Buying an ideal health insurance plan

Monday, January 30 2023
Source/Contribution by : NJ Publications

A Health Insurance is a must today. Every individual and family must be protected against the very probable risks to our health. The recent pandemic did a lot to push this awareness to everyone. 

However, selecting a health insurance plan is not as easy. With a mature health insurance market today in India, the choices are aplenty. While this is a good thing, choosing the most suitable product and features is not easy and we run the risk of loosing ourselves in jargons and the long list of features. The health insurance decision entails a good amount of understanding and consideration of our needs and our budget /affordability for the same. In this article, we will attempt to lay down the path for this decision-making.

1. Understanding your needs: 

The first step towards buying a suitable health insurance plan is a proper analysis and assessment of our requirements. The first questions usually are - who all are to be covered? What amount of cover do you need? Are there any specific health risks you wish to cover? What is existing health insurance cover?. These are just the primary questions which will set the broad parameters of the kind of health cover you need - like individual policy or family floater, cover for parents, critical illness cover, top-up or super top-up plans and the extent of the cover desired. With this clarify, next you need to decide on the type and the extent of your health coverage. For this, you must take into account the age, medical history, pre-existing illnesses, if any, etc. before finalising the sum insured and plan. 

2. Research the Insurers

You would not likely buy anything from someone who you do not trust. And buying a health insurance policy is a very critical decision that can have ramifications after many years. So, before you actually look out for the cheapest policy available with the most comprehensive cover, it is advisable to zero down on a list of preferred insurers. It is important to compare the various health insurance providers and understand few things, including the claim settlement ratios, the ease of the claim process, the network of cashless hospitals, customer support and their customer reviews /feedback in general. 


3. Check Policy Benefits

With the insurers shortlisted, the next step would be to check out and compare the policies of these preferred insurers. A health insurance policy has many benefits and features which we have discussed here in the past. Important among these are - the scope of cover for pre- and post-hospitalisation expenses, pre-existing diseases, consumables cover, OPD cover, maternity & newborn cover, ambulance expenses, room rent limits, network of cashless hospitals, deductibles, ​​restoration benefits, critical illness cover, AYUSH treatments and so on. You must also consider the relevant add-on covers to make your health insurance policy more comprehensive. 

While all features, benefits and add-on covers may look appealing, they may come at an additional cost. So, you need to strike a balance between the features and add-ons and the premium that you can afford. You will have to decide on what features are must-have and which can be considered as optional which you can skip in order to balance the equation.

4. Making the decision

With clarity on the type of insurance, the preferred insurers, the features and benefits required and the premium amounts for short-listed policies - you have all the ingredients ready for the decision-making. The next steps would be filling out the proposal forms and undergoing medicals, if any required. Remember that this too is a critical step and one should be honest in disclosing all facts to the insurers. We do not want a situation where any misrepresentation or hidden fact comes to light and becomes the reason for claim rejection in future. If you have any serious existing ailments, please consult your insurance advisor to guide you on the matter before you start searching for a policy. This is why we always say that it's better to not delay buying any insurance and the best time would be when you are young and healthy. 

Conclusion: 

Buying a health insurance is an important decision in life. Even after buying your health cover, it is important that you revisit your insurance portfolio every few years and plug any gaps that you see. It may happen that a policy bought five years ago looks inadequate today with high inflation in medical expenses and your improved and changed lifestyle. Whether you are buying health insurance for the first time or buying additional covers, a thorough assessment of needs and the products is required. Here is where your insurance advisor can be of great help in guiding you and helping you may the right decision. If you haven’t spoken with your insurance advisor on this for long, perhaps now is the right time to invite him/her for a cup of tea.