How Do You Plan the Best Health Insurance Policy?

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A well-structured health insurance checklist will help you to evaluate coverage, compare premiums, and understand the policy benefits.


So, if you are planning to buy a policy, reviewing certain factors in advance can help you make a smarter decision. Continue reading to get guidance for choosing a plan that has a balance of affordability and comprehensive protection.


How to Select the Best Health Insurance Policy?


From choosing the adequate sum insured to verifying the insurer's reputation, read on to discover the strategy to buy the best health insurance policy.



  1. Determine Your Policy Type


If you are part of a large family with young children, parents and in-laws, buying a family health insurance plan will be more cost-effective. This policy will cover an entire family in a single sum insured. However, for an unmarried adult or families with elderly parents, opting for an individual policy will be a wiser option for each family member.



  1. Choose an Adequate Sum Insured Amount


The sum insured is the maximum amount the insurer pays during a claim. Therefore, considering the rising medical inflation in India, which is around 12-15% annually, as reported by the Economic Times, it is essential to ensure your sum insured is sufficient to cover all your medical expenses.


In fact, it is ideal to choose an insured amount which is up to 50% of your annual income.



  1. Opt for Comprehensive Coverage


Try to get a comprehensive health insurance plan which will provide you coverage beyond hospitalisation expenses. This is why, while purchasing a policy, check the benefits, such as OPD treatments, day care treatments, maternity cover, AYUSH treatments, etc.


Even if these benefits are included in the base of your policy, they should be available as an add-on or rider.



  1. Avoid Co-pays


Co-payment is a fixed percentage of the claim amount that policyholders have to pay out of pocket every time they raise a claim. It limits your claim amount and creates an additional financial burden during medical emergencies.


Therefore, you should always choose a policy where the insurer pays the entire claim amount.



  1. Go With Shorter Waiting Period


Waiting period is a specific timeline when the policyholder cannot make any claims unless of accidents. In most insurance companies in India, the initial waiting period lasts for 30 days, while the waiting period for pre-existing diseases (PED) (e.g. diabetes, asthma) lasts for 12 to 36 months.


However, many companies can have a 48-month waiting period for PED. This is why, for policyholders with PED, it is important to opt for a shorter period to get the policy benefits sooner.



  1. Look for Restoration Benefit


The restoration benefit will automatically restore your coverage amount when your original sum insured is fully utilised. Therefore, to get uninterrupted coverage for medical emergencies, ensure that this benefit is in your healthcare plan.



  1. Check Reputation of the Insurance Company


Choose an insurer who has a high claim settlement ratio (above 90%), a wide range of network hospitals (at least over 10,000+) and positive customer feedback. You can also compare these features using online tools before purchasing a policy.


Final Word


To ensure complete financial protection and peace of mind during unexpected medical emergencies, always verify the given factors in your health insurance. In fact, sometimes higher premiums can ensure long-term benefits that cheap policies lack.