How to Choose The Most Suitable Health Insurance cover ?

health insurance
health insurance

Buying a health insurance policy is absolutely vital in order to be financially prepared for unexpected expenses related to medical treatments. Health issues can pop up at any time without any warning. Hence, it is important to purchase a good health insurance cover to avoid spending excessively from one’s pocket.  

Multiple health insurance policies are available in the market. Hence, it can get confusing for you as a prospective policyholder to pick the most appropriate one. Once you are sure that you want to buy a health insurance cover, you need to figure out how to choose a policy that suits you the most. The cover that you buy should be suitable for your lifestyle, health conditions, age, number of family members, etc. 

Factors to Assess While Comparing Health Insurance Plans 

There are several factors that need to be evaluated when you want to pick the best health insurance cover for you. Some of the common ones are: 

  • Sub-limits: In health insurance, a sub-limit refers to the degree or level to which your insurer will reimburse your claims for the medical expenses incurred by you. 
  • Deductibles: A deductible refers to the specific amount that you pay for your medical treatment before your health insurance policy starts to pay.  
  • Co-pay: This is a commonly used term in health insurance. It refers to the fixed amount that you must pay for a particular medical treatment after you have paid your deductible for the policy. 
  • Waiting period: It is the timeframe during which a policyholder should wait before the health insurance coverage comes into force. 
  • Network of hospitals: Every insurer has a particular network of hospital. This network will have a fixed list of hospitals, health care providers, and clinics that will offer medical treatment at pre-determined rates to the policyholders of the health insurers that have tied up with them. 

Hence, before you select your health insurance cover, you need to ensure that you assess each of these factors and then pick one that suits your personal and family healthcare needs. 

Types of Health Insurance Covers Based on the Extent of Reimbursement 

Before you start to compare the health insurance plans that are available, you need to be aware of the different types of health insurance coverage offered in the market.  

In health insurance, there are 2 types of covers based on the extent of reimbursement. They are: 

  • Indemnity plan: Under this type of plan, you will get reimbursement only for your hospital expenses. This should ideally be one of the main components of your overall health insurance plan. It offers a basic type of coverage. 
  • Defined-benefit plan: Under this plan, you will receive a lump-sum amount as coverage, regardless of the expenses actually incurred on hospitalisation. 

 As per insurance experts, the best thing to do is buy an indemnity plan by choosing an individual or family floater policy. Along with this, you can take a defined-benefit plan by selecting any good critical illness plan. 

 Kinds of Health Insurance Covers Depending on the Coverage 

The most commonly seen type of health insurance coverage is the group health insurance cover. If you are working in an organisation, you may already have a basic health insurance plan in your name that is offered by your employer. You will typically receive health insurance coverage under a group health insurance plan purchased by your organisation. However, you need to keep in mind that this cover offers very limited coverage. It may not be sufficient for severe health conditions. 

 If you or your loved ones have to get hospitalised and if you have high medical bills, you may not be able to fully cover the expenses incurred on your medical care with the health insurance cover offered by your employer. Hence, it is always advisable to purchase a separate health insurance cover apart from your employer-provided health insurance. 

 Now, let us take a look at the 3 main kinds of health insurance covers available in India. You can read about both of them carefully and then make a decision. 

  • Individual health insurance cover: When you buy such a cover, you will receive coverage only for yourself and only you will be able to obtain the benefits of the policy. You will ideally receive coverage for costs related to hospitalisation, ambulance charges, doctor’s consultation charges, pre- and post-hospitalisation charges, and treatment expenses. This cover gives you the option to purchase exclusive policies for every member of your family. 

It makes sense to choose this cover if you are looking for a plan only for yourself and if you are single. It is also a good idea to buy this if your parents already have an existing health insurance plan in their own name. In case they do not, then they can buy a different policy, probably a senior citizen insurance plan. 

  • Family floater cover: With this cover, you can take care of all the medical costs of your entire family. A family floater policy will cover medical expenses of you, your spouse, your parents, and your children. You will not have to buy separate policies for different members of your family. 
  • Senior citizen insurance cover: This cover takes care of expenses incurred by a customer who is higher than 60 years old. When you choose this cover, you can get tailor-made coverage as well as facilities as medical needs typically tend to increase with age. Moreover, you can enjoy different tax benefits if you have a health insurance policy that is designed exclusively for senior citizens.  

  Depending on your age, healthcare requirements, and financial condition, you can choose the most appropriate health cover by selecting the sum insured of your choice.