How To Choose Health Insurance Plans – A Master Class

Being unwell is a pesky feeling. When you’re sleeping after a long day of work, you want to sleep a little more and keep hitting that snooze button. But when you’re resting in a hospital bed owing to an illness, you can’t wait to get out of it. Besides that impatience to get better, hospitalization keeps your mind occupied with so many other things – a new diagnosis besides the one you are admitted for, the costs adding up with every passing day, the boring hospital food that you just cannot stomach. But all these issues multiply a hundred folds if you do not have the right health cover So, we’ve curated this handy list of things to consider before buying Health Insurance. Read on.

Simplifying Health Insurance – What it Means

On the surface, a health insurance policy looks like any other legal document filled with jargon and terminologies beyond our comprehension. But what it actually is, is a promise that allows you to receive the necessary coverage for your medical expenses should you be hospitalised. Essentially, your insurance company charges an annual premium and offers coverage worth a significant sum known as a sum insured. When you fall ill and need hospitalization, you can file a claim up to that sum insured amount and the insurer covers the costs of the same.

Now that we have the meaning of health insurance out of the way, let us move on and learn how to choose health insurance plans.

How to Pick Health Insurance Policies – The Tips You Must Consider

Choosing the best health insurance policy in India, one that is right for you and serves your needs is nothing short of an art. While you may not be able to customise every aspect of your health insurance policy, if you just ensure the following things, you will be sorted.

TL;DR Points

Let us break down the above-mentioned points, one by one.

• Tip 1: Choose A Policy With A Good Sum Insured

As explained earlier, the sum insured is the maximum coverage amount your insurer provides when you are hospitalized. With inflation being at an all-time high, you must ensure you buy a policy that covers you against the rising costs, especially if you intend to seek treatment at the best health care facilities, at the hands of the best medical professionals. Remember, higher the sum insured, better your chances of getting all your medical costs covered.

• Tip 2: Go for a Super Top-Up Plan on your Policy

One of the best tips for buying health insurance is to choose a policy with the option of a super-top. With super top-up, you can enhance your policy’s sum insured by paying a meagre sum of money. For instance, if you buy a policy with a basic sum insured of ₹10 lakhs, you may need to pay just a few thousand rupees, to get coverage worth ₹50 lakhs, ₹1 Crore, or even ₹2 Crore. The only condition for you to claim the super top-up cover, is that you should have exhausted the base amount of ₹10 lakhs.

• Tip 3: Ensure The Insurer’s Hospital Network is Wide

Having a policy with a high sum insured seems moot if you have to pay cash up front and then file a reimbursement claim. As such, among the health insurance tips to consider while picking a policy or an insurer, is to check the insurer’s hospital network. Choosing an insurer with a wide cashless network of hospitals, proves beneficial as you do not have to worry about upfront payments. You can concentrate on getting the necessary treatment while the insurer deals with the hospital directly.

• Tip 4: Consider the Coverage Included In Your Policy

Everyone want a health insurance plan offering maximum coverage. But no two policies are the same. You have to ensure that your policy covers you against specific conditions. Does it include pre-existing illnesses? What about critical illness treatment? Will you be able to file claims if you choose alternative treatment forms? Does it cover you against Covid, maternity-related costs, cataract procedures, etc? These are the questions you need to ask to ensure all-encompassing coverage.

• Tip 5: Customize with Add-on Riders

If your chosen policy does not provide adequate coverage, you may be able to customize it to a certain extent by purchasing a range of add-on riders. For instance, you can get higher coverage if you are diagnosed with a critical illness simply by purchasing a critical illness rider. Similarly, you can purchase a permanent disability rider that enables you to receive a fixed amount as pay out if an accident-induced permanent disability hampers your ability to earn money and maintain your livelihood.

• Tip 6: Check For No-Claims Bonus Features

Most medical insurance plans comprise a component known as No Claims Bonus under which your insurer increases your sum insured without charging any additional costs. The only caveat is that you should not have filed an insurance claim. For not filing claims, the insurer increases your sum insured by 10% for the first year, going all the way to 50% for five consecutive claim-free years. So, if the current sum insured on your policy is ₹20 lakhs, it can increase to ₹30 lakhs over five claim-free years.

