How to Find the Best Health Insurance Plan for Your Needs?

• Written by Jyotsana Shekhawat

  Reviewed by Akhil Pillai

• favorite0Like

  favoriteBe the First to Like

  • content_copy Copy Link Copied! Share on Facebook Share on Linkedin Share on Twitter Share on WhatsApp

  ios_shareShare

Good health is the key to not just a happy life but also a prosperous life. While most of us focus on living healthy and adopting a better lifestyle as a way to maintain good health, we overlook how, despite our best efforts, there are times when medical adversity could knock on our door. Sometimes, medical emergencies can cause physical, mental, and financial stress. Thus, having a health insurance plan is crucial, especially these days when medical inflation and healthcare service costs are at an all-time high.

When it comes to buying health insurance, you may find the market brimming with choices. However, the real challenge often is how to choose health insurance. Read on as we discuss health insurance benefits and also the things to keep in mind when hoping to buy the best health insurance in India.

Benefits of Health Insurance in India

Before we delve into choosing the right policy, let us take a look at the various benefits of investing in a health insurance plan:

Financial Security

The rising medical costs can sometimes burn a hole in your pocket when it comes to hefty medical treatments like surgeries. In such times, having health insurance helps you save your hard-earned money. So, even during a health crisis, you need not worry about finances.

Cashless Claims

Under cashless claims, you do not need to pay the admissible medical bills from your pocket. Your insurer will pay the bills directly to the hospital on your behalf. All you have to do is visit one of the network hospitals. As in the case of Care Health Insurance, you get more than 11400+ network hospitals across India. 

Wide Medical Coverage

A comprehensive health insurance plan can help you get a wide range of medical coverage. From daycare to hospitalisation and pre and post-hospitalisation expenses, a health plan can help you cope with all these expenses.

Customisable Options

The option of riders is quite helpful in customising your chosen health insurance plan. Depending on your chosen plan, you will have to pay a small amount of extra premium for the additional coverage along with the base plan of your health plan.

Tax Saving Benefits

Health insurance offers tax deductions as well. Section 80D of the Income Tax Act, people below 60 years of age can avail of a tax deduction of up to ₹25,000 and those above 60 years of can avail a tax deduction of up to ₹1 lakh.

Mental Peace

Apart from the aforementioned benefits, a health insurance plan also offers mental peace. Amid medical emergencies, having mental peace is important for quick recovery. Since your medical expenses will be managed by your health insurer, you can better focus on recovery.

How to Choose Health Insurance?

Simply put, there is no one-size-fits-all approach here that you can stick to. Rather, there are several factors that you need to keep in mind; let us delve into each one of them:

Understand Your Health Insurance Needs

Is it individual, or is it for the entire family or for a particular member(s), such as your elderly parents or children who are to be covered under the policy? Do you suffer from any ailments? Are you planning to start a family soon? 

These are some of the questions that can help you chalk out your health insurance needs and accordingly choose the benefits of health insurance. In India where seeking good quality treatment can be expensive, opting for a comprehensive plan is recommended.

You also need to think about the sum insured that you need. With the cost of medical expenses rising every year, the coverage you take today might not even be relevant 5 years down the line. So, it is best to think of future costs and not merely select an amount you feel is necessary today. We advise first-time policyholders to choose at least INR 25 lakhs of cover.

Know the Types of Health Insurance 

Broadly, there are two types of health insurance policies. In a family health insurance plan, the coverage can include more members where the policy is a floater, and the sum insured can be applicable to any member of the family during hospitalisation. Then, there are policies especially meant for senior citizens aged above sixty years or more for covering sickness and health issues that are age-related.

Did you know the Senior Citizens Health Insurance Plan offered by Care Health Insurance covers over 540 daycare treatments?

Dig deep into the Policy Document

Reading the policy document is extremely important, as you will better understand the inclusions and exclusions. Check for the sub-limits under the conditions of hospitalisation, such as room rent, doctor consultation and visit charges, medical examination fee, cost of medicine, surgery, etc. Always make sure to check for these sub-limits before availing the sum insured for which you are paying under the policy. If you wish to be a participant in your health-related costs, you can choose the co-payment option to reduce the premium amount.

Prefer an Insurer with a Wider Network of Hospitals

Network hospitals give cashless treatment throughout the country. With the help of your policy number, you can get cashless treatment in any of the health insurance company’s empanelled hospitals. This is the preferred mode of treatment to avail under health policy as it is free of any reimbursement-related formalities, which can sometimes be cumbersome. Go for the policy that offers an extensive list of network hospitals or the ones in your vicinity.

Did you know that Care Health Insurance offers cashless hospitalisation benefits at over 24800+ healthcare centres all across the country?

