What is health insurance?
Health insurance is a policy or legal agreement between you and the insurance company (the insurer) to protect you from future health related illness and injuries including hospitilizations, treatments, surgeries, etc, in return for a premium charged monthly or yearly.
Health insurance is critical in todays world where things like habits & lifestyle are changing rapidly.
Whats the need for health insurance:
Financial Protection
Health insurance protects you financially during uncertain times without depleting your savings entirely or prevents you from getting into huge debt. The financial protection is only applicable upto the sum insured and the coverages mentioned in the policy. So while taking a policy, check for the essential coverages you need.
Access to Quality healthcare
A fully covered health insurance is critical in accessing high quality health care facilities immediately when something happens. This directly impacts the treatment quality and the outcome of the treatment. Quality healthcare also includes convenient accommodation, food, medical bills, and timely procedures to guarantee successful treatment of the patient.
Unparalled convenience during emergencies.
Imagine a scenario when something bad happens that which you never even prepared for, an health insurance comes to rescue to cover all of it which cannot match with anything else. The key timing is the when the policy gets your back completely during those unexpected situations. Imagine taking to a nearby hospital and getting quality treatment for a ridiculous injury with no wait time is of utmost importance to the life of the patient.
Combat lifestyle related health issues.
In todays world, the quality of life worsens day by day due to lifestyle habits, food habits, pollution and what not. Even younger people nowadays get medical conditions that only those above a certain age would get. Health issues like heart attack due to unhealthy eating can be sudden and can get you without warning. Modern habits like smoking, drinking all contribute to sudden strikes on one’s health even when one is cautious. This is why a health insurance is necessary to be in place.
Inflating medical costs
Medical field and technology advancing daily, the cost keeps rising for providing advanced and quality healthcare facilities. Medical inflation rate is around 10% yearly. This means the cost of healthcare is going to rise and rise yearly, indicating an immediate need to have an health insurance policy in place with adequate coverage. Having an extensive coverage health insurance provides a way to get over the inflation and the ever growing medical costs without stress or difficulty.
What to look for when buying health insurance
Choose the right type of coverage
When buying health insurance, think about what type of coverage you need, either individual coverage or coverage for the whole family.
Select the coverage needed
Be aware of what you want to be covered specifically in the policy.Age limit Check the age ranges in the policies if you are including elderly people in your family.
Premium
Select the premium which is affordable and gives your required coverage. Never compensate for coverage due to low pricing. Choose optimal coverage.
Claim Settlement Ratio
Go with insurers with high CSR, because it shows you how much of the claims received have been settled successfully.
Deductible
It’s the payment you make to the insurance company before they pay for your treatment. This is to make people avoid low value claims. Check if the policy has it.
Co-payment
It’s the percentage of the medical bill the individual pays and the rest is paid by the insurance company. Check if the policy has it.
Lifetime renewability
Check policies for lifetime renewability option to ensure that the policy can be renewed each year or a set period to avoid finding a new insurer after the insured period.
Network Hospitals
Check for network hospitals that the insurance companies have tie ups with so that your preferred hospital is available during the treatment period. And these network hospitals also have caseless processes since they have tie ups with insurance companies. No paperwork and waiting period for approval required. So this is an important factor.
Preventive care benefits
Check for provisions that the policy provides for prevention measures such as vaccination, check up, etc.
Annual Health Checkup
Ensure the policy provides an annual health checkup to stay healthy each year. This also helps with detecting diseases early and clearing them early.
Policy terms, conditions, wordings
Take time and read the terms and conditions of the policy to have a clear understanding of what the policy is all about.
Restoration benefits
It’s an add-on service which refills your sum insured in case you’ve claimed your sum fully or partially and it automatically restores upto the sum insured limit again for the same policy period. So that you can claim the sum for the future treatments if needed.
Pre and Post Hospitalisation Cover
Check for policies with pre and post hospitalisation covers.
Sub-limits
Some policies will have capping to certain treatments and events. So never forget to check the limits of those cappings.
No Claim Bonus NCB
No claim bonus is an incentive provided by the insurance company if you don’t make any claims during the policy period. Usually it’s either a discount in future premiums or a boost in the sum insured.
Alternative Treatments
Policies also cover alternative treatments like ayurveda, unani, etc. Check for those wordings as well in the policy document.
Modern Treatment
The policy should provide new age treatment and should also give access to modern technology related treatments.
Day Care Procedures
Check the policy for how it covers day care treatment procedures and in-home treatment procedures.
Specific Inclusions and Exclusions:
This is the most important section as it lays out what’s covered and what’s not. Specific treatments and diseases may be excluded from the policy.
Waiting period
Usually there is a waiting period for pre-existing conditions and diseases ranging from 90 days to 2 years. Check for those in the policy document.
Capping
Certain policies will have capping on different accomodation in the hospital, medical bills, etc. Check for those as well.
Avail Routine Check ups
Check if the policy provides assistance for routine checkups for certain conditions which require on-going treatments and check-ups.
Ease of claim process
Check the settlement claim process, how the insurance company processes the claims and have a clear idea before signing the policy.
Settlement Turnaround Time
Its the time it takes from making a claim to settling a claim successfully. Go for the ones with low turn around time.