There has been a drastic rise in lifestyle or non-communicable diseases (NCDs) in India over the last few years. Alarmingly, the incidence of these diseases, such as diabetes, hypertension, and heart diseases, soar once individuals cross 35. Add skyrocketing healthcare costs and Covid-19 to the mix, and it is clear that comprehensive health insurance is the need of the hour today. Choosing the best health insurance plan wisely is vital as it is a long-term investment.
Therefore, here are 7 things to keep in mind when choosing the best health insurance plan:
- Family floater vs. Individual health plan: The primary decision is whether you want an individual health plan or one that covers your family members under a single policy, also known as a family floater plan. Family floater plans are economical for married individuals with children. However, once the children are over 25, they should also have individual health insurance plans. Moreover, as the premium for these plans is calculated with the senior-most family member’s age in mind, individuals with dependent parents should get individual health insurance.
- Optimum sum insured: The best health insurance plan offers adequate coverage—neither too less nor in excess. India’s health expenditure is predicted to rise by 11%; with that in mind, your sum insured should offer comprehensive coverage, including the latest therapies & advanced surgeries and alternative treatments such as Ayurveda and Homeopathy. When choosing your sum insured, consider your family member’s ages, family size, medical history, inflation, and residence. People living in metro cities need a higher sum insured than in other cities as medical treatment costs are higher.
- Cashless network: Most health insurance policies provide access to cashless benefits at network hospitals. It allows you to undertake treatment without paying from your pocket. If you avail of treatment at a non-network hospital, you will need to pay the hospital expenses first, which can be financially draining. For this reason, the best health insurance plan includes a vast network of good hospitals near you.
- Sub-limits: Check the terms and conditions carefully when choosing a plan. There may be sub-limits that restrict the plan’s reimbursement limits. For example, a specific procedure may have a limit of Rs 5 lac; if the total cost of the procedure comes up to Rs 8 lac, you will have to pay the extra Rs 3 lac.
- Waiting periods: Many policies traditionally have a waiting period of two years for specific ailments like cataracts and hernia. Pre-existing diseases such as diabetes or asthma may have a waiting period of four years. However, some insurers, such as Care Health Insurance, have add-ons where pre-existing diseases’ waiting period is reduced from 48 months to 24 months.
- Claim settlement ratio: It is imperative to check if the insurer has a good claim settlement ratio; this is the number of claims settled by the insurer divided by the number of claims received. Choose an insurer with a high claim settlement ratio; the closer to 100%, the better.
- Added benefits: Additional benefits can differentiate between an average and best health insurance plans. Your plan should cover OPD charges, ambulance expenses, medicines, doctor consultations for second opinions, no claim bonuses, room rent, and more. An example of a great added benefit is the Automatic Recharge Sum Insured. In this case, if you exhaust your coverage amount, the insurer reinstates the entire sum insured so that you are adequately covered again.
Now that you know what to remember while choosing the best health insurance plan, comparing at least two or three policies would be favorable. Pick a policy that offers the most value for your money. Remember to scrutinize the policy terms and conditions as well. Medical emergencies rarely come announced, so protect your loved ones and your finances by choosing the best health insurance plan today. Care Health Insurance is a great place to start, so check out their official website for more details.
