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Hidden Secrets to Choose The Best Health Insurance Plan in India

26 May 2022, 5:34 PM

Under the contemporary scenario, the need for having a health insurance plan cannot be exaggerated. With every passing day, the cost of medical expenses is on the rise especially with the coronavirus pandemic looming on our head. To cope up with this insane rise, possessing a good health insurance plan is no more a luxury, it has become an absolute necessity. There are several companies in operation with various sorts of policy schemes. The trick is to select the most befitting policy that will suffice the purpose and meet all the necessary requirements. 

8 Secrets for Selecting the Best Health Insurance Plan 

Consider the Basic 

While you compare multiple policies, you must not take into consideration the additional appendices that it offers. The best choice is to select a plan that will fulfil all the necessary coverages. Consider if it offers all-inclusive day-care expenses, ambulance charges, OPD charges, organ donor costs, etc. 

Pro-Tip: Opt for a basic indemnity health insurance plan that fits into your budget. You can always increase coverage later.

Carefully Check all the Pre-existing Clauses

While any health insurance plan is issued, any expenses for treatment of pre-existing diseases usually remain excluded for almost the first 2 to 4 years. Therefore, when you decide to buy a plan, do check carefully all the clauses related to the waiting period for such diseases, if any. 

Pro Tip: The target is to choose a plan with the minimal waiting time period for the pre-existing diseases if any. This will ensure earlier coverage. Also, try and opt for a health insurance plan very early in life, so that you have coverage before contracting any ailments!

Limits and the Sub-limits Careful Consideration

Most of the health insurance plans cover surgery expenses, room rents as well as ambulance expenses. But there remain differences in the limits and sub-limits of these coverages. It is advisable to choose the medical insurance plan that has no sub-limits or optimum limits. With all these things covered securely, the hospitalization charges will become a matter of lesser concern in the monetary aspect.

If you have a sub-limit in your health insurance plan, your health insurance claim would be paid proportionately, your room rent vis-à-vis the sub-limits. 

Pro Tip: Try and opt for the new-age health insurance plans which do not have any sub-limit restrictions. This plan might be a little expensive, but would be worth every penny if you get hospitalized without having to worry about the sub-limit clause!

Exclusions 

No health insurance policy covers all the aspects and fields of treatment. Apart from the pre-existing clauses, there also remain certain exclusions that do not include certain particular types of ailments, treatments due to injuries or HIV/AIDS. You should tread on this path with very careful consideration regarding the exclusion list of every plan. 

Incurred Claim Ratio and Claim Settlement Ratio

This is one of the most vital aspects of any health insurance plan. The incurred claim ratio is the total amount of money paid as claims vis-à-vis the total amount of money collected as premium. This ratio needs to be less than 100% for sure, for the company to remain profitable. So, 80-85% is a good ratio. This data is published in the IRDA handbook.

Now, there is another ratio called the Claim Settlement Ratio or the CSR. The claim settlement ratio denotes the proportion of the claims settled by the health insurance company against the total amount of claims raised. The higher the claim settlement ratio, the better. However, this data is not publicly disclosed and can only be found on the company’s records.

Pro Tip: Moreover, the settlement policy of the insurance company is also an important aspect. Before settling for a policy you must check how the insurer settles the claims—by cashless method or through reimbursement. Among these two methods, cashless is desirable as it lessens a load of exorbitant medical bills at the initial stage. 

Verify the Network of Hospitals

For claiming a cashless solution, you need to be admitted to a network hospital, officially known as Preferred Provider Network. 

Pro Tip: Before settling a health plan, you must check the list of hospitals that are tied up with the insurance company and at the same time, if your choice of hospitals are included in it or not. Early verification of all these factors saves a lot of hassles at the time of claim settlement. 

Discounts

Generally, most of the health insurance plans remain studded with multiple sorts of discount offers that help the policyholder with added benefits. The insurer guarantees discounts for buying a long-term plan or even for having a healthy lifestyle. 

Pro Tip: In the case of No Claim Bonus, it is advisable to choose a plan which offers an increased Sum Insured rather than a discounted premium. This is beneficial in the long-run as the expected medical costs will rise high in future. 

Evaluation of the Premium 

This evaluation of the premium does not necessarily mean getting the cheapest one of the lot but, a careful comparison of the sum spent and the value for money received in the end. 

Pro Tip: You can compare the plans of multiple companies to ensure and judge the best bargain. 

Summary

From the above discussion, it is clear that there is nothing tricky in this entire procedure. The tip is to carefully consider all the plausible aspects before settling for any particular health insurance plan. This will save a lot of confusion and hassles during the time of claim settlement. So just keep your eyes wide open and just go for it to enjoy a healthy future.

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