Health Insurance Checklist

This list of key policy elements should help you understand what to look for in a good health insurance plan.

Must have Features

1 Don’t split the Bill

Insurance companies may encourage you to think about a co-payment provision, which would require you to pay a portion of the premium each time you file a claim. 10%, perhaps. 20%, perhaps. possibly as much as 30% of the whole cost. Therefore, unless you have no other option, choosing to co-pay might not be the wisest course of action.

2 Restrictions on room & room rent

Some insurance companies won't let you select the room of your choice. Rather, the room rent will be limited. Additionally, they will charge you more for all services provided in the accommodation, not just the fee, if you go over this limit. You will ultimately be responsible for paying a significant amount of the bill. Therefore, choose a policy with minimal constraints on this front.

3 Check for Disease Wise Sub-limits

It occurs when an insurer provides you a large amount of coverage (say 10 lakhs) for a small charge, but places limitations on how much of that coverage may be used for each illness. Therefore, in most situations, you will probably only have a portion of the 10 lakhs available.

4 Opt for pre and post-hospitalization care

No one becomes ill immediately. Before being admitted to the hospital, you will probably need to undergo a number of diagnostic procedures. Medication will be a concern when you are released from the hospital. These expenses can also mount up. Therefore, it's advisable to get a coverage that covers both pre- and post-hospital treatment.

5 Seek a Low Waiting Period

You will probably have to wait a certain amount of time before your insurer begins paying claims resulting from pre-existing conditions, such as diabetes, high blood pressure, or thyroid-related disorders. Usually, fewer than three years. Therefore, choosing a policy that minimizes waiting times is always preferable.

6 Coverage for daycare treatments

Dialysis, chemotherapy, and a speedy appendectomy. These processes could all take less than a day. Additionally, some insurers may not pay for these claims even if you are admitted to the hospital for treatment since they do not provide "daycare treatments."

7 Ask for restoration benefit

You purchase a family policy. You're in the hospital. You assert something. Your cover expires. Then another family member becomes ill a few days later. However, the cover has already been used. If your insurer restores your coverage each time you file a claim, it is the only thing that can assist you. Perhaps once, if not all the time? It is feasible. All you have to do is ask.

Good to have Features

1 Bonus in case you don’t make a claim

What happens if the insurance company gives you additional coverage each year that you avoid filing a claim? That sounds good, doesn't it? Guess what, though? Certain insurance plans do provide a significant amount of bonus coverage. Therefore, it could be wise to see if these perks are also covered by your coverage.

2 Free health checkups every year

Certain insurance plans cover your annual physicals. Therefore, these health examinations may be helpful if you want to ensure that you're always in the best possible shape.

3 Cover for consumables (Gloves, syringes, PPE Kits etc)

Throughout your hospital stay, have you noticed the gloves, syringes, masks, surgical tapes, and other surgical tools that are used up? They are typically not covered by most insurance companies, therefore you will be responsible for paying between 5% and 10% of the total hospital charge. Nevertheless, a number of policies that provide consumables coverage as an optional or built-in benefit have lately emerged. Choose just one of these all-inclusive plans, and you'll be set!

4 Domiciliary coverage

Hospitals and medical facilities are typically the focus of health insurance policies, aren't they? However, what if an insured person is compelled to receive care at home because of a shortage of hospital beds or certain mobility challenges? This is the benefit of having domiciliary coverage, which is now a standard component of all the best health insurance policies! Your insurer will pay for medical bills, practitioner fees, medical equipment rental costs, and more in the two situations listed!

5 Cover for Alternative treatments

If you’re into alternative medicine — Think Ayurveda, Yunani, Siddha etc, then you might want to check if your insurer covers these treatment options as well. 
faq

Frequently Asked Questions

  • 1. What are the best policies without co-payment?
    The majority of businesses provide co-payment-free plan extensions. However, we believe that HDFC Ergo Optima Secure, Care Supreme, and Aditya Birla Activ One are the top three co-payment-free insurance.
  • 2. How many days worth of pre and post-hospitalization expenses should a good policy cover?
  • 3. What essential daycare treatments should a good policy cover?
    dialysis, radiation, appendicectomies, chemotherapy, and stone removal.
  • 4. What are some essential features you need in a senior citizen policy?
    Waiting periods for pre-existing diseases must be brief, ideally less than three years. A co-payment condition is not appropriate. The policy must also be reasonably priced.
  • 5. What diseases do you not want to see in the disease-wise sub-limit list?
    Dialysis, chemotherapy, cataracts, and cardiovascular disorders.
  • 6. What are proportionate deductions within room rent limits?
    You will be responsible for paying the additional rent, which includes a portion of the cost of all services provided in the room, if the rent for the room exceeds the policy's maximum. To compute this percentage, divide the policy's limit by the actual room rent, subtract 1 from the ratio, and then multiply the result by 100.
  • 7. What are the essential features you need in a family floater plan?
    An excellent restoration benefit is that you don't want to run out of coverage because several family members become ill at the same time. An excellent 50% no-claim bonus will also increase your coverage in the case of an emergency. Free health examinations are quite beneficial, particularly if you have little children.
  • 8. What are the essential features you should look for when buying a policy for a married couple?
    Maternity benefits: You will probably be preparing for childbirth within a year or two after getting married. Therefore, if you have more cash to spare, purchasing a plan that extends maternity benefits makes sense. An excellent restoration benefit is that you don't want to run out of coverage because several family members become ill at the same time.
  • 9. What are some of the essential tests a free health checkup must include?
    HDL/LDL, urinalysis, lipid profile, and complete blood count.
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