How to Buy Health Insurance Policy – The Ultimate Guide

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Health Insurance has always been a popular product in the market. In simple words, it is a contract between an insurer and an individual/group as the case may be, where the insurer agrees to pay medical expenses at a particular premium which is to be borne by the insured.

In today’s article we will cover how you can buy health insurance policy and what are the things you must consider. The medical expenses are increasing day by day and buying a Mediclaim policy is a must now. The most simple form of Health Insurance policy which is readily available today is Hospitalization Cover, though a variety of products are now available in the market.

 

Now, let me tell you that if you already have a health insurance policy from your employer then it is not enough. These are group insurance policies which might have different kinds of clauses like Co-pay, Room Rent Limit etc. Again, these policies might not cover your family and dependents. A major drawback is that they are active only till you are an employee of the company. You must have a health insurance policy of your own to be on the better side.

 

If you are having trouble finding out the right health insurance policy for yourself, you can Get in Touch With Us and we can help you decide on the right kind of health insurance policy based on your requirements. You can compare quotes, features and clauses of various health insurance companies and then decide for yourself.

 

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    7 Things to Consider Before you Buy Health Insurance Policy:

    1. Requirement Analysis:

    At first you need to understand your requirement. Do you need an Individual Policy or a Floater policy for you family? There are variety of products available in the market today to cover heart diseases, Diabetes, maternity etc. There are special senior citizen health insurance policies also. You must also try to figure out how much cover you want. Think about it like this, how much sum insured will be required to cover your hospitalization expenses based on your affordability.

    2. Examine the Coverage Offered

    You should be aware of what coverage you are opting for. First of all read the policy brochure in full. They are different clauses and features that are present there like:

    A. Hospital Network & In-Patient Treatment:

    You should check the network of hospitals for Cashless Treatment. In cashless treatments, the insurer settles the claim amount with hospital directly. Generally most of the companies give you In-Patient Treatment. In-Patient Treatment means treatment within a Hospital for more then 24 hrs.

    B. Room Rent Allowance:

    This is the maximum allowance for hospital room per day as per the plan opted. There are certain policies that do not have any room rent capping. Again some policies have room rent capping of 1% of Sum Insured. Suppose you have a sum insured of 5 lacs. If room rent capping is 1% every day, then your maximum room rent eligibility per day will be Rs. 5000.

     
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    C. Pre and Post-Hospitalization:

    We all know that before hospitalization we generally visit a doctor to get medicines. In case there is a hospitalization, then these Pre-Hospitalization expenses are also covered along with hospitalization expenses. Similarly, post-hospitalization expenses are also covered for a specific period. You must be aware of the Pre-Hospitalization and Post-Hospitalization periods so that you can claim them as required!

    D. Medical Check-up:

    Health Insurance policies are also giving free medical check-ups. You should know the medical check-up maximum limit also.

    E. Day-Care Treatment:

    Is the Health Insurance Policy covering day-care expenses? There are certain procedures that can be covered with 24 hrs in a hospital like cataract, tonsils, chemotherapy etc.

    F. Pre-Existing Diseases:

    You might be having some Pre-Existing Diseases which are generally not covered from the inception of the policy. There are waiting periods for such cases. Some Policies have a waiting period of 48 months. This can vary from policy to policy. You should be ware of this too.

     
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    G. Maternity:

    As told before, Maternity helps you in covering medical expenses related to pregnancy. You should be aware of the waiting period and sub-limits.

    H. Sub-Limits for Certain Treatments:

    There are sub-limits for certain treatments like Cataracts (Per eye), Maternity etc. You should know those sub-limits so that there is no problem in future.

    3. Co-Payment & Exclusions:

    You should also check out the Co-Payment clause. In case of Co-Payments you have to share the expenses with the insurer as per the ratio disclosed. There are also certain expenses and treatments which are not covered under the policy. You should take a note of this too.

    4. Claim Settlement:

    We pay handsome amount of premium and therefore we also expect a smooth health insurance claim settlement process. Health Insurance companies also have TPAs ( Third Party Administrators) who settle claims either directly with hospitals in case of cashless settlements or through reimbursements with the policy holder. One must be aware of the the claim settlement process and intimate the health insurance company on time. Again, you should find out the claim settlement ratio of the health insurance company. This helps you in choosing the right health insurance policy!

     
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    5. Cumulative Bonus

    Cumulative Bonus is generally a percentage of the sum insured which gets added to the sum insured in case of a claim-free year. This cumulative bonus can be used to pay claims over and above the sum insured. One must consider this factor when he/she buy a health insurance policy.

    6. Free Look Period:

    As per IRDAI guidelines, the health insurance companies have to provide a free look period to the insured. Free Look Period is the time during which the insured can go through all the terms and conditions of the policy and in the mean time if the insured feels unsatisfied then he/she can return the policy. This is made to safeguard the interest of the policy holders. This period is generally 15 days from beginning of the policy but sometimes also goes up to 30 days depending on the health insurance company. The policy holder has to furnish certain details and submit a request for availing this.

    7. Restoration Of Sum Insured:

    Many Health Insurance companies are offering the facility of restoration of sum insured once the base sum insured is exhausted. There are certain criteria and limitations as well for this too. Many companies do not allow the restored sum insured to be used for the same disease in the same year. One should go through the clauses properly and then decide.

     
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    When you go out there to buy a health insurance policy there is a lot of complexity and that’s where we come in. SSA INVESTORS is tied up with many of these health insurance companies to help people get the health insurance policy based on their requirements. You can compare quotations, features and clauses of all the health insurance policies and then decide yourself. We guide you in selecting the right kind of health insurance policy and we do not stop there. From the time you buy policy from us till getting claims/reimbursements on time, we stand by you. We understand that life is precious and a small delay can cause a great trouble.

     

    You can call us at +919830771603 / +919831035672. You can also reach out to us by Filling up this Form.

     

    Stay Healthy, Stay Safe!

     

    2 Comments on “How to Buy Health Insurance Policy – The Ultimate Guide

    1. I was excited to discover this website. I want to to thank you for your time. I definitely liked every part of it and i also have you book-marked to look at new things on your site as well.

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