How to Choose the Right Health Insurance Company?

You can purchase the right health insurance policy for yourself by following a few simple guidelines such as evaluating the insurer, enquiring about cashless facilities, sub-limits, waiting period, renewal age, co-payment facility, and so on.

Buying a health insurance policy is something which has now become more of a necessity than an option. Every day, costs of medical treatments, doctor’s fees, medicines, diagnosis, tests, etc., is rising at an alarming rate. With this inflation, many people can no longer afford to receive quality healthcare, and those who can, often have to break into their precious savings in order to fund the expenses that arise due to a medical emergency which often requires life-saving treatment. Considering all this, it has now become an absolute necessity for one to be covered under a health insurance plan.

In India, there are several general and stand-alone insurers which offer health insurance plans. There is also a large variety of health insurance policies which are now available in the market and cater to the varied needs of customers. When it comes to choosing a policy, there is ample literature available on the topic. However, what is seldom talked about is how to choose the right health insurance provider. With the plethora of options available, it may seem challenging to choose one insurer over the other. To help you in this regard, here is a list of parameters which you can keep in mind when choosing a health insurance provider.

Check The Company’s Credentials:

The first and foremost thing to check in a health insurance company is the firm’s credentials. Why is this important? Because, a company’s credentials will give you a fair idea of the kind of coverage they can offer you. If you are investing in a health insurance policy offered by a certain company, what are the chances that your claim will be honoured? After you have purchased the policy, it is likely that you may have some doubts or questions relating to your policy. In this case, does the insurer have an easily approachable customer support system where customers can get their queries resolved? Also important to find out is the insurer’s claim settlement ratio and solvency ratio which will give you a fair idea about the claim settlement probability.

Look For Variety:

Having a variety of plans is always a good thing when looking at insurance. When you are looking for a health insurance provider, look for one which offers you multiple options to choose from. Insurance companies often offer plans for a variety of budgets. An ideal insurer would give you multiple variants of a policies under different budgets or premium range. This is helpful as it allows one to choose a policy which fits their needs the best.

Cashless Hospital Network:

The facility of cashless hospitalization is something which is provided by most health insurance providers and is of great benefit to the policyholder. The basic idea behind cashless hospitalization is to provide the policyholder with a choice of network hospitals to choose from where they can get treated for a covered medical illness/condition. After the treatment/hospitalisation period is over, the bill for the same will be settled directly between the insurance provider and the hospital. The insurer will cover all expenses which are a part of the policy that the insured has taken. All other expenses that are not covered under the policy must be borne by the policyholder. This facility also spares the policyholder of the hassle of collecting the bills and receipts for the treatment and submitting the same under a claim later. This facility can help the policyholder hold on to their savings as the treatment expenses are borne by the insurer. Also, the greater and more wide-spread the network of cashless hospitals, the better. In times of an emergency, the last thing anyone wants to do is drive to a network cashless hospital which is miles away, especially when time is of the essence in saving a dear one’s life.

Sub-Limits on Treatments:

Most health insurance providers put sub-limits on costs related to medical treatment such as the consulting doctor’s fee, hospital room-rent, etc. For instance, your health insurance provider offers a health insurance plan which carries a sub-limit on room rent such that the daily room rent must not be over 1-1.5 times of the sum assured. So, if your policy carries a sum assured of Rs.2 lakh, you can only claim room rent up to the amount of Rs.2000/day under your policy. The remaining cost of room rent must be borne by you. Therefore, do check if your health insurance company has sub-limits attached to any clause under the health insurance plan that they offer.

Waiting Period on Coverage:

Almost all health insurance providers put terms and conditions on the time period from when the plan coverage shall commence. The gap period between the start of the policy and the time when it starts to provide coverage for covered illnesses or even pre-existing diseases is known as the policy waiting period. This means that the policyholder will have to undergo the waiting period before they can be covered for a pre-existing disease or an illness which comes with conditional coverage of undergoing a waiting period. When choosing an insurer, try to seek those who have the lowest waiting periods for covering pre-existing diseases and illnesses. Any claim that arises during the policy’s waiting period will not be taken up by the insurer.

Co-Payment Option:

Under the co-payment option, a part of the which is a part of many health insurance policies, the policyholder is asked to bear a part of the of doctor’s bill cost, before the insurance policy starts coverage. The co-pay or co-payment clause is mentioned in your health insurance policy, as is it’s specific limit. Most insurers include this clause mainly to deter people from making unnecessary claims on their policy. However, this clause is not beneficial to a policyholder as it may prevent them from seeking adequate medical care at the time of an emergency or even otherwise.

Renewal Age on Plans:

Most health insurers offer plans which can be renewed only till the policyholder reaches 70 or 80 years of age. This isn’t helpful as it is well-known that one’s health deteriorates with age. Considering this, it is only more likely that one will be in poorer health at an old age as compared to when they are young. The costs of medical treatments for older individuals are more expensive, which makes it all the more to have a health plan which covers you for a longer time. Choose an insurer which provides you cover for a longer period or till an older age.

Pre/Post-Hospitalization Expense Cover:

In addition to covering the cost of medical treatment, health insurance plans routinely also provide cover for pre and post hospitalization charges. Normally, health insurers provide cover for pre-hospitalization expenses for 60 days before start of treatment and 90 days after the treatment has concluded under post-hospitalization. An ideal choice of an insurer would be one which provides the maximum time period for coverage of pre and post hospitalization benefits.

No Claim Bonus:

The concept of no Claim Bonus is also present in the health insurance segment, like the motor insurance industry. The working of the concept is the same. If the policyholder has not raised a claim during the past policy year, they will be entitled to a No Claim Bonus when they get their policy renewed with the same insurer. Also, like a motor insurance policy, one can have their health insurance No Claim Bonus transferred from one insurer to the other. Therefore, go for an insurer which offers you a No Claim Bonus on your plan.

Streamlined Processes:

At the time of an emergency, the last thing that a person wants to do is be stuck trying to figure out the process to file a claim. This is one of the main reasons why it is important to choose an insurer which has set processes when it comes to policy related actions such as raising a claim, applying for a policy, tracking your application, etc.

Efficient Customer Care:

If you have a problem with your cellular connection or internet, getting in touch with the customer care is the most difficult thing on the planet. Almost all of us have gone through this. However, in case of health related emergency, this scenario can mean the very difference between life and death. When scouting for a health insurance provider, it is recommended to choose an insurer which has a dedicated and efficient customer support division that is easy to reach.

Online Presence:

In an age when groceries are available online, health insurance providers are fast catching on the trend. Actually, most major insurance companies have an online presence by way of a website which customers can access to not only buy a policy but also find out about other policies offered by the insurer, pay premiums, view NAV, fund value, calculate policy premiums, reach the customer care team, and do much more. The biggest advantage of having an online presence is that customers can access the products of the insurer from anywhere, as long as they have a working internet connection. With the help of a website, it also becomes much easier for the customers to get in touch with the insurer or request for assistance on policy related matters. These are some of the primary reasons why it is important to choose an insurer which has a website, therefore making it easy for the customer to choose from a variety of policies and also apply for one.

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