The Ultimate Guide for Health Insurance

If you have clicked the link, then you are interested for a health insurance might be for youself or elderly parents. But with tons of choices and conditions to look for and not sure which one to trust, we never end up buying one. With the covid-19 like dieseas hitting the globe, having a good insurnace becomes mandatory.

Health insurance is a must have thing for today. For a middle class family, a hospital bill for few lakhs can really hit their finances. Its importance got more highlighted during times of covid peaks. But irrespective of outside factors, one should have one atleast for their parents and elderly ones.

The important points to consider are :

1. Cover Amount : It is the total amount one can claim under the policy for any type of issues be it acidental, diesease etc. In India, healthcare inflation is 14% which is way higher for any normal pocket to bear. So, if going for parents and elderly, a cover of atleast 10 lakhs should be taken. A family floater policy can be taken which covers both father and mother.

2. No claim bonus: It is the amount that gets added to the total cover amount in case one does not makes a claim in a year of policy issuance. Generally it varies from 10% to 50%.

For example : a 50% NCB for a 10 lakh policy will make total cover amount to 15 lakh ater Year 2 and 20 lakh in year 3. The amount is capped at 100% of base cover.

3. Pre - Existing Diseases : In case one is having some pre - exisinting conditions like high BP, dibetes or any chronic issues, this needs to be declared at time of polivy buying. A claim for such diseases can be taken after a certain cool off period. It varies from insurer to insurer but a genuine time is 2 years.

This does not applies to a condition when person is not aware at all about the conditions. Like some diseases which takes years to show symptoms might come up after just 6 months of policy.

4. Disease Wise Limit : Insurance agents generally never discuss this point. But one should ask for disease wise limits if one is suffering from conditions. Limits to be asked for : Eye surgeries, preventive surgeries, open heart surgery etc.

5. Room Rent Limit : This is the most crucial point to be considered if all other points are factored in. It is the max rent of a room the insurer will pay in case of hospitalization.

All the bills while the time a hospital are attached to th room rent only.

6. Incurred Claim Ratio : This is the least talked about point. Most agents will discuss about claim settlement ratio bragging it to be above 95%. This is the ratio of total claim amount paid by the company to total premium collected in a financial year.

Lets say at company has a ICR of 70%, it means it paid Rs 70 for every Rs100 it collects from the customers. A good number is between 60 to 80.

7. Network Hospitals : Check if the policy covers hospitalization at your preferred hospital or if you need to switch to a network hospital for coverage.

The best companies in today's condition for a policy are HDFC Ergo, ICICI Prudential, Edelweiss, Liberty Insurance.

Tips for making the most of your health insurance

Here are a few tips that can help you make the most of your health insurance policy -

• Read the policy documents carefully: It is important to read the policy documents carefully and understand the inclusions, exclusions, and the claim process.

• Pre-authorization: If you are planning to get hospitalized, it is important to get a pre-authorization from your insurer. This will ensure that your claim is processed quickly.

• Use the cashless facility: Most health insurance policies provide the facility of cashless hospitalization. This means that you can avail medical treatments without having to pay any money upfront.

• No claim bonus: Most health insurance policies provide the facility of no claim bonus. This means that if you do not make any claims in a year, you will be eligible for a bonus that can be used to reduce the premium in the subsequent year.

We hope that this article has been helpful in providing you with an insight into health insurance in India. If you have any queries, feel free to reach out to us. We are always happy to help!