Selecting a suitable health insurance plan


Here are some tips to help you select a plan that fits your needs and offers you the maximum value for money

Arun Balakrishnan 

In times of soaring medical costs and increasing occurrence of lifestyle diseases and ailments, having an appropriate insurance policy is a must to avoid serious financial crisis. While most of us are aware of the need for medical insurance, we often procrastinate its purchase. One of the most common reasons for doing so is that there are there are multiple plans available and settling on one particular plan can get very confusing.

Here are some tips to help you select a plan that fits your needs and offers you the maximum value for money. Broadly, there are four types of policies.

Indemnity health plans or mediclaim policies are the most basic form of health cover. These provide for expenses arising on account of hospitalisation. These policies are most often provided by corporate employers under group health insurance.

Another health policy is the critical illness policy. These are specifically designed to tackle the implications of critical illnesses like cancer, stroke, heart condition etc which require expensive treatment and impair the patient’s ability to earn. These policies offer a pre-determined payout upon diagnosis of the disease irrespective of when the treatment is sought.

On the other hand, surgical benefit policies offer a fixed payout if one has to go for a surgical treatment. Hospital cash benefit plans offer a fixed amount on a daily basis if one is hospitalised, notwithstanding the actual treatment costs and the amount received through a mediclaim policy. 

 

The first step towards insuring one’s health is to get a vanilla mediclaim policy. Mediclaim for each family member is a must. This takes care of the expenses in cases where a short period of hospitalisation is required. However, in case of a long-drawn illness requiring expensive treatment, a critical illness cover may be necessary. Besides these four policies, one can opt for riders like personal accident, daily allowance etc to enhance the coverage.

Next, one must decide on the sum assured as per the requirements of the family. Points to be kept in consideration while determining the sum assured are family size, medical history of the family members as well as the area of residence. Medical care costs vary widely across different cities. Health care in Tier-1 cities like Delhi or Mumbai is very expensive necessitating a higher sum insured compared to smaller and less expensive towns and cities.

Depending on the family size and health conditions, one may also go for a top-up plan. Top-ups are add-ons to indemnity plans and function in a similar way. They kick in when the cover on the base plan gets exhausted thereby providing enhanced coverage over the base mediclaim.

Then, one must choose between buying individual policies for each member or a family floater covering all members. Family floaters typically offer larger cover at cheaper premium rates. However, the downside is that they usually terminate upon the demise of the primary insured person in which case the benefit of good claim history and cover for pre-existing diseases which are applicable on continuous renewal of the policy would be lost for the other members.

Also, if one member undergoes hospitalisation exhausting the entire cover, the others may be left without any cover. Family floaters usually work best for small families consisting of the policyholder and his/her spouse and minor children, where the members are young and healthy.

Before purchasing a medical policy, you must do your own research and make sure you are aware of the policy terms and exclusions. See whether pre-existing diseases are covered and check the waiting period. Check for sub-limits that may be applicable on various heads like room rent. Also, select an insurer with a wide hospital network as this will give you multiple options to avail the cashless facility benefit. Also make sure the network includes hospitals in your neighborhood as well.

With these points in mind, you can make a prudent choice of a health insurance policy. There are several online portals, which enable comparative analysis of the features and cost of such policies. This offers a convenient means to make an informed selection. Having selected the policy best suited to your needs, you can insure your family`s health at the click of a button.

The writer is CEO, BerkshireInsurance.com

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