How to choose the right health insurance plan?

 

Some important points to choosing the best health insurance policy:

Today's topic is health insurance, what should be the coverage of health insurance when we people take health insurance. People get confused about how much coverage should be. If you can opt for health insurance coverage, then you should decide on the cover keeping in mind many things. Remember that today's coverage may not be enough tomorrow. 

That is why you should decide the coverage amount considering today or tomorrow. Let us know what should you keep in mind while choosing a health insurance cover? Now let's look at the data received from Crisil. It’s a Corporate Analytical Company. Research rating risk provides policy advisory. According to the report of Crisil, the out-of-pocket expenditure out of the total expenditure in the health segment in India is 63%.

This means that if Indians spend ₹1 crore on health services, then only ₹ 37 lakh is suspended through the insurance policy. The remaining 63 lakh patients direct their savings through any liquidation or by taking debt. If we talk about the world average outer pocket expenditure is only 18%. But in the advanced country, this number is 11% in the USA and 17% in the UK.

These numbers indicate the penetration of health insurance in India. Simultaneously, these numbers also highlight the fact that there is a major region of savings depletion and investment liquidation in medical emergency India, with nearly 500 million lives covered under health insurance in 2020, but 362 million of them through live government sponsor programs were undercover, which may not be able to meet all of these requirements. 

At this point, you must have clearly understood the need and importance of insurance. Now we will discuss some points which will help you to choose a life-based insurance policy for you and your family. But let's take a look before proceeding. On the benefits that health insurance provides us. The first financial preparation that helps in unplanned medical emergencies. 

Insurance also covers the high-end cost of our medical care. The premium over the actual cost of the treatment is generally cheaper. Health insurance provides us with cashless treatment along with easy admittance and service of patients in network hospitals; it also provides tax benefits and other side benefits like periodic health check-ups. Now we will explain to you which will help you to choose the best insurance policy. 

The first is the sum insured, buying a policy. Either life insurance or health insurance Does you need to know what is your need? In the case of health insurance, you need to know how much sum should be insured to pay medical expenses if you face medical problems in the future. You can consider these three points to decide the sum insured. First is the average cost of health services in your city, because the city-to-city cost varies.

Second is the nature of your job, patients working in the job field will need more sum insured than people working in the IT industry and third is your lifestyle as I told you earlier. There is no way to calculate the total required sum insured. But according to experts, you must take a minimum of five lakh rupees annual coverage for your family.

The second step is the balance between family floaters and individual plans When you buy insurance, there are two plans in it family floaters and the second is individual plans. A major advantage of a family floater plan is that you get health insurance for all the members at a single premium.

When the age profile of family members is very wide or if a member already has a disease, then family floaters are not the best approach, let us understand with an example. Suppose there are five members in a family out of which four are young and healthy. But one person is older and at present, he has some type of disease. In this case, there will be two disadvantages of choosing a family floater plan. First, due to an elder member, the premium of the entire family will increase.

Elder members may have to make frequent health insurance claims because of their pre-existing diseases. So in any year if the elder member makes a claim then the other members will have to face the difficulty. If another member faces a medical condition in the same year, then it will be difficult for him to pay the medical expenses, because in many policies the sum assured amount can be claimed only once a year.

Then the only approach, in this case, would be to have a family floater plan for the four young members and an individual plan for the elder member. Third, the company's reputation and claim settlement, before buying health insurance from a company, you should check the company's reputation in the market. Like, how old is the company, what is its record or customer review? This thing needs to be seen. Another thing that you should check is the claim settlement ratio.

This ratio updates how many claims the company has received in a particular area and how many of them have passed. Suppose the company received 100 claims and settled 95 claims in a year, then the claim settlement ratio of the company is 95%, you should choose the company which has a higher claim settlement ratio. Fourth incurred claim ratio. While comparing insurance policies, this ratio is important.

Indicates the Incurred Claim Ratio. The premium collected through the company in a specific period against the percentage of net claims paid by the company, but individuals should always prefer a high Incurred Claim Ratio company. The next step is sub-limits and capping. In some cases, the company puts some limit on the claim amount for a specific disease, which is called a sub-limit, understood with an example.

If you have a health insurance policy whose sum assured is seven lakhs. But the sub-limit is 5 lakh for heart surgery. Suppose you have heart surgery in the future. If your medical bill is generated 6 lakh rupees, then the health insurance company will pay you only five lakh rupees and you will have to pay the remaining one lakh from your pocket.

So you should check the specific sub-limits and capping imposed by the insurance company and you should select the insurance policy which can provide you maximum flexibility and coverage. Sixth is network hospital coverage. An individual should choose the same health insurance company, whose hospital network's preferred hospital is around your locality.

This step is also important because at the time of a medical emergency, treatment of an individual is done in a trusted hospital and the procedure of treatment in that hospital is convenient and efficient. You also get more benefits like a cashless settlement in a network hospital.

Seven steps is Exclusion, before taking an insurance policy it is very important to study which medical conditions are not covered in it. In general, such a health plan has at least Exclusion, then it is best to choose the same.

Next is the Room Rent Limit Some insurance company puts a limit on room rent at the time of hospitalization. Generally, the room rent limit is 1% of the total sum insured, so if your sum insured is seven lakh then the room rent will be 7000. If you have an accident in the future. And if your room rent is more than 7000, you have to pay the room rent, and then you have to pay the amount from your pocket.

Along with this, many other benefits of your health insurance are linked to your room rent. Like you generate more room rent bills than seven thousand rupees and pay yours out of pocket. Similarly, you will also have to pay other benefits charges from your pocket. Therefore, you should choose the same insurance policy on which there is no room rent limit or capping.

Ninth is no claim bonus, suppose you have health insurance but in that year you do not have any health disease, neither any accident happens, then in this case company provides you no claim bonus in 2 ways, either company will give you no claim bonus in your next year or by increasing the sum insured by a percentage like 20% for the coming years. So the same company should be chosen, which provides a maximum no claim bonus.

10th is the waiting period, suppose you are buying health insurance and you have a pre-existing disease, then you cannot claim against your pre-existing disease for a few years. This period is called the waiting period, so while purchasing health insurance you should check the waiting period and related conditions of pre-existing disease.

11th is riders, ideally, you should buy some riders along with a health plan. Although add-on riders come with some extra cost, they also help you to extend insurance coverage in case of some specific diseases and accidents. According to the requirement of the customer, there are many types of riders. Like maternity cover or critical illness cover. Suppose you need an organ transplant, then in this case the critical illness rider will help in paying the medical bills of your specific disease.

And last is the flexibility to upgrade the insurance plan at a low cost, as our life changes with time, our health insurance plan changes according to the need of our health. Therefore, it is best to have a plan which is easy to upgrade and increases the insured amount, so that you can easily upgrade your insurance plan at a low cost. And you don't have to start from scratch to change plans.

So these were 12 important points that will help you in buying the best health insurance policy. If you have any questions, please comment on our site www.tradeipohub.co.in. Thanks for reading.