Being unwell is a pesky feeling. When you’re sleeping after a long day of work, you want to sleep a little more and keep hitting that snooze button. But when you’re resting in a hospital bed owing to an illness, you can’t wait to get out of it. Besides that impatience to get better, hospitalization keeps your mind occupied with so many other things – a new diagnosis besides the one you are admitted for, the costs adding up with every passing day, and the boring hospital food that you just cannot stomach. But all these issues multiply a hundredfold if you do not have the right health cover. So, we’ve curated this handy list of things to consider before buying Health Insurance. Read on.
Understanding the Basics of Health Insurance
On the surface, a health insurance policy looks like any other legal document filled with jargon and terminologies beyond our comprehension. But what it actually is is a promise that allows you to receive the necessary coverage for your medical expenses should you be hospitalised. Essentially, your insurance company charges an annual premium and offers coverage worth a significant sum known as a sum insured. When you fall ill and need hospitalization, you can file a claim up to the sum insured amount, and the insurer covers the costs of the same.
Now that we have the meaning of health insurance out of the way, let us move on and learn how to choose health insurance plans.
Essential Tips to Choose the Best Health Insurance Policy
Choosing the best health insurance policy in India, one that is right for you and serves your needs, is nothing short of an art. While you may not be able to customise every aspect of your health insurance policy, if you just ensure the following things, you will be sorted.
Check The Sum Insured | Go For A Super Top-Up Plan |
Check the Cashless Network Of Hospitals | Customise With Add-On Riders |
Check For No-Claims Bonus Features | Look For The Lifetime Renewal Clause |
Assess The Claim Settlement Ratio | Ensure Claims Are Processed Easily |
Look For Online Reviews | Check The Sub-Limits |
Understand The Important Clauses | Check The Waiting Periods |
See If You Can Get Discounts | Assess EMI Payment Facilities |
Let us break down the above-mentioned points, one by one.
Tip 1: Choose A Policy With A Good Sum Insured
As explained earlier, the sum insured is the maximum coverage amount your insurer provides when you are hospitalized. With inflation being at an all-time high, you must ensure you buy a policy that covers you against the rising costs, especially if you intend to seek treatment at the best health care facilities, at the hands of the best medical professionals. Remember, the higher the sum insured, the better your chances of getting all your medical costs covered.
Tip 2: Opt for a Super Top-Up Plan for Enhanced Coverage
One of the best tips for buying health insurance is to choose a policy with the option of a super-top. With a super top-up , you can enhance your policy’s sum insured by paying a meagre sum of money. For instance, if you buy a policy with a basic sum insured of ₹10 lakhs, you may need to pay just a few thousand rupees to get coverage worth ₹50 lakhs, ₹1 Crore, or even ₹2 Crore. The only condition for you to claim the super top-up cover is that you should have exhausted the base amount of ₹10 lakhs.
Trivia: While you’ll find lots of policies with sums insured of ₹10 and ₹20 lakh, if you really want to prepare for the future, you should consider buying a super-top-up cover with sums insured of 50 lakhs to 2 Crores. |
Tip 3: Ensure The Insurer’s Hospital Network is Wide
Having a policy with a high sum insured seems moot if you have to pay cash up front and then file a reimbursement claim. As such, among the health insurance tips to consider while picking a policy or an insurer is to check the insurer’s hospital network. Choosing an insurer with a wide cashless network of hospitals proves beneficial as you do not have to worry about upfront payments. You can concentrate on getting the necessary treatment while the insurer deals with the hospital directly.
Tip 4: Review Coverage Inclusions and Exclusions
Everyone wants a health insurance plan offering maximum coverage. But no two policies are the same. You have to ensure that your policy covers you against specific conditions. Does it include pre-existing illnesses? What about critical illness treatment? Will you be able to file claims if you choose alternative treatment forms? Does it cover you against Covid, maternity-related costs, cataract procedures, etc? These are the questions you need to ask to ensure all-encompassing coverage.
Tip 5: Customize with Add-on Riders
If your chosen policy does not provide adequate coverage, you may be able to customize it to a certain extent by purchasing a range of add-on riders. For instance, you can get higher coverage if you are diagnosed with a critical illness simply by purchasing a critical illness rider. Similarly, you can purchase a permanent disability rider that enables you to receive a fixed amount as a payout if an accident-induced permanent disability hampers your ability to earn money and maintain your livelihood.
Tip 6: Look for Plans Offering No-Claim Bonus Benefits
Most medical insurance plans comprise a component known as No Claims Bonus, under which your insurer increases your sum insured without charging any additional costs. The only caveat is that you should not have filed an insurance claim. For not filing claims, the insurer increases your sum insured by 10% for the first year, going all the way to 50% for five consecutive claim-free years. So, if the current sum insured on your policy is ₹20 lakhs, it can increase to ₹30 lakhs over five claim-free years.
