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5 Factors to Consider Before Buying Medical Insurance

In our country, the inflation in healthcare cost is constantly on the rise. A critical illness in the family can plunge them into severe financial distress. This makes it inevitable to equip yourself and your loved ones with adequate health insurance.

There are many who would not purchase health insurance because they are already covered under the corporate health insurance umbrella of their employers. It should be noted that the group health insurance plan offered by employers do not safeguard the employee from all medical conditions. Effectively, the coverage of such policies is usually not comprehensive enough to support all your healthcare needs.

       You should identify if the employer’s healthcare plan offers protection for all your dependents.

       You should also check the type of illnesses that your employer’s health insurance plan covers. This is particularly significant if you or your dependent has a history of known medical conditions.

       If the employer’s group insurance does not offer you sufficient coverage, then you should ideally purchase additional health insurance for your needs.

However, there are a couple of things to keep in mind when you look for a suitable insurance plan:

1.      Your requirement - When planning to get your family insured, you need to consider:

a.      the age of each member of your family

b.      if anyone is suffering from chronic illnesses, and,

c.       the medical history of the family

You should be aware that most health insurance plans have a mandatory waiting period for medical conditions that are pre-existing. So, you should plan and apply for a health insurance policy accordingly. If relevant, it is a great idea to include maternity coverage in your policy. 

2.      Sum insured - This is one of the most critical factors that drive your decision on a health policy. The sum insured is effectively the maximum amount of cover that is provided for medical expenses in a policy year. There is a direct correlation between the sum insured and the policy premium. You can decide on your sum insured by exploring factors that form the basis of this value, such as, your area of residence (because medical expenses  are usually higher in metro cities), the medical history of your family, and your medical expenses in the recent past. If you need a greater amount as sum insured, you will be required to pay higher premiums. In effect, you need to confirm that the sum insured is sufficient to cover your medical requirements.

3.      Coverage - You can choose to obtain an individual health insurance policy or a family floater plan. If you have a family, it is advisable to purchase a family floater plan, as the per person premium will work out to be cheaper in comparison to multiple individual policy premiums. Only if any family member has some pre-existing health issues should you buy him/her an individual medical insurance, while the rest of the family is covered by a family floater plan.

4.      Exclusions - If anyone in your family suffers from an illness that is not covered by the policy, your claim will be rejected, and you will have to bear the expenses yourself. In order to avoid such unpleasant situations, you should be aware of the exclusions in your medical insurance. It is prudent to ensure that hereditary diseases are included in the coverage as well.

5.      Network hospitals - Cashless hospitalization facilities can only be availed at network hospitals. So, browse through the list of network hospitals in the policy and see if it is inclusive of the facilities that you generally visit. Also check if the empanelled hospitals have good reputation and provide quality services. Additionally, you should identify if the policy covers hospitals in other cities, as you should be able to access network hospitals wherever you travel in the country.

Buying a medical insurance policy should be a well-thought-out move. The above pointers will assist you in identifying one that best suits your needs.

In our country, the inflation in healthcare cost is constantly on the rise. A critical illness in the family can plunge them into severe financial distress. This makes it inevitable to equip yourself and your loved ones with adequate health insurance.

There are many who would not purchase health insurance because they are already covered under the corporate health insurance umbrella of their employers. It should be noted that the group health insurance plan offered by employers do not safeguard the employee from all medical conditions. Effectively, the coverage of such policies is usually not comprehensive enough to support all your healthcare needs.

       You should identify if the employer’s healthcare plan offers protection for all your dependents.

       You should also check the type of illnesses that your employer’s health insurance plan covers. This is particularly significant if you or your dependent has a history of known medical conditions.

       If the employer’s group insurance does not offer you sufficient coverage, then you should ideally purchase additional health insurance for your needs.

However, there are a couple of things to keep in mind when you look for a suitable insurance plan:

1.      Your requirement - When planning to get your family insured, you need to consider:

a.      the age of each member of your family

b.      if anyone is suffering from chronic illnesses, and,

c.       the medical history of the family

You should be aware that most health insurance plans have a mandatory waiting period for medical conditions that are pre-existing. So, you should plan and apply for a health insurance policy accordingly. If relevant, it is a great idea to include maternity coverage in your policy. 

2.      Sum insured - This is one of the most critical factors that drive your decision on a health policy. The sum insured is effectively the maximum amount of cover that is provided for medical expenses in a policy year. There is a direct correlation between the sum insured and the policy premium. You can decide on your sum insured by exploring factors that form the basis of this value, such as, your area of residence (because medical expenses  are usually higher in metro cities), the medical history of your family, and your medical expenses in the recent past. If you need a greater amount as sum insured, you will be required to pay higher premiums. In effect, you need to confirm that the sum insured is sufficient to cover your medical requirements.

3.      Coverage - You can choose to obtain an individual health insurance policy or a family floater plan. If you have a family, it is advisable to purchase a family floater plan, as the per person premium will work out to be cheaper in comparison to multiple individual policy premiums. Only if any family member has some pre-existing health issues should you buy him/her an individual medical insurance, while the rest of the family is covered by a family floater plan.

4.      Exclusions - If anyone in your family suffers from an illness that is not covered by the policy, your claim will be rejected, and you will have to bear the expenses yourself. In order to avoid such unpleasant situations, you should be aware of the exclusions in your medical insurance. It is prudent to ensure that hereditary diseases are included in the coverage as well.

5.      Network hospitals - Cashless hospitalization facilities can only be availed at network hospitals. So, browse through the list of network hospitals in the policy and see if it is inclusive of the facilities that you generally visit. Also check if the empanelled hospitals have good reputation and provide quality services. Additionally, you should identify if the policy covers hospitals in other cities, as you should be able to access network hospitals wherever you travel in the country.

Buying a medical insurance policy should be a well-thought-out move. The above pointers will assist you in identifying one that best suits your needs.

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Comments 1

shobhit mehrotra on Sunday, 23 September 2018 12:51

sir thanks for valuable points can you suggest your best medical insurance company out of available....

sir thanks for valuable points can you suggest your best medical insurance company out of available....
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