Tips to choose health insuranceRaman was a young and enthusiastic 25-year-old. He had a new job and was on top of the world. His father suffered a heart attack and had to be rushed to the hospital. Raman din’t know what to do, and was left scrounging for money to pay the hefty hospital bills. He was not covered by any health insurance policy. Most people, like Raman, do not realize the importance of a good health insurance policy till they are in circumstances where they need it. Some of them who do have one, is thanks to the company group health insurance policy. Unfortunately, even these aren’t enough and most people don’t even know it.

Ok, you finally decide to get health insurance. But how do you decide which one to get? Here are 10 practical tips for you:

1. Choose your insurance company wisely:

Generally, companies that offer health insurance are either general insurance or life insurance companies. Experts say that it is better to pick a general insurance company over one that offers life insurance, because a company that provides life insurance is invested in policies that will reimburse the family members of the deceased, and will not be focused on health insurance. Another reason is that the policy usually costs more when taken from a life insurance company.

2. Plan for future needs:

You need to think of the needs that might arise in the future. If you have a family with ageing parents or are newly married and are planning to start a family in the near future, it is important to think of policies that will cover aged parents or possibly cover maternity costs. 

3. Make an informed decision about the type of health insurance:

Read all that you can about the various options your health insurance company is providing you. Ask questions. Generally, if you have a family it is advisable to opt for a family floater plan. It is more economical and effective in the long run. Similarly choosing a cashless policy over a reimbursement type of policy may suit some but may not be beneficial to all.

4. Choose the right amount as ‘sum assured’:

‘Sum assured’ in simple terms is the maximum amount that a person who is insured can be reimbursed or covered for in one policy year. Basically, it is the base for all your future medical claims. Before you choose the sum assured, take into account the rising medical costs. At the same time, the amount shouldn’t be so high that it would be difficult for you to pay the premium.

For example, an insurance company assumes that the cost of a hospital bed for one day is one percent of the sum assured. Therefore if your sum assured is one lakh, hospitalization should cost you  thousand rupees per day. If you were hospitalized for seven days and the hospital charges more than a thousand rupees per day, you will be left paying the difference. Hence choosing the right amount is imperative.

5. Check the empanelled hospitals:

Every insurance company has empanelled hospitals, with whom they have a tie up. These hospitals are instructed on how to settle the claims of a patient who has a particular company’s cover. Therefore it is best to check which hospitals are under the insurance company. Checking for their specialty, reputation and distance from your home is important. This is because in case of an emergency you are most likely to visit a hospital closest to your home.

Another consideration is that there should be hospitals with varied specialites under the insurance company– it is better to have a choice when it comes to certain illnesses rather than going to the same hospital that may not provide you with appropriate care.

6. Understand the premium calculation process:

A premium is the sum you pay to the insurance company while buying an insurance policy. Although the formula to calculate one’s premium usually has a common formula, there are a few factors that may change while charging a premium. Some of the main factors are —  the ‘sum assured’, the number of times you have used the policy and for how much. Talk to your insurance agent about the amount of premium you will have to pay per year and how the company will charge for various services.

7. Read the fine print:

A health insurance policy has a number of clauses – what could be called the ‘fine print’. Reading them well is very important. And if you do not understand them, do ask questions.

For example: Read clauses related to the renewability of an insurance policy. This means that the policy will no longer hold good after a person attains a particular age. This could mean that you may not have a health insurance at the age of 70 or 75, when you need it the most. Here, choosing a policy that will cover you for life rather than one that will expire when you need it the most is adviceable.

If you have a pre-existing disease (for eg: diabetes), policies can be used only after a stipulated time period decided by the company.

If you are planning to start a family, ask the company about their maternity clause. Many companies do not cover costs of delivery or of any complications arising from that.

8. Read reviews and compare policies:

In the case of a medical emergency it is important that you and our family have complete peace of mind when it comes to money matters. Therefore, talk to your friends who might have the same policy, or read reviews about the policy you are about to buy. Another good tool is to compare policies. Knowing that the company takes care of your finances seamlessly is important for a smooth stay at the hospital and a stress free recovery.

9. Check flexibility of the policy:

In the case of an illness, it important that the company allows the insured person to have some flexibility in paying the premium for the amount used. A premium is recalculated at the end of a policy year and is increased depending on the amount the policy has been used. Therefore it is important that the policy you choose allows you the leeway of paying older premium amount for some time, after which you can start paying the increased premium without interest or other charges levied on it.

10.   Check if the company offers a no-claim bonus or discount:

If you haven’t claimed any insurance in the policy year, some companies offer either a bonus amount or a discount on the premium in the next year. This is called a ‘no-claim’ bonus or discount. This is a good feature and also an incentive to keep yourself fit and healthy.

Bajaj Allianz Family Floater Health Guard is an all-round health insurance policy that covers you and your family against medical expenses such as hospitalization, doctor’s consultation, diagnostic tests, medicines, ambulance, etc. With Bajaj Allianz Health Guard you and your family can afford the best treatment without having to worry about expenses and at a hospital of your choice. Click here for more information about this health insurance plan.

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  • AJAY

    Dear readers,

    I came across this page while searching for my answer to best medical insurance policy for me and my family, in India. But am still confused.

    I am 45yo male supporting a family of four. I had been subscribing to a public sector insurance company for last 7 claimless years. Last year my adviser advised me to port to a private sector company, as there were some limits on critical illness and room rent in existing policy and the private company clears 100% claim without any deduction.

    Now, when I did this, a friend of mine who is in same business, commented that it was not a good decision as this company charges very high premium the preceding year if I submit a claim any particular year.

    Please can someone advise pros and cons of various health insurance companies in India, as I want to decide a suitable company and stay with them for old age when I would really need their services.

  • Ganesh B

    i am looking for health insurance company where we can get full benefit if we get treatment from another country or others states

  • BALWANT SINGH

    The 10 practical tips are marvelous but why only “Bajaj Allianz Family Floater Health Guard is an all-round health insurance policy ‘ recommended on top of the world ??????
    OR
    NORTH -SOUTH-EAST- WEST :BAJAJ ALLIANZ IS THE BEST.

  • SUNILPAL

    SEX PROBLEM

  • Amit Das

    I am Amit Das , I need a best health insurance plan for mu family daughter wife and mother , guide me to chose the health insurance .

    • India.com Health

      Dear Mr Amit Das,

      It is best you go in for a family floater plan. This will cover you, your children, wife and mother. In the case of your mother do check with the company for clauses on pre-existing diseases.

  • Alton Duke

    Nice sharing. Got lots more information about heath insurance from your post. Expecting the next one.

    • India.com Health

      Hi Alton,

      We are happy that you liked our article, do tell us what you would like to read about in this space. We will try to write about the topic.

  • Prashant S

    Dear Sir,

    I need your advice on Health Insurance of my Nephew who is two years old and based in Nagpur,Maharashtra.

    My Nephew was diagnosed with Pulmonary Embolism when he was six month old and treated for the same. As per Doctors who treated him, he has fully recovered.

    We wanted to do Health Insurance for Him. We are aware about clause of pre existing ailments and accepted the same but still no Insurance company is providing the Health Insurance.

    Can you suggest how do we go ahead for his health Insurance?

    Any further details required please let me know.

  • Jasneet kour

    I am 30yrs old I want to purchase family health policy .plz suggest me the best health company policy in india which has good claim and best service .as during the time of claim I don’t face any problem