HomePersonal FinanceHealth InsuranceBuying a Health Insurance - 15 Key Factors to Consider

Buying a Health Insurance – 15 Key Factors to Consider

health insurance

Let’s assume you are buying a health insurance policy for yourself and your family. Obviously, you would like to select “Best health insurance policy” available in the market. But, how you will zero down to best health insurance policy? There are multiple health insurance companies which offer several options and choices. Jargons dealing with health insurance policies are confusing. If you are not careful in making a sensible choice you may end up putting your and your’ s family health at risk. In order to help you Here are 15 Key Factors to consider while buying a Health Insurance.

Buying a Health Insurance – 15 Key Factors to Consider

Claim Process

A claim process and time required for settlement plays a vital role while selecting health insurance policy. A process of claiming should be simpler. It should offer cashless benefit. A good customer support is an additional advantage you should look for.

Waiting Period

The waiting period is a time you have to wait before you can apply claim for the pre-existing disease. All health insurances have a waiting period regardless of brand. The waiting period varies from policy to policy. You should confirm with a provider about wait period. This will ease out when you want to raise a claim for a pre-existing disease.

Also Read – Best Health Insurance Plans in India

Lifetime Renewal

Lifetime renewal is another important factor to consider while buying a health insurance. There are many insurance policies where renewability is limited only up to 60-70 years. One should give higher weight to a policy which offers lifetime renewal facility. It is known fact that requirement of health insurance is higher in the old age, so it is better to purchase health insurance with lifetime renewal in the young age.

Room Rent Cap

Another crucial factor for the consideration is room rent charges. In case of hospitalization, it is obvious that you will be opting for a room at the hospital. A facility included in the room is charged.

It is recommended to select a policy which allows higher room amount. If a policy is purchased with some limited amount you need to pay the additional amount from your pocket.

Claim Ratio

A claim settlement ratio is another important factor for the consideration. There are several examples where an insurance claim is delayed or rejected by the insurance company. In order to avoid such situation, it is better to do a background research and study about IRDA claim settlement ratio. A higher claim settlement ratio helps you to build trust in the insurance company. It also gives comfort that you will not have any issue in settlement of the claim.

Network Hospitals

One should go through the detail of associated cashless hospital network while purchasing a health insurance. At the time of medical emergency cashless option plays a vital role as claim settlement take place directly with the insurer.

Maternity Benefits

Very few medical insurance policies offer whole maternity benefits. If you are recently married or expecting a child in future, you should check for available maternity benefit with the insurance policy. A cost of pregnancy is increasing maternity benefit provide help to withstand the cost.

Sub Limit

Sub Limit is a monetary cap that insurer places on health insurance claim. Sub Limits are applicable to hospital room rent, doctor’s consultant charges, ambulance charges and other medical procedure. The applicable sub-limit should be higher or health insurance should be without sub-limit.

Also Read – Best Health Insurance for Parents

Pre/Post Hospitalization

Another important factor to consider is pre and post hospitalization expenses. It is generally observed that medical treatment and medicine is required pre and post hospitalization. It is advisable to choose an insurance plan which covers pre/post hospitalization expenses.

Critical illness Coverage

Critical illness is diseases that can lead to permanent disability or death. Some examples of such diseases are cancer, kidney failure, paralysis, strokes etc. You need to make sure that these types of critical illness are covered in health insurance policy.

Sum Assured Restoration

Sum Assured Restoration is new services offered by many health insurance companies. If you have consumed entire sum assured within policy annual term, health insurer restores it for other disease or for another family member. If possible, opt for this feature. However, please note that premium for this facility is higher.

OPD Expense  

OPD Expense coverage is another factor. If your OPD expense is high, you should consider this feature while buying a health insurance. OPD expense means expense incurred for doctor’s fees, consultation charges, cost of medicine etc. You don’t need to be hospitalized to make this claim.

Also Read – Health Insurance Plans for NRI in India

Dental Treatment

A treatment of dentist is expensive in nature. Your health plan should give complete coverage including dental treatment cover.

No Claim Bonus

If you don’t file a claim for the longer duration, you will be eligible for No Claim Bonus. The bonus could be in terms of reduction in the premium amount or increase in coverage. You can consider this feature while evaluating health insurance.

Individual or Family Floater

The last factor for consideration is to opt for Individual or family floater plan. A family floater plan covers more than one family member for fixed cover. The entire coverage amount is shared by a family for the specific year. It is less expensive policy and suitable for younger family with less health risk. If your health risk is higher you will need individual health cover.

I hope 15 factors mentioned above will help you in selecting best health insurance policy.

If you have any queries about a selection of health insurance, please post it into the comment section.

Shitanshu Kapadia
Shitanshu Kapadia
Hi, I am Shitanshu founder of moneyexcel.com. I am engaged in blogging & Digital Marketing for 10 years. The purpose of this blog is to share my experience, knowledge and help people in managing money. Please note that the views expressed on this Blog are clarifications meant for reference and guidance of the readers to explore further on the topics. These should not be construed as investment , tax, financial advice or legal opinion. Please consult a qualified financial planner and do your own due diligence before making any investment decision.