi-Individual & Family Floater 

• Policy Tenure: 1, 2 & 3 Years 

• Renewability: Lifelong 

• Waiting Period: No Waiting Period. 

• Base Covers: In-patient hospitalization, Day Care Treatment, Pre & Post Hospitalization Medical Expenses, Domiciliary Hospitalization, Road Ambulance, Donor Expenses, AYUSH Treatment, Restoration of Sum Insured, Gullak (Guaranteed Cumulative Bonus).

• Value Added Covers: Tele-consultation, Wellness Benefits, Discounts from Network Providers, Health Check-ups.

• Add-on Covers: Personal Accident Cover, Temporary Total Disablement, Air Ambulance, Room Rent Modification, Surplus, Deductible, Voluntary Co-Pay, Coverage for Non-Medical Items and Durable Medical Equipment, Pratiksha (reduce your cost by including 24 months waiting period for Specified Disease/Procedure Waiting Period and 30 Days Initial Waiting Period).

Strategies for Managing Health Insurance Costs 

Managing health insurance costs effectively ensures you get the best coverage without straining your finances. Here are some strategies to consider: 

• Choose Family Floater Plans: Cover multiple family members under a single policy. 

• Choose Higher Deductibles: Reduce premiums by opting for a higher deductible. 

• Utilize Wellness Programs: Take advantage of discounts and benefits from wellness programs. 

• Pay Premiums Annually: Save on additional charges by paying premiums annually instead of monthly or quarterly. 

• Leverage Tax Benefits: Utilize tax deductions available under Section 80D of the Income Tax Act. 

• Review and Renew Regularly: Keep track of policy renewal dates and review coverage annually to make necessary adjustments. 

• Select Network Hospitals: Use hospitals within the insurer’s network to avoid extra costs. 

Checklist for Things to Do After Buying Health Insurance 

Once you have purchased your health insurance policy, it is crucial to follow a checklist to ensure you are prepared for a medical emergency. Here are the steps to follow: 

Conclusion 

In conclusion, navigating health insurance for the first time can be overwhelming, but a thorough health insurance checklist can simplify the process. By understanding your coverage needs, comparing plans, and reviewing terms carefully, you can make an informed choice that suits your health and financial goals. Remember, the right health insurance provides financial protection and peace of mind. Take the time to research and choose wisely to secure the best coverage for your needs. 

FAQ's  

1. What are the different types of health insurance? 

There are several types of health insurance plans, including individual health insurance, family floater plans, senior citizen health insurance, critical illness insurance, and top-up/super top-up plans. Each type caters to different needs, from individual coverage to comprehensive family plans and specific coverage for critical illnesses. 

2. What are the documents required to buy health insurance? 

To purchase health insurance, you generally need to provide identification proof (Aadhaar card, PAN card, passport), address proof (utility bills, voter ID), age proof (birth certificate, school certificate), and medical reports if required. The specific requirements may vary by insurer. 

3. Is it worth buying health insurance? 

Buying health insurance is worth it as it provides financial protection against high medical expenses, ensures access to quality healthcare, and offers peace of mind. Health insurance policies often come with benefits like cashless hospitalization, preventive health check-ups, and tax savings. 

4. Do I need to buy personal health insurance even though I have corporate health insurance from my employer? 

Yes, it is advisable to buy personal health insurance even if you have corporate health insurance. Corporate plans may not offer comprehensive coverage, have limitations on the sum insured, and could cease if you change jobs. Personal health insurance ensures continuity and adequate coverage tailored to your needs.