Tip 7: Ensure There’s a Lifetime Renewal Clause In Your Policy
One thing you may miss in your hurry to buy the best health insurance plans is that you may overlook the duration of coverage. Many policies come with limitations on the number of years your insurer offers coverage. In some cases, you may not be eligible for coverage once you reach your golden years – your 70s and beyond. But isn’t old age the time when you are most prone to falling ill, when you may need coverage the most? So, you must ensure your health plan includes a lifetime renewal clause.
Tip 8: Check The Insurer’s Claim Settlement Ratio
While most insurance policies look the same, mainly because the coverage and other relevant guidelines are set by the Insurance Regulatory Development Authority of India (IRDAI), every insurer is different. So, how do you choose the right one? Simple – you should check their claim settlement ratio. This ratio is a percentage that represents the total number of claims received by the insurer versus the claims settled. Consider choosing an insurer with a claim settlement ratio exceeding 80%.
Trivia: The last thing you want while dealing with a health crisis is to come up with the cash deposit amount needed by the hospital. To avoid this, choose an insurer with a wide network of cashless hospitals. |
Tip 9: Assess The Simplicity Of the Claim Process
Another vital tip on how to pick health insurance plans is to ensure you do not have to run from pillar to post to get your claims settled, nor should you have to follow up with insurers about your claim status 100 times. You can ensure you don’t get stuck in such a situation by assessing the insurer’s claim process. Consider choosing an insurer who allows you to file your claims online and does not require extensive paperwork and other formalities, so your claims are processed without delay.
Tip 10: Read Reviews and Customer Feedback
Many times when something looks too good to be true, it is because it actually is! For instance, you may find a policy that offers a whole lot of benefits at an extremely low cost. But when the time to file a claim arises, the insurer imposes various restrictions that prevent you from getting the promised coverage. So, before you excitedly buy such a policy, remember to check its reviews online. A pro-tip here is to look for reviews on general online forums, not only those on the insurer’s own websites.
Tip 11: Prefer Policies with Flexible or No Sub-Limits
Being hospitalised for an illness entails a range of expenses. You may need to bear ICU room costs, room rent costs, domiciliary hospitalization costs, etc. Your insurer typically determines a sub-limit on the amount you can spend on such costs. For instance, if your policy states that your daily room rent should not exceed ₹8,000, and your hospital charges you ₹10,000 for your chosen room category, you have to bear the difference of ₹2,000. So, ensure you check the sub-limits and choose the right policy.
Tip 12: Be Aware of Co-Payments, Deductibles, and Other Clauses
Insurers typically include clauses like deductibles and co-payments in health insurance policies. They may make these clauses voluntary or compulsory. Even if you choose a health plan with a voluntary co-payment clause, you may find that the premium payable against it is low. As for deductibles, this clause typically applies to super-top policies, wherein you have to exhaust the entire coverage amount in the base policy before you can encash the sums covered in the super top-up policy.
Trivia: An Insurer’s Claim Settlement Ratio is an excellent yardstick to assess how likely they are to approve your claim. Remember to choose an insurer with a high claim settlement ratio. |
Tip 13: Consider The Waiting Periods Applicable To Your Health Plan
Every health insurance policy you buy comes with a predetermined waiting period – a time during which you cannot file an insurance claim. Waiting periods can range from 3 months to 4 years, depending on the policy type and coverage terms. For instance, a regular health insurance policy might have a 3-month waiting period, but if you have a maternity cover as an add-on rider, you may be able to file a maternity claim only after riding out the waiting period, which could be two or more years.
Tip 14: Check If You Are Eligible For Discounts
Health insurers today are coming up with various ways and means to help reduce your premium costs. One of the most unique methods employed by them is to encourage policyholders to take steps towards being physically fit, thereby reducing their chances of filing claims. As part of your health plan, your insurer may offer you a discount if you complete, say, 10,000 steps every day in a policy year or fulfill the different, accepted fitness goals as per the policy terms.
Tip 15: Explore Flexible Premium Payment Options (EMIs)
If you want to buy the best health insurance policy in India, but if the budget is a concern, you need not lose heart. Today, insurers allow you to choose the best health insurance policies and pay the annual premiums in Equated Monthly Instalments (EMIs). As such, you do not have to worry about paying a lump sum once a year; instead, you can buy your preferred health plan and pay the premium amount in affordable monthly instalments. You can even set up automated payments for these EMIs.
Explore the Best Health Insurance Options with ManipalCigna
ManipalCigna is reputed to offer health insurance solutions that focus on customer care, flexibility and full coverage.It is essential to know what makes a plan advantageous in the long run when you are investigating your options.
