What Should You Look For in Health Insurance?


Consider these things when shopping for a health insurance policy

The need for a health insurance policy has increased significantly since the COVID-19 pandemic. According to media reports, Corona virus hospitalizations can cost several lakhs. People have been able to Purchase health insurance. Those who have one already have an enhanced coverage. The Corona virus dedicated insurance plans gave buyers a new choice.

It is not a good financial decision to leave things up to chance, especially in the face of a pandemic. A good health insurance policy for yourself and your family helps you avoid having to dip into emergency funds or invest, and preserves your long-term savings.

These are some things you should keep in mind if you’re looking to purchase new insurance or to increase the coverage on your existing policy. These will assist you in making an informed purchase decision.

Find out which type of plan you’re buying

First, it is important to know that there are many types of health insurance plans on the market today. They all work in different ways. There are indemnity plans and benefit-based plans. Indemnity plans pay for hospital bills. However, defined-benefit plans pay a lump sum regardless of actual hospital expenses. Indemnity plans include Family Floater Plans and Individual Health Plans. Critical Illness plans fall under the benefit-based plan category.

Let’s say that the sum insured or coverage is Rs 9 lakh, and the hospital bill, Rs 1.8 lakh. In the case of Mediclaim plans, the hospital bills of Rs 1.8 million are refunded. However, if the policyholder has a Critical Illness plan the whole sum insured of Rs 9. lakh is paid by the insurer, provided that the hospitalisation was for any one of the listed diseases.

Individual Health Plans and Critical Illness Plans do not complement each other, as they serve different purposes. They are, however, complementary in nature.

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Find out if there are sub-limits in your plan

Sub-Limits are one of the most important aspects of Mediclaim Plans. Sub-limits may mean that you will have to pay some of your hospital bills out of your own pocket. The reason is that room rent is linked to sub-limits in plans. These include ICU charges, doctor fees, and nursing charges. The room rent is generally capped at 1% of the plan’s total insured amount. Other hospital expenses are also capped at 1%. If the policyholder opts for a room with higher rent, then all other hospital expenses are reduced before the insurer reimburses them. It is better to stay within the permitted room rent limit or to choose plans that do not have such sub-limits.

Pre-existing conditions should be disclosed

Unexpected medical emergencies are what health insurance covers. Insurers do not cover diseases or ailments from the day they purchase the policy. This means that existing diseases are not covered. Existing diseases are not covered. Pre-existing conditions are any medical condition the buyer may be suffering from. These diseases can only be covered after a waiting period. The current rules regarding health insurance require that pre-existing conditions are covered by the insurers after a waiting period not exceeding 48 months. In some plans, insurers allow for a shorter waiting period of 24 to 36 months.

This coverage is contingent on the buyer disclosing all medical information and not concealing any relevant information about existing conditions at the time they purchased the health insurance plan. Insurers may reject a claim if the buyer fails to comply with this condition. When you sign the application form, be sure to give a complete and honest declaration of your medical history.

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Find out if there are copayments

Some plans for health insurance, particularly those designed for seniors, may offer co-payment. This simply means that the policyholder must pay a portion of the hospital bill before the insurer will pay the rest. The co-payment typically amounts to around 20% of the total bill amount. You can even choose to pay a higher limit. A higher co-payment limit can save premium in most cases.

Get the scoop on – The Amount of Coverage

To estimate the cost of your health insurance coverage, there is no calculator or thumb rule. However, you should consider the location of your home, local hospital costs, and other factors. As medical costs rise and are unpredictable, it is a good idea to have a large amount of coverage. Your family members should also be covered. If you rely on your employer-provided group coverage for health, make sure that you have independent coverage.

Once you have an understanding of the basics of health coverage, you can go ahead and purchase or increase your health insurance coverage. Before you sign on the dotted sheet, be sure to fully understand all features, exclusions, and inclusions.