• Tip 7: Ensure There’s a Lifetime Renewal Clause In Your Policy

One thing you may miss in your hurry to buy the best health insurance plans, is that you may overlook the duration of coverage. Many policies come with limitations on the number of years your insurer offers coverage. In some cases, you may not be eligible for coverage once you reach your golden years – your 70s and beyond. But isn’t old age the time when you are most prone to falling ill, when you may need coverage the most? So, you must ensure your health plan includes a lifetime renewal clause.

• Tip 8: Check The Insurer’s Claim Settlement Ratio

While most insurance policies look the same, mainly because the coverage and other relevant guidelines are set by the Insurance Regulatory Development Authority of India (IRDAI), every insurer is different. So, how do you choose the right one? Simple – you should check their claim settlement ratio. This ratio is a percentage that represents the total number of claims received by the insurer versus the claims settled. Consider choosing an insurer with a claim settlement ratio exceeding 80%.

• Tip 9: Assess The Simplicity Of the Claim Process

Another vital tip on how to pick health insurance plans is to ensure you do not have to run from pillar to post to get your claims settled, nor should you have to follow up with insurers about your claim status 100 times. You can ensure you don’t get stuck in such a situation by assessing the insurer’s claim process. Consider choosing an insurer who allows you to file your claims online and does not bother with extensive paperwork and other formalities so your claims are processed without delay.

• Tip 10: Check What Others are Saying

Many-a-times when something looks too good to be true, it is because it actually is! For instance, you may find a policy that offers a whole lot of benefits at an extremely low cost. But when the time to file a claim arises, the insurer imposes various restrictions that prevent you from getting the promised coverage. So, before you excitedly buy such a policy, remember to check its reviews online. A pro-tip here is to look for reviews on general online forums; not only those on the insurer’s own websites.

• Tip 11: Choose a Policy With Higher The Sub-Limits

Being hospitalised for an illness entails a range of expenses. You may need to bear ICU room costs, room rent costs, domiciliary hospitalization costs, etc. Your insurer typically determines a sub-limit on the amount you can spend on such costs. For instance, if your policy states that your daily room rent should not exceed ₹8,000, and your hospital charges you ₹10,000 for your chosen room category you have to bear the difference of ₹2,000. So, ensure you check the sub-limits and choose the right policy.

• Tip 12: Be Aware of Co-Payments, Deductibles and Other Clauses

Insurers typically include clauses like deductibles and co-payments in health insurance policies. They may make these clauses voluntary or compulsory. Even, if you choose a health plan with a voluntary co-payment clause, you may find that the premium payable against it, low. As for deductibles, this clause typically applies to super-top policies, wherein you have to exhaust the entire coverage amount in the base policy before you can encash the sums covered in the super top-up policy.

• Tip 13: Consider The Waiting Periods Applicable To Your Health Plan

Every health insurance policy you buy comes with a predetermined waiting period – a time during which you cannot file an insurance claim. Waiting periods can range from 3 months to 4 years, depending on the policy type and coverage terms. For instance, a regular health insurance policy might have a 3-months waiting period, but if you have a maternity cover as an add-on rider, you may be able to file a maternity claim only after riding out the waiting period, which could be 2 or more years.

• Tip 14: Check If You Are Eligible For Discounts

Health insurer’s today are coming up with various ways and means to help reduce your premium costs. One of the most unique methods employed by them is to encourage policyholders to take steps towards being physically fit, thereby reducing their chances of filing claims. As part of your health plan, your insurer may offer you a discount if you complete, say, 10,000 steps every day in a policy year or fulfil the different, accepted fitness goals as per the policy terms.

• Tip 15: See If You Can Pay Premiums in EMIs

If you want to buy the best health insurance policy in India, but if the budget is a concern, you need not lose heart. Today, insurers allow you to choose the best health insurance policies and pay the annual premiums in Equated Monthly Instalments (EMIs). As such, you do not have to worry about paying a lumpsum once a year; instead you can buy your preferred health plan and pay the premium amount in affordable monthly instalments. You can even set up automated payments for these EMIs.

Looking For the Best Health Insurance Plans – Think Manipal Cigna Health Insurance

If you are wondering, ‘how do I choose the best health insurance plan’, then your search ends with Manipal Cigna Health Insurance. At Manipal Cigna, we strive to offer our customers an assortment of health care policies, keeping different budgets and coverage needs in mind. You can hope to find an array of health care policies for yourself and your family members. Whether you need individual policies or family floater plans, you can head to our website, use our health and term plan calculators, and shortlist policies covering your specific needs.

Choose Medical Insurance Plans From Manipal Cigna Health Insurance Today.