Health insurance provides for medical expenses to the insured in case of hospitalization, for more than 24 hours, caused due to illness or accident. Health insurance covers Medicare needed of individual or family for surgeries, nursing care, consultation fees, diagnostic tests, hospital accommodation etc. Health insurance also pays for regular checkups. The insured in return pays a specified amount called premium on an annual or bi-annual basis.
No one plans to get sick or hurt, but most people need medical care at some point. Health insurance covers these costs and offers many other important benefits.
Also called comprehensive or major medical, individual and family coverage is likely the first type of health insurance you might think of. It covers a wide range of services.
Features to be compared while purchasing a Health Insurance Policy
Room Rent is one of the major expenses you have to bear if any member of your family gets hospitalised; so some general insurance companies cap the maximum amount that they will pay under their health insurance plan. Generally such limit is to the extent of 1% of sum assured and in case of ICU (Intensive Care Unit) the maximum limit is 2% of sum assured. But there are various general insurance companies which do not have any maximum limit on room rent, so you should look for such health insurance plans.
Pre-Existing Diseases are those which you are suffering from before opting to buy a health insurance plan, and therefore insurance companies do not cover them from day 1 of your policy. They have a waiting period ranging from 2-4 years in which they will not be liable for any claim arising on account of your pre-existing disease. Therefore, you should look for health plans which will cover your existing disease and have the least number of years of waiting period.
Co-payment is a clause in health insurance plans that requires cost-sharing by the policyholder. Cost sharing is the specified percentage of the admissible claim amount. For instance, suppose you have a health insurance plan which has a 20% co-payment clause; so in case you are hospitalised and your claim amount is Rs. 1 lakh, then you as an insured would be liable to bear Rs. 20,000 (Rs 1,00,000 * 20%), while the rest--Rs 80,000--would be settled by the insurance company. Hence, you should look for health insurance plans which do not have any co-payment clause at any stage of your life.
Network hospitals are those which have a direct tie up with your health insurance company; so in case of a claim you can go for cashless facility. Cashless facility saves you from settling the bill amount with the hospital as the insurer directly settles your bill. You do not have to file for reimbursement.
In the years that you have not made any claim, the insurance companies also provide you with a no claim bonus. This has an effect of increasing your sum assured in the next renewal of the policy. Such a bonus can range from 10-50% for a claim-free year. Hence, you should look for a policy which provides you highest no claim bonus.
Once you buy a health insurance plan, you might feel relaxed that you have covered yourself and your family against any possible hospitalisation in future. But if you don't go through the exclusion section of your policy, then you might get surprises at the time of a claim. So before finalising on any health insurance plan go through it's exclusion and select the one which has the least number of exclusions and exclusions are clearly defined.
The premium you would pay is a vital aspect you should consider while buying a health insurance plan; but mind you, it shouldn't be paramount in your selection process. Just think, you buy a health plan with a very low premium without even taking into consideration the features of the policy. At the time of claim you learn that the insurance company is not liable to reimburse you as the cause for which you were hospitalized was not covered under the policy.