In today’s hassle and bustle, health insurance and life insurance are becoming necessities. These tools protect us from unexpected expenses of hospitalization due to an injury or illness. Health insurance reimburses you and your loved ones if something undesirable happens. Therefore, Health insurance is a best option when you’re looking to protect your loved ones against unforeseen health expenses. Usually, health insurance covers medical expenses incurred in a hospital for the treatment of an injury or illness; health insurance also provides financial support to insured’s loved ones, in case of insured person death. Undoubtedly, insured person’s family suffers from unbearable pain when they loose their loved one; but it also makes family members’ life harder. Therefore, a health insurance or life insurance gives you peace of mind that your family will not face financial crisis upon your death. All of us should buy a health insurance policy but with full awareness of what does your policy cover and doesn’t cover? Many people feel cheated when they can’t settle claims with their insurance companies. There are many medical conditions under which your insurance company will not pay you any claim; some of are permanent exclusions and some of are waiting period basis (Read: Health Insurance Exclusions: Medical Conditions Your Health Insurance Policy Doesn’t Cover).
In this post, we’ll be discussing on how to choose a best health insurance policy. It is very important to understand what does your policy cover and doesn’t cover? We’re highlighting the major factors to consider before opting a health insurance policy. You may know that many types of health insurance exist in insurance marketplace; so to choose best out of all consider following parameters:
Disclaimer: The information and benefits provided herein are for informational purpose only. Please do not take it as a legal advice.
1.Recognize Your Health Insurance Needs
Health insurance needs varies person to person for example; person who travel often may need a travel health insurance; senior citizens may need critical illness health insurance because at that stage most people need more medical facilities; basic health plan like hospitalization policy is enough for person who follows healthy life style. Which health insurance policy should you buy depends on your financial conditions and your stage in life. Answer the following questions to know what kind of health insurance policy is better for me;
- How much cover do you think enough for you? Tip: Buying maximum cover may reduce your financial burden; in case you’re hospitalized due to injury or illness.
- How long do I need the coverage for? Tip: Decide the term of a health insurance plan as per your present and future needs.
- What is my budget? Tip: Stay in your budget; don’t be extravagant.
2.Types of Health Insurance
Once you’ve got the answers of above questions; the next step is to decide which health insurance policy fulfills your health insurance requirements. At present, there are numerous health insurance products exist in insurance marketplace. Therefore, it becomes very important to understand, “what are the various types of health insurance policies exist in market and what are the advantages of a specific policy?” This factor could help you choose which health insurance type is suitable for you. Basically, there are three types of health insurance policies in India; Hospitalization Policy, Daily Cash Bonus Policy, and Critical illness policy; but at present scenarios, as per customers needs insurance companies have launched many health insurance products click here to read detailed post on types of health insurance policies in India
3.What does your policy cover and doesn’t cover?
Once you decide the best type of health insurance policy for you. The proceeding step is to see, what your policy covers? Carefully read all terms and conditions related to your policy. This way, you can decide that do you need to buy extra covers, known as riders to cover the events that are not listed in your insurance perils. It is remarkable that insurance companies strictly follow their perils; therefore, to minimize the risks of disputes related to claim settlement at the time of claim, read all the events that your policy covers. Don’t assume anything; if an event of medical condition/emergency is not mentioned in your policy that means your policy does not cover that event. Different insurers provide different benefits; so if one insurance company is not fulfilling your insurance needs in your budget, then you may look for another insurer who fulfills your requirements.
The term exclusion is used in health insurance when an event of medical emergency/need is excluded from an existing health insurance policy. There are many types of medical conditions that are not covered by your health insurance policy; therefore, it would be good for you to read carefully what does your policy cover and doesn’t cover? Some exclusion may be exempted over time and some are permanent click here to read Health Insurance Exclusions: Medical Conditions Your Health Insurance Policy Doesn’t Cover
Deductible is an amount which you pay for medical expenses before your insurer pays the claim for example; Let’s say John has bought a health insurance policy; in which 30% deductible is applicable, and he has to pay 1Lac for hospital expenses (suppose he’s hospitalized due injury or illness). In that scenario, John has to pay RS 30,000 (because of 30% deductible and 30% of 1Lac is 30,000) from his pocket before insurance company pays for the rest. In many health insurance policies deductibles are applicable. Always remember, you pay high premiums for low deductibles; and you pay low premiums for high deductibles. See what is the percentage of deductibles in your health insurance policy?
6.Network of Hospitals and Doctors
Your health insurance company provides you a list of doctors and hospitals for cashless treatment in your health insurance network. Therefore, it is always good to see that is your doctor listed in your health plan’s network? If your doctor is not listed (you may request your physician to join your plan’s network) in your heath plan’s network; then you have only one option to choose a doctor or hospital from your network. If you don’t choose then you have to pay cost for out of network doctors from your own pocket. In case your doctor is listed in your network of doctors then also see that does your policy allow you to choose your primary care physician (PCP) or not? Also insurance companies do not provide coverage for all types of prescription drugs. Therefore, see the list of prescription drugs that your insurer provides; in case you need cover for prescription drugs.
7.How long will the policy cover me?
Health insurance policies provide cover for 6 months, one year, two years and more. So it would be good for you to see how long can the policy cover you?
8.See Benefits from Your Employer’s Health Scheme
As per Employees’ State Insurance Act, 1948, employees of certain organizations get coverage for certain medical conditions such as; maternity, illness, temporary or permanent disablement, death, medical care to employee and his/her family members etc. If you’re an employee then see what type of health benefits are you getting from your employer’s side? It also very important factor because it is unworthy to buy coverage for a medical condition which your employer’s health scheme already covers.
To lure customers, some health insurance policies give you extra benefits like; gym discounts, free periodic check-ups, free dental care and vision care etc. If your policy provides you benefits like that; then there is nothing wrong to take advantage of them.
Nowadays, insurance industry is growing very rapidly around the globe. Customers are getting lucrative offers from different insurance companies. With the help of comparison, you could find a health insurance policy at very cheap rates. There is numerous insurance comparison websites exist on internet; use them and save your bucks.
Though, you’re following every crucial step before buying a health plan. But, you can’t achieve expert level because they’re pursuing this profession for long time; and they understand customers’ needs better than an individual. So, before making final decision, take an advice from expert person. You may approach different insurance companies’ experts for advice. Usually, insurance agents don’t charge any fee; however, there is nothing wrong if they are taking some consultation fee from you.
An underwriter has the right to reject your health insurance policy request; when you apply for it (On the basis of proposal form). On the same way, once the insurance company approves your application then you also have 15 days time to terminate your health insurance contract; if you’re not satisfied with your insurer’s services. In case you refuse to continue your policy; premium paid will be refunded you as per the insurance act 1938
It is crystal clear that no one wants to buy an insurance policy but it is very important thing. We don’t understand the value of an insurance policy; until we need to file a claim. Above factors could help you opt best insurance policy for you; however, further research can make you an insurance agent (just kidding!).