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Some Important Chek Points For Buying Health Insurance in India?

A lot of changes has happened in health insurance industry over last half decade. The overall health insurance industry to some level is standardized and new regulations are in place.

Health Insurance products are far more transparent now like never before, For instance

  •     Policies are now mandatorily renewed for life-time.
  •     Insurance companies cannot levy claim based loading.
  •     Insurers need to give an advance notification before increasing premiums or terms.

Even after strict regulatory measures, you need to keep check of some IMPORTANT CHECKPOINTS while buying an health insurance policy for yourself, as give:

Point #1 – Don’t be too late in buying a health insurance policy ::

More you delay to enter a health insurance plan, more costly and complex it would get. Even company can legally deny issuing you a new policy (now renewal) on the basis of your medical test reports. So, EARLY you BUY, BETTER you Get.

Point #2 – Assess who do you want to cover and their health status ::

Check exactly which kind of policy would cover your needs best. use our PLAN GRID to see types of cover need and plans suitable for them.

Point #3 – Assess your lifestyle ::

Keep a check on your own lifestyle, as well as your family’s. If your family is fit, following a healthy routine or regularly exercising, have healthy food habits, doesn’t smoke/drink, you come under good rick cover category.
Else, you have a much higher risk to cover. This, apart from inflation, needs to be taken into consideration, when deciding the sum insured.
But be clear that just having good health or good lifestyle is not an excuse to ignore health insurance policy. You never have much control on accidents that does happen in everyfay life, or some diseases which can still happen even though you have a good lifestyle.

Point #4 – Individual Covers or Family Floater?

If you don't have a family then individual cover is the only option.

But in case you have loving lamily, then it would be wise and advisable to opt for FLOATOR FAMILY COVER as its always cheaper than seperate INDIVIDUAL COVER for each family member, also FLOATOR COVER comes with added benefits, or your can opt for combination of individual+floator cover.

If any of family member has certain existing health issues, then always consider buying seperate health cover, which is either disease specific health plan or normal mediclaim policy.

Point #5 – Zero down on Sum Insured from Long Term perspective ::

Always consider INFLATION and increasing cost of treatment in tier-1 cities, as  hospitalization costs today could be ranging from Rs. 50000 to Rs. 3 Lakhs. Assuming you are 32 today, at an modest average healthcare inflation of 8% for the next 20 years, single hospitalization bills will range at around Rs. 13 Lakhs when you are 52 years old.

What’s more, if you live a unhealthy lifestyle, you may have to bump the cover by another 25%, as you are at much higher risk.

Think in terms of the long run, you may not need this policy right away, but in the future, you will most definitely benefit from having a higher cover.

Also check cost benefit analysis

Point #6 – Compare Hospital Room Eligibility Capping ::

Today a Private room rent per day averages to around Rs. 4000. At an inflation of 8% for next 20 years, the room rent would be in the range of Rs. 20500 per day.

So it's wise to go for HIGHER SUM ASSURED, as its also cost effective.

Point #7 –  Check for any sublimit/co-pay ::

Check the health insurance plan you have or had shortlisted. Also check for words like “limits”, “co-pay” or “deductible” in the policy.
These are set deductions in claims. Ensure you have understood, and compared what these mean, before your decision to purchase is made.

There are few Insurance products that have limits for specified surgeries also. So even if your sum assured is Rs 5 lacs, they might restrict a particular surgery expenses to 50% of your sum assured.

Point #8 – Hospital Network is Important Parameter ::

One of the most important factor to be noted as you compare other key features , you should also compare the CASHLESS TREATMENT hospital network availabe in your loacal are first. Though such lists are dynamic and can change anytime, it still gives you a good idea of the network that the Insurer has in place.

Point #9 – Finally, go through Policy Wordings ::

Always ask for your copy of policy wordings of the product you have / shortlisted (could be downloaded from insurer website). Make sure that you read the Customer Information Sheet in full.  Every health insurance product needs to file this with the Government (IRDA).

Ask questions till you are satisfied.Its your RIGHT and in your RIGHT benefit.

Point #10 – Go for Super-Topup ::

TOP-UP policies coveres you from RISK OF INFLATING costs or treatment in good hospitals. We recommend, that you go with a Rs. 5 Lakhs base cover with a Super Topup cover of Rs. 10 Lakhs. This can save close to 25-30% of premium vis-a-vis buying a Rs. 20 Lakh base plan.

3 important things here >>

  1. Ensure there is no room rent limit in your Super Topup policy.
  2. Ensure you buy a Super Topup Health Insurance along with your Base health Insurance policy.
  3. Tenure of both policies and their renewal dates are same.

Point #11 – What to ignore while buying a policy ?

Features like Ambulance, Daily Hospital Cash, Domiciliary, and any other benefits that don’t get used often, have a low consequence in the overall scheme of things.

Hence, in my opinion, these should be overlooked, so focus on the network of hospital, fees for doctor consultation, Room rent Limit, ICU charges, Check if they are paying for medicines or not and these kind of expenses which make the the major part of your overall bill.

Point #13 – Review your existing policy and look at options to Port ::

If you had already purchased a mediclaim policy which does satisfy above check points for good, and YOU HAD NOT FILED ANY CLAIM YET, it's recommended to look at PORTING OPTION on your mediclaim policy to a better company around 45 days before your policy renewal date.

Unfortunately, if you have already made claims in your existing policy, then porting is not advisable and it's better you look at topping up your cover, with options like Super Topup by which you can hedge the negatives in your existing coverage.

Point #14 – LAST BUT NOT LEAST ::

Public sector/ provate sector cmpanies tend to change their policies from time to time, which happens due to cost cutting factor or re-structuring process, in any case your exiting group health insurance cover MAY GET BLOWED away and your family may left cover less, and the worst  part is ACCIDENTS never knocks before they happen.

Never ever always RELY ON GROUP HEALTH PLANS or government sponsored health plans to cover your family health care needs, and always buy your PERSNOLA FAMILY HEALTH COVER which you have complete control of.

Government policies on health care and public welfare expenditure also keeps changing according to national budgeting and conomic conditions, so it may happed what today if offered FREE from government, might not be avaiable tomorrow. Thus its wise to hold an independent HEALTH COVER for your family members at all times, and never depend on others to cover medical expenses for treatment of your loved ones.

How to buy