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11 Point Checklist for Buying Health Insurance In India

19 May 2022, 10:43 AM

Purchasing the right health insurance policy can be quite confusing. There are a wide variety of options available today; however, the varying options for premium and coverage can make it quite difficult to choose the one which is the best.

Let us check out the 11 point checklist which definitely should be your criteria, if you are looking for buying health insurance plans in India.

Purchasing Health Insurance Early can be Helpful in the Long Run

It is advisable to purchase a health insurance policy early so that it would provide you with the much needed support at the time of medical emergencies. Many youngsters think they are healthy and would not need a health insurance policy. There are even a lot of people who search for health insurance policies at a low premium throughout their life. However, health insurance premiums are low, when you are young and so is the risk to your health. With an increase in your age, your susceptibility towards diseases would increase and this acts as a risk factor for the insurance providers. 

Pro Tip: So, the earlier you purchase the health insurance policy, the better it is as you get wider coverage without any exclusion.

Assessment of Whom do You Want to Get Covered

It is necessary that you finalise the list of people whom you are going to provide cover. Moreover, you should also take into account their health status. You must ensure that you are providing cover for most of your family members for whom you are responsible. If you are having family members who are quite aged who must be insured, you should opt for medical insurance according to their health conditions. If you are married and are planning for a baby, then you must choose a medical insurance plan which offers maternity cover and also provides cover for the expenses of prenatal and postnatal treatment.

Pro Tip: Choose your health plan based on your life stage!

Assess Your Lifestyle and the Health Risks

While purchasing your health insurance policy, it is necessary to assess your lifestyle and health risks. If you are fit and are following a healthy routine, then you are at a good place concerning the health insurance policy’s sum insured and coverage. However, if you are a smoker or you do not have extremely healthy lifestyle habits, you must opt for a health insurance policy that provides wide coverage.  

Pro Tip: Choose your health plan based on your lifestyle! Quite a few plans offer discounts or wellness vouchers for non-smokers and with a healthy lifestyle.

Consider the Future While the Determination of the Sum Insured

You must not commit the mistake of calculating the amount of sum insured based upon the medical expenses that are being incurred today. With an increase in age, hospital expenses would also increase. Your major health insurance claims would be made in the future after around 15-20 years. So, if the average hospital bill today is around INR 1 lakh; after 15 years it would be around INR 10 lakh to INR 15 lakh. This is due to the inflation in the costs of the medical services which can be around 7.5% for the upcoming 20 years. Thus, you must opt for medical insurance with a high sum insured to cover the medical expenses at the time of utmost need.

Pro Tip: Check your premium affordability and opt for the highest sum insured possible, even if that entails opting for a super-top up plan along with your base plan so that you do not fall short of your coverage amount when you might actually need it.

Choose Between Individual Health Insurance Plans or Family Floater Plans

You must understand which choice would be better – an individual health insurance policy or a family floater plan. Mostly, family health insurance plans are a common choice as a single sum insured of these plans can provide cover for the entire family. The premium price would be lower as compared to that of an individual health insurance plan. 

Pro Tip: However, if you have a family member who is around 55 years of age or has some health issues; then it would be better to purchase an individual cover for him along with the Family Floater plan. If this member has frequent claims throughout the year, others would not have any cover left out for themselves.

Your Budget Limits

You need to consider the future while purchasing the health insurance policy. At the same time, you must keep in mind your budget limit too. Investing now into health insurance plans would be an easy task as you are having a steady income now. 

Hospital Network

You must check out the list of the network hospitals covered under the insurance provider which you are selecting. It is advisable to find out if the good hospitals in your locality are enlisted in the network list. This would help you in obtaining cashless hospitalisation coverage at the time of any medical emergency.

Preference for those Policies which have no Capping on Rent of the Rooms

After some years, when there might be the need for hospitalisation, it is obvious for you to find that the capping limits are not matching with the hospital room rent at present. In such a scenario, you might have to spend money from your pocket to pay for the rent of the hospital room. If there would be an increase of 1% in the room rent per year, then it would reach up to 6% in 6 years. So, while buying a health insurance plan today you should select a policy that would provide the option for private rooms. 

Pro Tip: It is necessary that you must check the number of sub-limits and their applicability on the policies. It reduces the amount payable on the claim.

Market Reputation

The market reputation of your health insurance provider is important. You should check the insurer's reputation online, read reviews, and talk to others such as friends/relatives for their experiences. You should also do your research about the claim settlement ratio of the insurance provider and its network size.

Pro Tip: Do not worry a lot about your health insurance provider as health plans are portable. So, if you do not like the service of any health insurance company, you can always choose to port the same to anywhere else and continue to receive the continuity benefits for the same. 

Pre-existing Diseases and Other Exclusions

Pre-existing conditions are a common scenario and health insurance coverage would be necessary for this. Pre-existing conditions such as cataract, hysterectomies, kidney stones surgeries, knee replacement surgeries, etc. would always involve a waiting period along with them. You must read the policy document carefully to know about the waiting period. In some cases, it can be 2 years whereas some insurance providers can make it up to 4 years.

Similarly, you must also know about those treatments, illnesses, or medical tests that are excluded from the coverage of your health insurance policy. If you do not have an idea about the exclusions of your health insurance policy, you would have to bear the medical expenses related to those exclusions. 

Pro Tip: It is always advisable to give a thorough reading of your policy document to know about the exclusions. You can also choose to cancel it in the first 15 days of free-look period without any charges.

Options for Portability

You must know about the options of portability provided by your health insurance provider. If you are not satisfied with the features and benefits provided by your health insurance policy or their service, you can port your medical insurance policy to another insurance provider.


So, a rapid increase in the cost of the medical facilities makes it inevitable for every individual to have a health insurance policy. However, to a common man, all the mediclaim policies might appear the same. Hence, this checklist would help in selecting the best health insurance policy without much hassle.

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