With the uncertainty of the pandemic, has made us realise the importance of having a health insurance policy. The awareness regarding personal hygiene and different types of health care plans has increased during this period. However, people are still not completely aware of the limitations and benefits of various health insurance policies. The below tips will give insights on the ways to determine the best health insurance plans as per your health care needs:
Claim Settlement Ratio in health insurance plans
A high claim settlement ratio tells that the insurance company tends to approve claims more as compared to rejections. Though it is a smart move to check the claim settlement ratio, the claims are approved or rejected as per the claim you raise and the documents you provide to support your claim. Therefore, you must check the exclusions and inclusions thoroughly to become fully aware of when and how to raise the claims. Some of the common exclusions mentioned under several health insurance plans are listed below:
- Medical complications caused due to excessive consumption of drugs, alcohol, and cigarettes are not covered by most health insurance plans.
- AIDS, HIV, and other sexually transmitted diseases are excluded from the health insurance policies.
- Self-inflicted injuries and medical conditions detected before the completion of 30 days from the insurance purchase date are also not covered by most health care plans.
Apart from the things mentioned above, some other diseases or medical conditions might not be covered under a health insurance plan. Therefore, analyse the exclusions before getting the policy and before raising a claim.
The reputation of the insurer
An insurer’s reputation is another factor you analyse before buying a health insurance plan from an insurance provider. It includes the domain experience, trust among the policyholders, and various other factors. Therefore, treat the policy premium as an investment and invest only in a reliable insurance company.
Choice of add-on cover plans in health insurance plans
Add-on cover plans or riders can help you extend the benefits of your existing medical insurance policy. However, they also increase the premium, and you should subscribe to them only if necessary.
For example, if you have a history of a severe illness in your family, get a critical illness cover before you are diagnosed with it. Such preventive measures might help you protect your life savings in the future. A critical illness policy can opt as a rider to your existing policy. Similarly, if you are not satisfied with the sum assured, get a top-up health insurance plan that increases the coverage amount.
Choose sum insured wisely
A higher sum insured reduces your out-of-pocket expenses during severe illnesses and medical conditions. Therefore, you must choose it wisely. The sum insured also depends on the type of health insurance policy — for example, a sum insured of Rs. 5 lakh can be sufficient for a single individual but if you have opted for a family floater plan, choose at least Rs. 10 lakh as the coverage amount. In most cases a best mediclaim policy for family provides that coverage amount.
Check age limit
Some medical insurance companies apply an age limit to their plans. It means that you won’t be able to purchase or renew that plan once you cross a certain age. Senior citizen plans are available for those who are above 60. However, check whether the plan that you choose provides the lifetime renewal option.
Eligibility criteria in health insurance plans
It would help if you also went through other eligibility criteria applicable, apart from the age limit. For instance, some policies might require senior citizens to undergo a medical test, whereas no test may be necessary if the individual is below 60.
Also, dependent children older than 90 days and younger than 25 years can be included under specific health insurance plans. You can go through the eligibility criteria set by different insurance providers and apply for a health care plan that allows you to get the policy with minimum documents and without any hassles.
Network hospitals
Insurance providers have tie-ups with the country’s leading healthcare centers and hospitals. If you get admitted to one of these hospitals, your entire treatment can be completed without paying anything. This facility is called a cashless service and applies only to the hospitals present in the insurer’s network. Therefore, get an idea of the network hospitals and their locations before getting a health insurance policy.
Analyse all the details in health insurance plans
Before paying the premium, check details like a waiting period, pre and post-hospitalisation coverage, room rent cap, exclusions, and inclusions. It will allow you to avoid making unnecessary and incorrect claims.
To find the best health insurance plan, you might need the assistance of an experienced health insurance agent. However, you can avoid paying the commission and subscribe to top health insurance companies in India by going through the health insurance policies offered on the official site of Bajaj Finserv. All types of plans and add-on cover plans are available on this platform.
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