10 Practical Tips to Choose the Right Health Insurance

8/12/2019 10 Practical Tips to Choose the Right Health Insurance

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If you are planning to start a family, ask the company about their maternity clause. Many

companies do not cover costs of delivery or of any complications arising from that.

8. Read reviews and compare policies:

In the case of a medical emergency it is important that you and our family have complete peace

of mind when it comes to money matters. Therefore, talk to your friends who might have the

same policy, or read reviews about the policy you are about to buy. Another good tool is to

compare policies. Knowing that the company takes care of your finances seamlessly is importantfor a smooth stay at the hospital and a stress free recovery.

9. Check flexibility of the policy:

In the case of an illness, it important that the company allows the insured person to have some

flexibility in paying the premium for the amount used. A premium is recalculated at the end of a

policy year and is increased depending on the amount the policy has been used. Therefore it is

important that the policy you choose allows you the leeway of paying older premium amount forsome time, after which you can start paying the increased premium without interest or other

charges levied on it.

10. Check if the company offers a no-claim bonus or discount:

If you havent claimed any insurance in the policy year, some companies offer either a bonus

amount or a discount on the premium in the next year. This is called a no-claim bonus or

discount. This is a good feature and also an incentive to keep yourself fit and healthy.

Bajaj Allianz Family Floater Health Guard is an all-round health insurance policy that covers

you and your family against medical expenses such as hospitalization, doctors consultation,

diagnostic tests, medicines, ambulance, etc. With Bajaj Allianz Health Guard you and yourfamily can afford the best treatment without having to worry about expenses and at a hospital of

your choice.Click here for more information about this health insurance plan.

Here are some related articles that you would like to read:

Our focus should be more on health assurance than health insurance says Narendra Modi

5 to-dos for using your health insurance well

New health insurance product ensures complete reimbursement in case of death

Should bariatric surgery be included under insurance cover?

New health insurance grid to ensure transparency and better pricing

How to Choose Best Health Insurance in

India

by Manish Chauhan 776 comments

Today we will find out how to Choose Best Health Insurancein India . With so many Insurance

companies , so many health insurance policies with different names and complex features, it
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becomes an impossible task for a common man to pick a policy and be confident about it . So I

requestedMahavir Choprafrommedimanage.com,a vetern in the Health Insurance sectorhaving a vast experience to give some insights to readers on how to choose health insurance

product and explain the think step wise. Medimanage is a health insurance broker, which blends

unbiased Health Insurance Expertise, Technology Powered Delivery and Professional Claims

Management into one integrated service model. Over to Mahavir from here on -

Health Insurance, as its known worldwide is the only effective mechanism known and available

that can ensure you to get the best healthcare at affordable price. Whereas, the healthcare

industry being more organized abroad, has resulted in insurance companies offering morecomprehensive range of products overseas. Comparing this to the Indian Healthcare system, in

its current form, can be actually be called by Hospitalization Insurance. The products that are

available in country, only covers for the expenses related to hospitalization charges for accidentsas well as sickness. This benefit of course is subject to a looooong list of term and conditions.

Manish asked me to be very specific, and give the readers (of JagoInvestor.com, a blog I admirefor its simplicity and rich content) a clear take away on how they can zero in the best product in
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man, life expectancy in India will move higher from the current average of around 70 years. A

product with a lower renewal ceasing age than 70 years is a complete no no.

Bottom-line: An insurance product which does not work, when you most need it, is notinsurance.

4. Look for Limits (Treatment wise limits & Copay)

Look for treatment wise limits in the products. Treatment wise limits basically cap the amountyou can claim for a particular surgery under the policy. Say, there could be limits for Cardiac

treatments of Rs. 1.50 Lakhs or for Cataract for Rs. 20000 per eye. Such limits would cap your

claim, even n when you have a large sum insured under the policy. You need to weigh this in,

before you sign up. Some products I remember are United Indias Family Medicare, StarHealths Red Carpet have such limits. Bajaj Allianz General and ICICI Lombard have a limit

only for Cataract. (Max Bupa Review)
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Another condition is theCOPAYit is basically the share of admissible claim that the customer

would have to pay from their own pocket. For instance, with copay option of 10%, the claimamount is of Rs. 50,000, and the admissible claim is Rs. 48,000 then the copay amount would be

Rs. 4800. The Total amount you would have to pay is Rs. 6800/- (Rs. 2000 deduction in the

policy + Rs. 4800 of Copay) .

Couple of products which have Copay

Oriental Happy Family Floater at 10% of the Sum Insured upto Rs. 5 Lakhs Sum Insured.

Bajaj Allianz has a copay of 10% for treatment at Non-Network Hospitals in their Health Guard

products, and 20% in Silver Health.

Star Senior Citizen Red Carpet has a copay of 30%. For Pre-existing the copay is 50%.

Bottom-line: Know what you will not get paid.

