Best Affordable Health Insurance Plans in India: Most Indians are one medical bill away from slipping into poverty. To safeguard yourself from such a situation, there are various medical insurance available in the market that can help you with finances during medical exigencies. With numerous plans available, selecting the right one can be overwhelming. This guide will equip you to make an informed decision by highlighting key factors to consider.
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Sharad Bajaj, chief operating officer of InsuranceDekho.com, told news18.com, “Before purchasing health insurance, several factors should be considered. Firstly, assess your coverage needs, taking into account specific medical and family requirements and the number of members to be covered under the policy. Additionally, verify that your preferred doctors and hospitals are included in the network, and evaluate associated costs, such as premiums, deductibles, co-payments, and out-of-pocket maximums.
Next, it is important to review coverage details, including inclusions, exclusions, and waiting periods for pre-existing medical conditions. Look into supplementary advantages like wellness programs and preventive care. It’s also very crucial to investigate the claim process, policy limits, renewability, portability, and customer service provided by the insurer. Consider the reputation of the insurer in the market. Lastly, ensure adherence to regulations and explore potential tax benefits associated with the chosen health insurance plan, he added.
The Detailed Guide To Purchase A Medical Insurance Policy
Coverage Needs
Individual or Family Plan: Decide if you need coverage just for yourself or your entire family. Consider future plans like having children when making this choice.
Hospitalisation Expenses: Estimate your potential hospital bill based on your city’s healthcare costs and your preferred hospital type (private/government). According to a recent survey, the average cost of a private hospital stay in a metro city can exceed Rs. 40,000 per day.
Pre-existing Conditions: Disclose any pre-existing illnesses like diabetes or heart disease. Plans might have waiting periods for availing coverage for these conditions. Aditya Birla Health Insurance’s ‘Activ One’ provides an option to cover pre-existing diseases from Day 1.
Policy Features
Sum Insured: This is the maximum amount the insurer will pay for your medical bills. Choose a sum insured that adequately covers your estimated hospitalization expenses. Consider factors like inflation when deciding the amount. As a general recommendation, a sum insured of Rs. 5 lakh or more is advisable in metros.
Room Rent Limits: Plans set limits on daily room rent charges covered during hospitalization. Choose a limit that aligns with your preferred hospital type (single room in a private hospital might have higher limits).
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Co-payment Clause: Some plans require you to share a portion of the hospitalization cost. This reduces the premium but increases your out-of-pocket expense.
Network Hospitals
Network Hospitals: These are hospitals where the insurance company has cashless tie-ups, allowing them to settle bills directly. Choose a plan with a network that includes hospitals you or your family frequent or those with good reputations. Leading companies with extensive network hospitals include Star Health Insurance, HDFC ERGO, and Aditya Birla Health Insurance.
Cashless Vs Reimbursement: Cashless hospitalization is convenient, but some plans might require reimbursement (you pay upfront and claim later).
Additional Benefits:
Maternity Coverage: If you plan to have children, opt for a plan that covers maternity expenses, including delivery and newborn care. Top performers in this category include Niva Bupa’s Aspire plan and Reliance Health’s Gain Policy.
Daycare Procedures: Some plans cover daycare procedures (procedures not requiring overnight stay). This can be beneficial for surgeries like cataract removal. Look for plans from companies like Care Health Insurance and ICICI Lombard that offer such coverage.
Preventive Health Check-ups: Certain plans offer free or discounted annual health check-ups, which can be a valuable benefit for early disease detection. HDFC ERGO’s Optima Secure plan and Star Health’s Assure plan are examples that include preventive health check-ups.
Claim Settlement Ratio
Claim Settlement Ratio (CSR): This ratio indicates the percentage of claims settled by the insurance company. A higher CSR signifies a higher likelihood of your claim being approved. According to Insurance Regulatory and Development Authority of India (IRDAI), Reliance General Health Insurance (98.65%) and HDFC Ergo Health Insurance (98.49%) have consistently maintained high CSRs (as of 2021-22 data).
Premium Vs Coverage
Strike a Balance: While a lower premium might be tempting, ensure the plan offers adequate coverage for your needs. Don’t compromise on essential benefits to save a small amount on the premium.
Read Policy Documents Thoroughly
Read the Policy Document: Carefully review the policy document to understand inclusions, exclusions, claim processes, and waiting periods.
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Compare Plans: Don’t settle for the first plan you see. Get quotes from different insurance companies and compare their offerings before making a decision.
By considering these factors and using the examples provided, you’ll be well-equipped to choose a health insurance plan that provides comprehensive coverage and peace of mind for you and your loved ones.
