8 Pillars of Health Insurance You Must Consider Before Buying a Policy

The path to buying quality health insurance is flecked with a series of small choices and decisions that impact the future health and treatment decisions you make for yourself and your family. Luckily, the internet is full of information that makes this process easier. From policy stipulations to premium calculators, there is detailed literature that is intended to help first-time policy buyers make the right choice. However, the sheer volume of information can seem overwhelming if you don’t have the right questions ready. Here is a checklist of 8 things to know before buying health insurance.

The 8 Pillars of Health Insurance Plans

1. Price Point

As a first-time or well-seasoned policy buyer, there is one thing you will always look out for when buying medical insurance, is more affordable premiums. At first glance, low premiums appear lucrative. But the lower the premium the higher the chance that the policy contains hidden costs such as co-payment clauses, claim deductibles, etc. Buying a policy that is cost-effective should be the goal as opposed to the cheapest policy available in the market. A slightly more expensive policy over an overtly cheap one could save you lakhs at the time of claim settlement. That’s the catch with affordable health insurance.

2. Full Coverage for All Medical Expenses

A good health insurance policy covers not just the costs incurred during hospitalization but also pre and post-operation or treatment care. It is extremely important to be mindful of the coverage your plan offers by reading the fine print. Pre and post-hospitalization expenses include tests, check-ups, medication, ambulance charges, doctors’ fees etc. Your medical insurance should also cover an annual routine health check-up. There are policies that give you all these benefits but charge for them in their monthly premiums. Based on health and lifestyle, you should prioritize what are the most important features of the health care plan for you.

3. No Claim Bonus

A no claim bonus is a concession offered by insurers to policyholders for making no claims in a given policy year. To incentivize customers who have taken good care of themselves and not filed any claims, insurance providers offer a 10%-50% discount on the premium in the subsequent years offering greater coverage at the same premium. You should look at the No Claim Bonus proposed to you as part of your plan before selecting a policy.

4. Maternity Coverage

5. Go Cashless

Insurance providers entered the cashless ecosystem early on. Cashless claims reduce paperwork for the insured and give you the surety of swift, and quality medical care. It is one of the best benefits of opting for health insurance coverage. It even eliminates the need for an emergency medical fund by guaranteeing that your expenses will be covered without having to shell out a dime upfront. Insurers are able to offer a cashless facility by forming a nexus with as many hospitals as possible and paying them directly for patient care. You can ask the insurer which hospitals they have partnered with before buying the policy. The added benefit of informing yourself on the tie-ups is you can also see if the insurance provider has partnered with the hospitals in your neighborhood, the ones you are most likely to go to in case of an emergency. 

6. Age

Health insurance premiums are determined in large part by the age of the policyholder. For family health insurance plans, the entry age can be as little as 91-days old or as high as 25 years old. Similarly, the maximum age can be 50 or 60 years. There are plans that have no age limit, so you need not bother about having to change plans after crossing a certain age or bringing a small child on board the plan. Age-related limitations should be considered before choosing a health insurance plan.

7. Co-Payments

Co-payment clauses in a health insurance plan are the ones you should pay the closest attention to. Co-payment means that the insurer limits their liability on the claim amount to a certain percentage. For example, the co-payment clause may provide that the insurer will cover only 70% of the claim amount and the balance 30% will be borne by the policyholder. Co-payment clauses are common in insurance policies that offer lower premiums than market standards. Co-payment also applies in policies for policyholders of advanced age or with pre-existing medical conditions.

8. Read Up

Looking up reviews online and speaking to family and friends that have dealt with the same insurer should give you insight on what the claim settlement process is like, customer care timelines, grievance redressal, turnaround time on queries, etc. Speaking to the insurance agent or the provider isn’t enough. Reading the policy document independently and understanding its full implications is absolutely necessary before signing it.

Conclusion

Buying a medical insurance policy is among the best things you can do towards personal healthcare. It is also a smart thing to do for your financial well-being. Investments in health insurance are deductible. It also saves you the trouble of having liquidity for medical emergencies when that money could be put away in a return yielding instruments. The benefits of health insurance outweigh the certainty and surety of having emergency medical funds for your needs. You can evaluate some of the best health insurance plans in the country by reviewing them online. While there is a laundry list of parameters to consider before choosing a mediclaim policy, a short checklist like the one listed above of your personalized requirements and conditions will help filter plans best suited to your individual needs and the needs of your family.