Looking to Get a Health Insurance Policy? Here’s a Handy Checklist for Choosing Your Cover

Aug 30, 2018 | 4 months ago | Read Time: 4 minutes | By iKnowledge Team

In these times of medical inflation, choosing a health insurance policy  is the only way out of ensuring retirement savings are not entirely wiped out.

As per a survey by ICICI Lombard of 1,400 people in the age group of 25-35, 75% of the respondents said they had health cover. 46% of them said it was the tax deduction provision under Section 80D of the Income Tax Act that made them invest in health insurance.

This study is troublesome because it indicates that people are buying health insurance not for its utility in case of any unforeseen health problems, but as a way to save tax.

Buy Best Health Insurance

Ashish was a part of the population who bought a health insurance policy because he needed a deduction under Section 80D. He got his deduction and had a cover of Rs. 5 lakhs, but when he was hospitalized because of an accident, he realized his policy hardly covered the items from his hospital bill. In spite of having a cover of Rs. 5 lakhs, he ended up paying most of his hospital bills out of his own pocket.

Unfortunately for people in India, this is a very common scenario. When health insurance is purchased without giving much thought to the terms and conditions, you must be prepared for eventualities like this. It’s best to know what to look out for in a typical health insurance policy so that you can make the best decision.

Health Insurance Guide

Here are the important things to consider while buying Health Insurance:

  1. Claims process: It is better to select an insurer who has a history of settling claims. Each insurer has a claim settlement ratio, and it is to the customer’s benefit to choose one who has a high claim settlement ratio and a fast settlement time. That way, if the claim is genuine, it will get settled very soon.
  2. Waiting period: A waiting period means a period during which the insurer can reject any claims for pre-existing diseases. This may be from 2 to 5 years. This is why it is recommended to buy health insurance when young so that the waiting period is spent out in good health.
  3. Family Health Insurance: Buying health insurance also depends upon the family. Buying a family floater policy is recommended for people having a family and aging parents. 
  4. Sum Assured: The sum assured should be selected in such a way that it would cover medical expenses of the family for a year. If a critical illness is sought to be included, the sum assured should cover the treatment expenses.
  5. Co-payment: Co-payment means a certain sum of money which will be borne by the Insurer and the rest will be paid out of pocket. One of the main points to look out for in the policy is whether it has any amount of co-payment, and if so, what percentage. Knowing this in advance avoids a lot of hassles while claiming.
  6. Network hospitals: Each insurer has a certain number of network hospitals which accept their policies and provide a list of facilities. The policy document usually involves this list. It helps to know this while traveling for treatment. Cashless treatment is possible at network hospitals.
  7. Pre and post hospitalization charges: Most illnesses involve some pre-hospitalization charges for diagnoses and post-hospitalization care for follow-ups and medicine charges. It is important to look into these provisions and check to what extent are they reimbursed.
  8. No-claim Bonus: Many policies include a No-claim bonus if the applicant did not make any claims in the previous year. This bonus can either be in the form of a reduction in premiums or an increase in the sum assured. 
  9. Maternity benefits: For most people, maternity costs are a substantial portion of costs. While buying a health insurance policy, it is essential to check the maternity coverage. Policies specify waiting time, the limits to expenses reimbursed and several inclusions/exclusions.
  10. Lifetime renewal: Lifetime renewal offers the policyholder the option to renew policies with the same benefits without any age restriction. This helps because there may be a significant amount of medical costs in old age.
  11. Free medical checkup: Most health insurance policies require a medical check-up before approval. Some policies have a free medical check-up involved when policies undergo renewal as well.
  12. Day-care procedures: It is essential to check when the claim gets activated. Some policies get active after a particular number of hours in a hospital. Some procedures do not require hospitalization, like for example, a cataract surgery takes 2-3 hours to be performed. It is important to check which day care procedures are allowed in the policy.

 Aegon Life’s iTerm Plus plan provides the benefit of life insurance with health cover for 10 different critical illnesses in the Life+Health plan. Under the Life + Health Plus plan, 36 critical illnesses are covered, thus ensuring a wider coverage and safety in case of illness, or death.

Choosing a health insurance policy is very easy once you evaluate all the points from this checklist. By ensuring you read the terms and conditions of the policy, you can get the best policy for your needs and ensure there are no hassles at the time of claims.

Advt. no.: II/Jul 2018/4236


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