5. Understand Day wise Cash limit Health Products

There are some products marketed and sold as Health Insurance (Aegon Religare Life, Tata AIG

General are the popular ones) which provide a daily cash benefit for the no. of days one is

hospitalization. Most surgeries require an average of 6-10 days, so at the Rs. 5000 per day limit
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multiplied by 10 Days would pay Rs. 50000 per hospitalization, irrespective of the actual charges

incurred. An Angioplasty in this will unknowingly burn a big hole in your pocket. Please avoidthis product for your core healthcare expenditure risks or as an alternative to a Standard Health

Insurance product. This product is more like an add-on cover, than the bigger solution.

Important Note: Do not confuse the above with products that have specific limits on Room

Rent. Room Rent Limits, to an extent, make sense both for the customer, as well as the Insurance

Company, as they categorize people paying a higher premium in the higher eligibility bracket.

This has been further discussed in detail below in this article.

Bottom-line: All plans which are called Health Insurance may not be what you are looking for.

6. Zero in on a Coverage amount/Sum Insured

Sum Insured is the total annual liability

under the policy. Since this is a long-term product, you should look at the maximum availablecover you can afford. Remember, a sum insured of Rs. 2 to 3 Lakhs will have no value, by the

time you start using it. As per a very recent report on Healthcare in India by Tower Watson, the

medical inflation in India is rocketing anywhere between 17 to 20% annual

Option of Upgrading Sum Insured:The option of upgrading the cover at a later stage when

you are older is dicey and complicated. There could be a requirement for a medical test.Moreover, if you or any of the family members contact a new disease in the interim, the ailment

would be excluded for the upgraded amount. Upgrade would be almost like taking a new policy

at that age, which I would not recommend.

Bottom-line: Look for the highest cover affordable. An I-will-upgrade-it-later option may not

work.

7. Compare Premiums for age bands higher than 45 years

Premium in Health Insurance increases as per increase in your age, but, theres something about

the no. 45. Insurance Companies dislike this no. Have a look at the rate charts, and you will be

surprised to see good jump in premiums after one cross the age of 45 yrs. In some cases, theincrease in premium is as high as 50%. You need to factor this, before you sign up. Ensure

premium remains affordable in your retirement days, and does not kill your hard-earned

retirement savings.


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Note: You need to factor in that these premium charts can change even tomorrow, like they have

changed earlier, but looking at the current charts for older brackets would get you a flavour ofthe companys pricing philosophy for older age bands.

Bottom-line: Know how the premiums change in the long run.

8. Credibility, Check. Look at the history of the company

If it is a new company, you could look at thehistory of the promotersand their businesses.Generally, a company or set of promoters known for their ethics and excellent governance,venturing out into Insurance would be a decent bet. Get information from your advisor, on the

overall claims experience, on responsiveness, about changes and number of changes in the

product, since it was launched. Too many or too large changes, indicates there could be moretomorrow.

Bottom-line: History in the best teacher.

9. Products for older age/Senior Citizen family members.

Most Insurers, including the ones specialized in Health Insurance resist covering membersabove 45 years. Remember, you need to somewhere take the responsibility of not covering your

parents, earlier in their life, and not completely blame Insurance Companies for not coveringthem, now.

There is no perfect product available for Senior Citizens. All products for senior citizens arerestrictive. You need to settle for a product, best affordable to you, even if it has co-pay,

exclusions and other restrictions. Again, if your parents have existing ailments, then this

becomes more complicated.
https://www.ppfas.net/blog/2011/05/14/why-promoters-cheat/https://www.ppfas.net/blog/2011/05/14/why-promoters-cheat/https://www.ppfas.net/blog/2011/05/14/why-promoters-cheat/https://www.ppfas.net/blog/2011/05/14/why-promoters-cheat/


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hence would be very responsive. Public Sector, are the Governments mechanism to ensure a

great healthcare infrastructure, and hence somewhat have a social angle, changes in the policyare not driven only by profits but also need to socially acceptable. You need to understand the

pros and cons diligently and hence set your own expectations right for your choice.

12. Finally, Ensure you have a Good Advisor

I have always said this, ensure you spend good time in deciding, who is your intermediary. Once

you have taken pain to finalize a good advisor, you are more than half way done. A good advisoris one who would provide -

a) Unbiased advice, without any special affiliation to any Insurance Company.

b) Provides Routine services like Pickups, Renewals etc.c) Assists and Guides you at the time of Claims.

Health Insurance industry is witnessing huge changes both in products, price as well as

processes, being an insider, it is sensible to have an expert on your side, who updates you onchanges, their impact on your coverage and suggest change in course, in case necessary.

Bottom-line: Insurance Companies will always have their own vested interests. Have someoneon your side.

Note: The other terms & benefits comparable are Pre and Post Hospitalization, Benefits like NoClaim Bonus/Discount, Loading of Premium, 1-2 or 4 year waiting Period for Specified

Ailments have not been considered as they do not make a very big impact on the decision to

purchase Health Insurance.

Documents

10 Practical Tips to Choose the Right Health Insurance