Key Questions to Ask Before Buying Health Insurance

Type of Health Plan

To categorise broadly, there are three basic types of plans: Fixed benefit plan, Medical plan and Critical Illness plan. A fixed benefit plan pays out a pre-determined fixed amount regardless of the actual expenses. Critical illness plans are a type of fixed benefit plan, but they only pay for illnesses listed in the policy, like heart attacks, cancer, kidney failure, etc. The medical health plans are more comprehensive and reimburse the actual expenses incurred during hospitalisation. A thorough reading of the benefits of the plans should help you understand which would suit you better as financial support.

Correct Combination of Premium and Coverage

While comparing health insurance plans on an aggregator website like Jio Insurance Broking, you might be tempted to go for the lowest premium. However, before making a decision, please review the benefits and coverage you are being offered at that price. Dig deeper for the reasons for the low premium. It should not come at the cost of the required coverage. Read the fine print to find out any clauses for co-payment, sub-limits for specific diseases, or any deductibles that may lead to higher out-of-pocket expenses at the time of claim. The key areas of coverage should include consultations with the doctor, pre- and post-hospitalisation expenses, prescribed drugs, no-claim bonuses and alternative treatment options. Again, the premium and coverage would both depend on the age of the client. The premium increases with age as the risk of exposure is also high. Hence, starting early is best.

Cashless Treatment at a Network of Hospitals

Most insurers have tie-ups with hospitals where the customers can avail of cashless treatments. It is called a third-party transfer, where the expenses are paid out directly by the insurer to the hospital if it is listed under their network. It not only helps you to get the best treatment available due to the exhaustive nature of their hospital and doctors' lists, but also saves you from cumbersome and tedious paperwork, which becomes a real hassle during medical emergencies. Hence, if you feel documentation and negotiation with hospitals are not your cup of tea, check the empanelled list of hospitals to understand where you can have a stress-free experience.

Provision for Waiting Period

A waiting period is the time between the issuance of your policy and the time when you start enjoying your coverage. The pre-existing diseases or some specific illnesses like thyroid, blood pressure and diabetes are not covered in this period of 24 to 48 months. Moreover, it is further applicable to diseases like arthritis, varicose veins, cataracts, etc. It is crucial to check for such clauses to avoid any such unwanted surprises.

Bonuses and Discounts

Insurance providers often reward clients for nil claims in the form of a no-claim bonus. NCB is the discount that is offered by the insurers for the years that you have not raised any claims. It reflects in the increase in the amount of coverage at the time of policy renewals. Most providers specify a ceiling of such incremental coverage.

For example, if you purchase a health insurance plan of 5 lakhs, and the provider offers 10% NCB to a maximum of 50 %, then the total increase of coverage amount remains capped at Rs. 7,50,000.

Alternate Therapy Benefits

Different health plans give you options of varied treatments like Ayurveda, acupuncture, chiropractic therapies, etc. Check for these benefits, as some chronic diseases have solutions in other forms of medicine. Physical fitness is also an important factor in an individual's life and wellness benefits like nutrition consulting, online yoga classes and preventive health check-ups are also included in most of the comprehensive plans.

Claim process

It's a must to check out the claim settlement ratio and the process of claim settlement of any insurer. The reputation in the market is also a good indicator to understand whether their claim settlement methods are hassle-free and seamless. It is also important to know how many claims can be made annually, even if the amount is within the coverage amount.

Research your provider, read the client reviews online and ask your family and friends about their experiences. 

Final Thoughts

Armed with these important parameters, you should enthusiastically look for providers that can offer you a gamut of products to choose what is best aligned with your income, age, dependents and your lifestyle. Do check on the reputation of the insurance provider and their claim process. No one wants extra stress during any medical emergency. Choose a plan based on thorough research and secure your and your family’s health.