In today’s era of soaring medical costs, having a health insurance plan, commonly referred to as ‘Mediclaim,’ is essential. With one, you can avoid significant out-of-pocket expenses.
Recognising the importance of best health insurance plans for family is just the beginning. The next crucial step is choosing the best health insurance plan from today’s many available options. While some plans offer unique features, there are common aspects shared by all policies that you should assess before making a final decision.
Here are 7 key features to compare when purchasing a health plan:
Sub-limits on Room Rent
When a family member requires hospitalisation, room rent often constitutes a significant expense. Therefore, certain general insurance companies impose an upper limit on the amount they will cover within their health insurance plans. Typically, this limit is set at 1% of the total sum assured, and for intensive care units (ICUs), it can extend to 2% of the sum assured. However, some general insurance companies offer medical insurance plans with no maximum room rent limit. Hence, it is advisable to explore health plans that do not have such limitations.
Pre-existing Diseases
Pre-existing conditions refer to medical ailments you have before obtaining the best health insurance in India. As a result, insurance providers do not offer immediate coverage for these conditions when your policy begins. Instead, there is typically a waiting period of 2 to 4 years, during which the insurance company will not be responsible for any claims related to your pre-existing condition. Consequently, it’s advisable to seek medical insurance plans that offer coverage for your pre-existing conditions with the shortest waiting period possible.
Co-payment
Co-payment is a provision in health policies requiring the policyholder to share costs. This sharing involves a specified percentage of the eligible claim amount. To illustrate, let’s consider an example: If you have a health insurance plan with a 20% co-payment clause, and you’re hospitalised with a claim amount of ₹1 lakh, you, as the insured, would be responsible for covering ₹20,000 (which is 20% of ₹1,00,000), while the remaining ₹80,000 would be settled by the insurance company. Therefore, seeking health insurance plans that do not impose any co-payment requirement at any stage of your life is advisable.
Network Hospitals
Network hospitals are medical facilities directly partnered with your medical insurance provider. This partnership allows you to benefit from the cashless facility when making a claim. The cashless facility spares you from the hassle of paying the hospital bill upfront, as the insurance company handles the settlement directly on your behalf. Consequently, there’s no need to file a reimbursement claim since the insurance company has already handled it. It’s advisable to seek health insurance plans that offer a wide network of hospitals, particularly high-quality ones in your city.
No Claim Bonus (NCB)
In the years when you remain in good health and don’t need to make a health plan claim, insurance companies offer a No Claim Bonus (NCB). This bonus results in an increase in your sum assured during the next policy renewal. Typically, the NCB can range from 10% to 50% for each claim-free year. Therefore, seeking a policy that provides the highest possible NCB is advisable.
Exclusions
When you buy a medical insurance plan, you might feel secure, believing that you’ve protected yourself and your family from potential hospitalisation costs in the future. However, failing to review the exclusion section of your policy can lead to surprises when making a claim. Before finalising any health plan, carefully examine its exclusions and select one with the fewest and most clearly defined restrictions.
Premium
The premium you’ll pay is critical when purchasing a medical insurance plan. However, it should not be the sole focus of your selection process. Imagine you opt for a health plan with a very low premium without considering the policy’s features. When it’s time to make a claim, you discover that the insurance company won’t reimburse you because the cause of your hospitalisation isn’t covered under the policy. To avoid such situations, it’s crucial to fully understand all the policy features, ensuring you don’t find yourself burdened with a substantial hospital bill when recovering from health issues.
Wrapping Up
It’s essential to recognise that medical emergencies can arise unexpectedly. Therefore, having sufficient medical insurance coverage from a reputable provider like Niva Bupa, the best health insurance company is crucial for improved financial management during medical crises. Maintaining optimal insurance coverage is an integral component of financial planning. It helps you organise your finances and contributes to the attainment of long-term financial objectives.