Include Alternate Treatments if Need be

Your health insurance should be comprehensive in the truest sense. Like today apart from covering allopathic treatments, health insurance companies also cover non-allopathic ones such as Ayurveda, Unani, Homoeopathy & Siddha. If you or your family members prefer an alternate line of treatment, you can get coverage for that as well.

Keep an Eye on Additional Benefits

Health insurance plans may offer some distinct features. Look out for the following:

• Wellness Benefit: Some health insurance policies offer preventive healthcare and annual health check-ups to promote a healthy lifestyle. 
• PED Waiver: With this benefit, the waiting period for pre-existing illness can be waived as per the policy terms.
• Cumulative Bonus Super: With this add-on, one can boost SI amount by up to 500% in 5 consecutive years.
• Air Ambulance Cover: Expenses of shifting patients via air is covered

*For a complete list of add-on covers, kindly refer to the policy document.

Always go for a Reliable Health Insurer

The next most important factor is the servicing commitment of the company. One must look for a company that has the best claims settlement ratio & the turn-around time in which they settle their claims. The company’s credibility counts and you should check the ICR, i.e. the Incurred Claim Ratio. Compare the ICR of the companies that are calculated each year from the amount settled as claims against the amount collected as premiums. 

Relying solely on an Employer’s Health Insurance May Not be Sufficient

If the organisation where you are employed takes care of your health needs for you and your dependents, there is nothing like it, as the payment of the premium shall be covered by the company under your cost to the company. However, you should still opt for health insurance as the same policy will no longer cover you the moment you leave the organisation.

A Low Premium does not mean the Best Choice

While the health plan with the lowest premium might seem attractive, it is not always the best choice. Yes, you should be on the lookout for a decent and affordable plan, but make sure to keep a careful eye on the coverage as well.

Renewing the Policy is Crucial

Always renew your policy on time by asking your insurance company for any more benefits that can be added based on your credentials with the insurer. You can also increase the amount as you age or based on your health conditions.

Types of Health Insurance Plans

Choosing the right health insurance plan is not a cakewalk, but it gets easier once you understand your needs and expectations. There are a variety of health insurance plans, each tailored to cater to those specific needs. Let’s catch up over a rundown of the most popular types of health insurance plans available in India:

Individual Health Insurance Plans: These plans are perfect for individuals and cover medical expenses, including hospitalisation, surgeries, and pre and post-hospitalisation costs.

Family Floater Plans: Family floater plans help you secure your entire family against medical mishaps! These plans are cost-effective guards that help each family member with a common coverage limit.

Senior Citizen Health Insurance: Senior citizen health insurance plans, tailored specifically for people aged 60 and above, provide coverage for pre-existing conditions. These plans often require minimal waiting periods.

Critical Illness Plans: These health insurance plans offer a lump-sum benefit, which can be availed of if/when you are diagnosed with a specified critical illness, like heart attack or cancer. This plan has been designed especially to help manage the high costs of serious medical treatments.

Group Health Insurance: Employer-provided plans cover a group of individuals under a single policy, usually with fewer benefits than standalone plans.

Tips for Comparing Health Insurance Plans

Comparing health insurance plans makes sure you make the best use of your money. Here’s  what you should evaluate:

• Claim settlement ratio: Opt for insurers with a high CSR, as it reflects their efficiency in processing as well as settling claims promptly.
• Co-payment: Check if the health insurance plan requires you to make a co-payment (sharing the medical expenses). Note that a higher co-payment will reduce premiums but might boost out-of-pocket costs during claims.
• Sub-limits: Some plans cap the amount reimbursed for room rents or specific treatments. Choose a policy with minimal or no sub-limits for better coverage flexibility.
• Exclusions in coverage: Review the list of exclusions to avoid surprises later. This could include waiting periods for pre-existing conditions or treatments not covered by the plan.

Importance of Reading Policy Documents

Reading health insurance policy documents may seem tiresome, but it is crucial to review the wording to avoid any misunderstandings later. These documents walk you through detailed information about inclusions and exclusions, along with the terms and conditions of your coverage. These plans outline key features such as sub-limits, claim procedures, and waiting periods. By reading the finer details upfront, you can avoid gaps and make sure your plan aligns with your needs.

Wrapping Up!

A health insurance plan can be one of your wisest investments. It helps you keep your hard-earned money safe. Also, when you have a financial backup, you need not compromise but get the best possible medical treatment. It is best to purchase a plan as early as possible as it typically charges you less premium at a young age. So, now is the right time to invest in a health insurance plan of your choice.

Disclaimers: All plan features, benefits, coverage, and claims underwriting are subject to policy terms and conditions. Kindly refer to the brochure, sales prospectus, and policy documents carefully.