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Premium or Coverage: Which in Health Insurance Matters More?

23 September, 2024

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In today's uncertain world, health insurance has become a necessity rather than a luxury. It provides financial security and peace of mind during medical emergencies. However, when it comes to choosing the right medical insurance plan, individuals often need guidance on premiums and coverage. So, let's delve deeper into this dilemma and understand which aspect holds more significance.

What is Health Insurance?

Health insurance is a contract between you and an insurance company that covers your medical expenses in exchange for a premium. It acts as a safety net, ensuring that you don't have to bear the burden of excessive medical bills alone during times of illness or injury.

Why Knowing about Premiums and Coverage is Important?

Understanding the concepts of health insurance premiums and health insurance coverage is crucial for making informed decisions about your medical insurance plans.

Health Insurance Premium

A premium is the amount you pay to the insurance company to maintain your health insurance coverage. It is usually paid monthly or annually. The premium amount varies depending on factors such as age, health status, location, and coverage level.

 

Factors affecting Premium

Explanation

Age

Premiums tend to increase with age, as older individuals are more prone to health issues.

Health Status

Individuals with pre-existing medical conditions may have higher premiums.

Location

Premiums may vary based on the area you reside in, as healthcare costs differ regionally.

Coverage Level

Plans with comprehensive coverage typically have higher premiums compared to basic plans.

Health Insurance Coverage

Coverage refers to the extent of protection provided by your health insurance plan. It outlines what medical services and expenses are included in your policy. Comprehensive coverage ensures a wider range of benefits, including hospitalisation, doctor visits, prescription drugs, and preventive care.

Types of Coverage

Explanation

Hospitalisation

Covers expenses related to inpatient care, surgeries, and hospital stays.

Outpatient Care

Includes doctor visits, diagnostic tests, and treatments that don't require hospitalisation.

Prescription Drugs

Covers the cost of prescribed medications.

Preventive Care

Includes routine check-ups, vaccinations, and screenings to maintain good health.

Considerations for Health Insurance Selection

When it comes to prioritising premiums and medical insurance coverage, the emphasis should be on obtaining adequate coverage that meets your healthcare needs. While low premiums may seem appealing initially, they often come with limited coverage and higher out-of-pocket expenses in the long run.

Factors to Consider 

Several factors should be considered when purchasing a medical insurance plan, as buying the right health insurance matters more. Some of the factors are listed below. 

 

  • Financial Stability: Opting for a plan with comprehensive coverage ensures that you are adequately protected against unforeseen medical expenses, safeguarding your financial stability.
  • Healthcare Needs: Assess your healthcare needs and choose a plan that provides coverage for services and treatments you anticipate requiring in the future.
  • Out-of-Pocket Costs: Evaluate the co-payments, deductibles, and coinsurance associated with the plan to determine the total out-of-pocket costs you may incur.
  • Network of Providers: Check whether the plan's network includes healthcare providers and facilities that you prefer or regularly visit to ensure convenient access to quality care.

Bottom Line

While premiums play a significant role in determining the affordability of medical insurance, coverage ultimately matters more in ensuring comprehensive protection against medical expenses. Prioritise obtaining a plan with adequate coverage tailored to your healthcare needs, even if it means paying slightly higher premiums. 

 

So, choose wisely, prioritise coverage, and secure your health and financial well-being. Niva Bupa is one of the best health insurance company, as we cater for you with plans specifically designed to meet your needs and requirements. So, make an informed decision today and pave the way for a healthier and more secure tomorrow.

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  • Insurance is a subject matter of solicitation. Niva Bupa Health Insurance Company Limited (formerly known as Max Bupa Health Insurance Company Limited) (IRDAI Registration Number 145, Category:Health), 'Bupa' and 'HEARTBEAT' logo are registered trademarks of their respective owners and are being used by Niva Bupa Health Insurance Company Limited (formerly known as Max Bupa Health Insurance Company Limited) under license. CIN: U66000DL2008PLC182918
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  • 2 Since Inception refers to claim data from 2010 till December 2023.
  • 3 ReAssure 2.0 Premium: The premium is including taxes and for Bronze Variant, for a 25-year-old individual living in Delhi.
  • 4 Aspire Premium: The premium is including taxes and for Gold+ Variant, for a 25-year-old individual living in Delhi.
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  • 6 Health Premia Premium: The premium is including taxes and for Silver Variant, for a 25-year-old individual living in Delhi.
  • 7 SmartHealth + Disease Management Premium: The premium is including taxes and for Disease Management Gold Variant rider when bought with ReAssure 2.0 Bronze variant with Base Sum Insured of 5 lacs, for a 25-year-old individual living in Delhi.
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