The Latest Guide you need before buying Health Insurance policy. Buying health insurance should be a simple and easy process. Knowing your needs, comparing different plans.
The Latest Guide you need before buying Health Insurance policy
Selecting the right one can save you from potentially extensive medical expenses. Understanding the terms and conditions, however, is critical. To help you make a sound decision, here is a checklist of what you need to consider before buying a health insurance policy.
Comprehensive Coverage
Your health insurance policy should provide comprehensive coverage. This includes cover for hospitalisation, pre-hospitalisation, post-hospitalisation bills, medical check-up, maternity, certain day-care procedures, and so on. Your policy should also include emergency ambulance services and domiciliary treatments.
Hospital Network
Many health insurers have tie-ups with various hospitals across the country. This is known as a Hospital Network. It is important to check the hospital network of the insurer to ensure that the hospital you are seeking treatment from is a part of the network.
Cashless Claims
You should also check if the insurer you are considering offers cashless claims. This way, you won’t have to pay for any expenses out-of-pocket. Instead, the health insurer will pay the hospital directly.
Co-payment and Deductible amounts
The deductible is the amount you need to pay from your pocket before the health insurer pays for the expenses. For example, if your deductible is Rs.1000, your insurer will start paying for the expenses only after you have paid Rs.1000 from your pocket.
The co-payment is another amount that the health insurer might charge you to pay for the expenses. For example, if there are medical expenses of Rs.10000, and your co-payment is 10%, then you will be required to pay Rs.1000 (10% of Rs.10000).
Pre-existing Diseases Coverage
It is important to check if the health policy covers pre-existing diseases or not. Some policies may have a waiting period in case of pre-existing diseases after which they may cover them.
Network and Non-Network hospitals Restrictions
Network hospital restrictions specify the number of days you can avail the cashless facility. It is important to understand the restrictions for both Network and Non-Network hospitals.
Premium Amount
Premium is one of the most important factors to consider while buying a health policy. A policy with a higher premium may have better coverage when compared to one with a lower premium. It is important to make sure that you are getting the right coverage for the premium that you are paying.
Claim Settlement Ratio
The Claim Settlement Ratio (CSR) is the number of claims settled by an insurance company compared to the number of claims received.
A higher CSR reflects that a larger number of claims were settled by the insurer. This indicates that the insurer is more likely to settle claims without delay or hassle.
Add-on covers and Rider
You should also check if the policy comes with any add-on covers or riders that can be used to enhance the coverage of the policy. These add-ons may include coverage for personal accident, critical illness, OPD, and so on.
Tax Benefits
It is important to check if the policy you are considering offers tax benefits under Section 80D of the Income Tax Act. If it does, make sure to avail of this benefit.
Limits and Exclusions
Every health insurance policy will come with certain limits, exclusions and restrictions for various treatments. It is important to understand these exclusions so that you can choose the right policy.
Inclusions and Gender
You should also check the inclusions and exclusions of the policy with regards to different genders. There may be certain treatments that may be covered for males but not for females.
Free Health Check-up
You should also check if the policy comes with a free health check-up. This can help you detect any medical conditions early on and get treatment accordingly.
Claim Procedure
Lastly, it is important to understand the claim procedure of the health insurer. This can help you avoid any hassles and ensure that the claims are settled quickly.
FAQs
What is the Claim Settlement Ratio?
The Claim Settlement Ratio (CSR) is the number of claims settled by an insurance company compared to the number of claims received. A higher CSR reflects that a larger number of claims were settled by the insurer. This indicates that the insurer is more likely to settle claims without delay or hassle.
Are there any tax benefits associated with a health policy?
Yes, some health policies offer tax benefits under Section 80D of the Income Tax Act. These benefits can be availed by paying a certain amount of premium.
Is it necessary to understand the inclusions and exclusions with regards to different genders?
Yes, it is important to understand the inclusions and exclusions of the policy with regards to different genders. There may be certain treatments that may be covered for males but not for females.
What is the benefit of a free health check-up?
A free health check-up can help you detect any medical conditions early on and get treatment accordingly. This can help you save money on the treatment costs in the long run.
What should I look into while choosing a health policy?
When selecting a health policy, it is important to consider factors such as the hospital network, cashless claims, deductible amounts, co-payment, pre-existing diseases coverage, network and non-network hospital restrictions, premium amount, Claim Settlement Ratio (CSR), add-on covers and riders, and the claim procedure.
Is the network hospital restriction applicable to cashless claims?
Yes, the network hospital restrictions specify the number of days you can avail the cashless facility. It is important to understand the restrictions for both Network and Non-Network hospitals.
How do I know if the policy comes with comprehensive coverage?
The best way to check is to read through the policy document carefully. Comprehensive coverage typically includes hospitalization, pre-hospitalization, post-hospitalization bills, medical check-up, maternity, certain day-care procedures, emergency ambulance services and domiciliary treatments.