At a young age, the last thing one expects is to fall seriously ill and be hospitalized. We feel invincible, like no one can harm us, so we never feel the need for protection. It is this attitude which leads to a lot of us having almost negligible coverage when we need to go to the hospital.
I was diagnosed with Dengue in 2019. My hospital bills came to around one lakh for four days at a private hospital. I did have health insurance from my employer, but not everybody does. And my insurance covered most of the expenses, but it got me thinking, what if the situation were more serious? What if I meet with an accident in the future? Is the insurance I have enough?
I immediately contacted the family advisor to get myself and my family a much better insurance policy with a high coverage.
There is a reason Virat Kohli uses body armour when he plays. He knows that no matter how good he is, one miscalculation can turn him into a vegetable. Even then, he doesn’t opt for something cheap just to do the job, he goes for the best in protection. This is exactly how Health Insurance works. So I’ve put together five must-knows that I’d say are essential when choosing a policy for yourself.
1. Coverage Amount
We must be smart while selecting health insurance, especially with regard to the coverage amount of the policy. Opt for the plan which provides a high coverage and treatment amount. In the advent of inflated medical expenses, even a basic surgery can cost between 4-5 lakh rupees. This is huge for the average middle class family. However, with the right coverage amount you will not have to spend a single penny.
It would be wise to invest in a plan that covers upto 5-10 lakhs. Of course, the higher the cover, the more the premium.
2. Compare Premiums and Sub-limits
Check the premiums from all providers and see which one gives you the best value for money. Paying a higher premium is not necessarily a bad thing if the service provided justifies the price. Speak to your advisor or visit aggregator websites, like Policy Bazaar, that help you compare various insurance plans.
Also check for sub-limits. Basically this means limits on per day expenses, the kind of room you want in case of hospitalization. You want a luxurious suite at a top hospital? Read the fine print.
3. Family Health Plan
Anyone will tell you, you get more ice cream in a family pack then an individual cup. Most health insurance plans are designed for individuals only. However as a family man/woman its best to look at floater plans that provide coverage for your entire family. This way you do not need to buy separate plans for each family member, they are all covered by a single premium.
This plan also makes sure that you pay a lower overall premium as compared to multiple plans with multiple premiums. Most importantly, in an emergency you won’t need to scour through a lot of documents to find data, everything will be in one place. Your parents may not be able to get insurance due to their age or certain illnesses, but with a floater plan you can them covered as well.
4. Higher Claim Settlement Ratio (CSR)
Very important! It’s all gloss and shine when you are buying an insurance policy. This is after all a business. You go about your days paying your premium on time. Then when the time comes for a claim to be made, the provider finds a loophole you didn’t even know existed and denies your claim, leaving you stuck with a bill worth lakhs and ultimately in debt.
This is why we look at the settlement ratio of a company. Do not rush in for the first policy you see, but also if they settle claims on time and in full as is the agreement. Simply put A high CSR indicates that the company is more likely to settle a claim without any hassles.
5. Network Hospitals
When you buy a car, a vital part is knowing whether you have enough service centres around you and whether parts are available easily. What’s the point of having a car with nobody to repair it for you?
That’s why a vital part of your health insurance plan, if you’re looking for cashless transactions, is finding the network hospitals linked to your insurance provider. If you or your family members are based in rural areas your provider may not have a network based there. Be very careful with this detail otherwise your plan will be pointless. Most major providers do tie up with all the best hospitals but you should be aware of it nonetheless.
Finally do not disregard online reviews. Go through everything you find about your provider. Speak to them about adding riders to your plan in case of medical emergencies as well. Look at medical exclusions and choose the plan with the least number of exclusions. In these uncertain times of the pandemic, choosing a plan that covers COVID-19 expenses would be advisable too.
As someone who has faced issues with their provider making me run from pillar to post and still not giving me my full coverage, I can tell you that I did the wise thing and got myself a comprehensive family plan, covering both my wife and myself. It took me one trip to a hospital to realize this, but I certainly hope you don’t wait that long or make the same mistake.
