12 Things to Keep in Mind When Choosing Health Insurance Plans for Family

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12 Things to Keep in Mind When Choosing Health Insurance Plans for Family

The emergence of the Covid-19 virus has disrupted the lives of many. All of a sudden, people made health-conscious decisions to stay away from the virus. Unfortunately, we required a pandemic to realize that mental and physical health stands as a priority over anything in your life. In the time being, the demand and importance of health insurance plans for families increased manifold. This underlines the importance of health insurance too.

Why Choose a Health Insurance Plan?

  • People plan for income, investments, and expenses. However, they often forget to keep a breathing space for any unexpected outflow due to health issues. The increased fast-food-driven lifestyle has an impact on rising physical and mental health diseases and so does its cost of treatment.
  • When a medical emergency arises, it’s always urgent and cannot be postponed. The hospitalization cost in any Tier 1 city in India can ramp up from Rs. 4,452 per day in a government hospital to Rs. 30,000 per for any intensive care unit in a private hospital. In case of any serious disease such as cancer, the cost can be Rs. 93,305 per day (Source: Forbes)
  • Hence, unplanned and unexpected medical costs are a financial dent. Medical inflation is on the rise and thus, the cost of treatment is rising at a higher rate. This is why the importance of health insurance plans for families has increased.
  • Monetary investments would help you in case of financial needs by earning returns. Similarly, health insurance would give you a hedge against unexpected hospitalization costs.
  • So, the next time you get a call from a medical insurance company, do not abruptly disconnect it! Take a pause and think about it.

How to Find Best Health insurance Plans

Here, we help you with checking some aspects while selecting the best suitable health insurance plans for your family.

 

Check whether you have an independent Health insurance policy – The first checkpoint

  • In case you are a salaried employee, check with your employer whether you are covered under the group medical insurance policy. Generally, your spouse, dependent children, and dependent parents are covered under such a policy. However, the plan would be ineffective if you leave the organization. Thus, you should supplement such plans with your medical insurance plan.
  • In case you are a self-employed individual, you have to take a comprehensive health plan for your family. In case the premium cost is not suitable for your budget, you may go ahead with a basic plan at first and then go for a top-up plan later on.

Check the coverage amount suitable for your needs

  • Choose a health insurance plan for the family that covers the transportation, pre- and post-hospitalization, daycare expenses, and all costs associated with the treatment. Also, while deciding the cover amount, check whether any family-specific disease is covered.
  • The coverage amount would be helpful only if it considers the medical needs of each family member.

Keep it affordable

  • You cannot go ahead with any abrupt coverage amount. The higher coverage amount comes with a higher premium cost. The premium is a pinch to your pocket and hence you have to check whether the cost is affordable as per your needs.
  • On the other hand, you should not derail your medical needs. Thus, consider a reasonable plan that suits your needs as well as your pocket. As your income level rises, you can review the coverage amount.

Compare the premiums

  • Check two things while comparing the plans viz., the coverage offered and the premium to be charged. This will help you pick what you actually need.

The exclusion list

  • The exclusion list specifies what is not included in the benefits offered. These are policy exclusions and differ for each insurer. There is some logic for such exclusion.
  • However, the common exclusions are the abuse of intoxicants or hallucinogenic substances such as intoxicating drugs and alcohol, experimental and unproven treatments, intentional self-injury, or attempted suicide while sane or insane, any insured person attempting to commit a breach of law with criminal intent, etc.

Comprehensive coverage benefits

  • Comprehensive coverage ensures that every possible medical expense is covered in the plan and you don’t need to spend from your pocket.
  • For example, if you had planned for a child, then check whether maternity benefits are covered. If anyone from your family frequently falls ill, check whether OPD expenses are covered.

Check the hospital network

  • At the time of a medical emergency, you don’t wish to focus on paying the bills. Hence, choose the insurance plan with the greater number of hospital networks. In networked hospitals, the hospitalization facility is cashless.
  • Cashless hospitalization increases your financial independence and convenience. The insurer will specify the list of hospitals with which the insurance has tied up. Check whether the said network hospitals are available in your city and then decide accordingly.

Check for coverage riders

  • Optional riders are the additional special coverages such as room rent rider, maternity rider, critical illness rider, etc. Optional coverage benefits come with an additional premium.
  • However, the additional premium is at a lower rate and increases the scope of your insurance policy.

Limits and sub-limits

  • Limits are applicable for the coverage benefits and sub-limits are applicable on the expenses.
  • In case the sum assured is lower, insurers provide a sublimit on the insurance plans. Sublimit is generally on the room rent. In case the rent is higher than the sublimit level, you don’t need to pay for excess cost rather your claim amount would be adjusted for the said difference.
  • On the other hand, health insurance plans for the family without any sublimit demand a higher premium amount.

Pre-existing disease waiting period

  • Pre-existing illness means the health issue which any of your family is presently suffering at the time of buying the health insurance plan. You have to inform the insurer of such a pre-existing condition. In such a case, the policy contains a condition for a waiting period before you can avail of the benefits. This is known as a pre-existing waiting period.
  • Hence, if any of your family members is suffering from a health issue, choose the plan with a lower waiting period. Else, you may choose the plan with a longer waiting period and save on the premium amount.

Check the claim settlement ratio

  • The claim settlement ratio refers to the number of claims settled against the total claims received. If the number of claims settled is higher, the ratio would rise.
  • Hence, while comparing two or more insurers, keep a check on this ratio. Rank the insurer in the order of higher claim settlement ratio.

Claim Process

  • Once any of your family has unfortunately met with an undesirable event, you want the medication to be faster and the claim settlement process to be quicker. Don’t you?
  • When you are at the hospital, the focus should be taking care of the family member at the bed and not at the claim process. Discuss the claim process with the insurer and also check reviews of the insurance holders.

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