Selecting a health insurance plan is a decision which is certainly not an easy one. It is something which helps you as well as your family when you need it the most, so ensure you pay attention to every minute detail while finalizing the one for you and your family. Many health insurance providers tell how their health insurance plans are the best for you but the reality is far from that and this comes to fore as a shock. So, how could one ensure that the plan they are choosing their plan is the best? In this blog, we talk about what all things to look closely at when it is about staying in the pink of health.
1. Understanding of Health Insurance Plans
Broadly talking, there are 2 categories of Health Insurance Plans available in the markets.
a) Individual Health Insurance Plan
b) Family Floater Health Insurance Plan
Depending upon your needs and your means, you can choose a plan out of these two. If you have a family, then you should prefer the latter plan as it is cost-efficient & time-saving.
2. Age is an Important Factor
Hit the iron when it’s hot. As they say Fun is like insurance the older you get the more it costs.So start early in your life, many policy providers come up with premiums for younger age group policyholders. On the other hand, as you age, some or the other diseases tend to surround you and you are supposed to undergo compulsory pre-policy medical checks. Majorly all Health insurance Companies goes for compulsory medicals for the client’s post 45 years of age.
3. A 360 Degree Cover-up Plan
Many health insurance providers have sub-limits and capping on their various plans. Here is an understanding of both the terms. Sub-limit is the division they come up with i.e. some have 80-20 sub-limit where you can claim only 80% of the total whereas the remaining amount of 20% needs to be submitted by you. Capping is in regards to the room rent. Some providers set a limit on the room rent they provide on their particular plan and anything that exceeds that amount is borne by the individual itself. To make sure that you get quality treatment, ensure that your plan covers everything and there is no sub-limit or capping barrier.
4. Always Prefer Cashless Facility Plans
Generally, the insurance companies ask you to pay the bill at the hospital and then apply for reimbursement. This is a very time- and energy- consuming process. In a case of an emergency, one might not even have money to pay at the hospital billing counter. So better is to go cashless when it comes to choosing a health insurance policy. This way, you just need to pay attention to your/ patient’s health while everything else is taken care of by the insurance company.
5. Check the No-Claim Incentive
If in a particular year, there is no claim on the policy from your side, many companies offer an incentive- increased sum insurance claim- cumulative bonus. Depending upon companies and their various plans, this may vary from 5% to 10% to 50%. On the other hand, some companies offer a premium reduction. Going the cumulative bonus way is always better.
6. Check Whois The Third Party Administrator (TPA)
The middleman between the Insurance Company, healthcare provider, and the customer is known as the Third Party Administrator. TPA comes to fore when it is time to process the claim. This happens to be a time-taking process as there are certain levels involved. Many companies, however- now process claims in-house. Go in for these and save a lot of your time.
7. Be transparent While Declaring Your Health Status
If you have an existing health issue, declare it beforehand. Sometimes we forget that and other times we try to avoid thinking we will have to shell out more money. But declaring it at the time of form-filing is best as it does not become a hurdle when you go in for the claim, just in case.
8. Read & Understand the Exclusions Carefully
Last but not the least, always pay attention to what is being excluded in the plan you are about to choose. Some necessary things are sometimes excluded from the policies which you realize at the delicate moment. It is sure that you check that the following don’t play a spoil-sport:
a) 30-day exclusion
b) 1-year exclusion of certain diseases and procedures
c) 2-year exclusion of certain diseases and procedures
Note: Kindly refer the policy brochure for the list of diseases covered/ excluded and the procedures involved.