The following are some of the main factors that make ManipalCigna a good option:
1. Wide Range of Sum Insured Options
The medical needs of each family vary.Some feel comfortable with a simple plan that has basic coverage, whereas others will require a larger amount insured based on lifestyle, age, urban area where they live, or any underlying health conditions.ManipalCigna has a wide range of sum insured- starting with low entry-level cover to more comprehensive cover to protect you against the increasing healthcare costs.
2. Coverage for Major Medical Needs
The contemporary health policies should cover the ailments that involve expensive treatment.ManipalCigna plans are designed such that they provide coverage to:
- Critical illnesses
- Advanced medical procedures
- Hospitalisation and daycare treatments.
- Organ transplants
- Mental health care
This guarantees all-around protection to the policyholders without the concern of having to incur unnecessary costs.
3. Cashless Network Strength
One of the biggest advantages of choosing ManipalCigna is its extensive network of hospitals offering cashless treatment. A good network facilitates a hassle-free and quicker hospitalisation.Ensure that you verify whether the hospitals that you are trusting are within the network.
4. Flexible Add-On Benefits
Add-ons also provide you with the ability to tailor your plan depending on your own needs.ManipalCigna offers optional covers like room rent modifiers, maternity benefits, critical illness add-ons, non-medical item coverage, and more. These add-ons enhance your protection without needing a separate policy.
5. Wellness and Preventive Health Benefits
A significant aspect of health protection is preventive care.ManipalCigna plans include clever health check-ups, wellness initiatives, and rewards for healthy behaviour, which will enable the customers to remain health-conscious and minimise risks in the long-term health.
Common Mistakes to Avoid When Choosing a Health Plan
Even though buying health insurance seems simple, many people make mistakes that reduce coverage value or lead to claim rejections later. By avoiding these pitfalls, you will be able to have a proper plan when you need it most.
Ignoring Policy Exclusions
Among the biggest mistakes that people make when purchasing health insurance is the lack of reading the exclusions carefully. Exclusions are conditions or treatments that your policy will not cover. They may include:
- Cosmetic procedures
- Pre-existing diseases during the waiting period
- Non-medical consumables
- Certain advanced treatments, depending on policy terms
- Dental or vision care (unless offered under specific add-ons)
Always take time to go through the fine print. Ask the insurer if you’re unclear about any condition. Understanding exclusions ensures there are no surprises during claims.
Focusing Only on Low Premiums
The desire to have an affordable health plan is natural, and selecting one based on its affordable cost can be an expensive error. A low premium may mean:
- Lower sum insured
- Limited features
- Sub-limits on room rent or treatments
- High co-pay requirements
- Restricted hospital network
Instead of choosing the cheapest plan, look for value. A slightly higher premium that provides better features, stronger coverage, and higher protection is always more beneficial in the long run.
Not Comparing Enough Plans
Another common mistake is to purchase the first plan that you encounter.Health insurance is a long-term commitment, and hence it is important to take time to compare various plans. Compare the following:
- Coverage benefits
- Waiting periods
- Sub-limits
- Add-on options
- Hospital network
- Claim settlement process
- Customer reviews
Comparing multiple plans helps you identify what truly meets your needs rather than settling for a plan that falls short later.
Conclusion
Choosing the right health insurance plan requires careful evaluation, but the effort is worth the peace of mind it provides. Start by analysing your family’s healthcare needs, choose a trusted insurer like ManipalCigna, and compare policies with attention to coverage, exclusions, and long-term benefits.
An effective health insurance policy is not just a way of covering hospital bills, but an insurance of your financial well-being, a way of ensuring better health results, and a way of being ready against unforeseeable medical issues.You can be confident that you can count on your plan to be there when you need it the most by avoiding pitfalls and concentrating on what matters.
FAQs
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What is the first thing to check before buying a health insurance plan?
The first thing to check is the coverage offered, especially whether it matches your medical needs. Look at hospitalisation coverage, daycare procedures, pre-and post-hospitalisation benefits, and any sub-limits or waiting periods that may affect your claims.
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Is it better to take individual or family floater health insurance?
If you have a family with members under 60, a family floater plan is usually more cost-effective and convenient. For senior citizens or individuals with medical conditions, individual plans may offer better personalised coverage.
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How can I compare health insurance plans easily?
Compare plans by evaluating sum insured options, exclusions, waiting periods, premiums, add-ons, hospital networks, and claim settlement processes. Many insurers, including ManipalCigna, provide online comparison tools to simplify the process.
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Which features make a health plan truly comprehensive?
A comprehensive plan should include high sum insured, wide hospital coverage, low waiting periods, no room rent restrictions, OPD or health check-up benefits, coverage for critical illnesses, and minimal sub-limits or exclusions.
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How does the claim settlement ratio impact my choice of insurer?
A higher claim settlement ratio indicates that the insurer settles claims efficiently and reliably. This builds trust and assures you that your claims will be processed smoothly during emergencies.
