Health Insurance: 10 most important things to keep in mind before buying a plan
Health insurance is an essential tool for financial protection against rising medical costs in India. By carefully choosing the right plan, people can ensure they are adequately protected against unforeseen health-related expenses.
In its 54th meeting on Monday (September 9), the GST Council reached a broad consensus on reducing taxes on health and life insurance premiums, with a final decision slated for the November meeting. The Council was chaired by Union Finance Minister Nirmala Sitharaman. After the meeting, Sitharaman briefed reporters, stating that the Council has decided to form two new Groups of Ministers (GoMs): one focusing on medical and health insurance, and the other on compensation cess. These GoMs will further explore the proposed changes and present their recommendations at the upcoming meeting.
Health insurance penetration in India remains significantly low, with many individuals relying solely on employer-provided health coverage. Factors such as lack of awareness, affordability, process complexity, and trust issues deter people from purchasing their own health insurance policies. However, it is crucial to note that health insurance companies in India are strictly regulated by the Insurance Regulatory and Development Authority of India (IRDAI), which enforces rules regarding disease coverage. No insurance company can deny a genuine claim, and claims must be settled within a stipulated time frame. A wide variety of health insurance policies are available in India, each offering numerous variations to cater to different needs and circumstances.
Choosing the right health insurance policy can be daunting, given the numerous options available in the market. However, understanding the essential factors to look for can simplify the process and ensure that you make an informed decision.
Here are some important aspects to consider before purchasing a health insurance policy:
- Coverage and Benefits: Check what the policy covers, including hospitalisation, pre and post-hospitalisation expenses, daycare procedures, and critical illnesses. Ensure that the policy provides comprehensive coverage that meets your healthcare needs.
- Network hospitals: Look for insurance providers with a wide network of hospitals where you can avail of cashless treatment. This reduces the financial burden during emergencies and simplifies the claims process.
- Premium and affordability: Compare premiums of different policies, but don’t choose solely based on the lowest price. Consider the coverage and benefits in relation to the premium to ensure you’re getting good value for money.
- Waiting period: Health insurance policies often have a waiting period for pre-existing conditions and certain specified diseases. Check the waiting periods and choose a policy with a shorter duration if possible.
- Claim Settlement Ratio: A higher claim settlement ratio indicates the insurer's reliability in processing claims. Look for companies with a good track record to avoid hassles during claim processing.
- Exclusions and limitations: Read the fine print to understand what is not covered by the policy. Knowing the exclusions upfront will help avoid surprises when you file a claim.
- Lifetime renewability: Opt for policies that offer lifetime renewability. This ensures that you remain covered as you age, without the need to purchase a new policy later in life.
- Add-Ons and riders: Consider additional benefits like maternity coverage, critical illness riders, and personal accident cover. These add-ons can enhance your policy’s coverage according to your specific needs.
- Sub-limits and co-payment clauses: Some policies have sub-limits on room rent, specific treatments, or co-payment clauses where the insured has to bear a portion of the costs. Understand these clauses to avoid unexpected expenses.
- Insurer’s reputation and customer service: Research the insurer’s reputation and read customer reviews to gauge their service quality. A good insurer will have efficient customer service and support during claims.