With a large number of competing health insurance plans at your disposal in recent times,it is difficult to opt for the ideal Insurance Plan that is the most befitting for you. However, to minimalize the hassle of browsing through tons of options, let’s point out some necessaryfactors and features of health insurance plans that you must look for while making a decision.
Things to Consider Before Choosing Health Insurance Plan
- Cashless treatment at network hospitals all over the country.
- Cover for pre and post hospitalization expenses
- Reimbursement for routine medical expenses including check-ups and reimbursement of ambulance and ICU charges.
- In-patient hospitalization expenses including room rent and charge for medicines, doctor visits etc.
- Cover charges of treatment availed at home for the insured illness.
Exemptions
As against these, there are some standard exemptions which may be prevalent in all health insurance policies as under:
- No coverage during a waiting period, normally for 30 days after the policy commencement.For pre-existing diseases, the waiting period ranges from 2 to 4 years
- Critical illness gets coverage is subject to a waiting period of 2 to 3 years.
- Injuries caused by war or suicide are not covered unless they are specifically covered with higher premiums.
- Cosmetic surgeries and treatment by an under qualified medical practitioner are specifically excluded from coverage
Factors influencing Health Insurance Purchasing decision
The options therefore available to the prospective insurer are to look for the health insurance policy with features that best suits the insured. This could mean a network hospital near his home,lifelong renewal of policy with no age bar, ease of claim processing after a cashless treatment made available initially and of course, a comparison of the Incurred Claim Ratio (ICR) which should be above 50. The waiting period for exclusions also can be a differentiating feature.
Family Floater
Many company-sponsored Health insurance plans offer a family floater where all family members get covered under one umbrella policy with a high sum assured, with any actual reimbursement getting deducted from the overall sum assured.Quite popular with a lot of individuals, the one major setback is in case an aged parent is also covered and need hospitalization; it could wipe off the entire assured cover. So, the current advice to employed insured is to cover immediate family of spouse and children under a floater while opting for separate policies for the parents, to take care of any eventuality. Some insurers do not offer floater for entire families including parents, citing advanced age as a reason for non-inclusion.An interesting aspect of ICR for a public sector health care insurer showed a high ICR ratio of 114% which obviously resulted in losses for the company as they had gone on an aggressive campaign to get maximum clients.
It is therefore essential to compare the facilities offered before finalizing a health insurance provider as the benefit of continuity will be lost if the initial selection is not made judiciously.