Key factors to consider while buying a health insurance policy

by April 18, 2017
Key factors to consider while buying a health insurance policy

After you save and before you start investing your money, it is advisable to create adequate cover for your life and safeguard your family with a health insurance policy. There are a few key factors that you must consider before buying a health insurance policy. This would ensure that you have the apt coverage on the health of your family. More importantly, an apt health insurance policy can help you to recover a significant amount of the cost towards your (or your dependants) treatment or hospitalization.

  1. Is the “cover” adequate? When you opt for health insurance, it is important to check if the “sum assured” in the policy is adequate to meet the anticipated medical expenses. You might want to ensure that the medical history of your dependents and you are factored in, the cost of treatment based on the treatment type and place you reside in is also taken into consideration.

  2. Is cashless hospitalization available? Health insurance companies are ensuring that their customers enjoy the benefit of cashless hospitalization and treatment across a list of hospitals that are a part of their affiliate network. This facility becomes very important as you may not always have liquid cash to settle the hospitalization bill. Hence, before buying a health insurance policy, you ought to check if the hospitals that you would go to is covered in the list of hospitals where your insurer offers a cashless facility.

  3. Is there any underlying exclusion? Some health insurers do not cover for pre-existing diseases or conditions. Some health insurers provide it only after a waiting period. To reduce the incidence of claim, some health insurers also exclude any disease or illness that arises from a pre-existing condition. For example, if you already have hypertension while opting for the health insurance policy, the insurer may exclude a stroke or kidney failure. In such cases, the insurance policy won’t come to your aid when you need it. Hence, checking such exclusions and getting clarity about them is very critical.

  4. Check for diseases/ conditions that are excluded in the policy: Every health insurance intends to suit the requirements of multiple customers. It also aims to reduce the incidence of claims from the insurance company’s sustainability point of view. There are many illnesses or conditions that the policy might have already excluded. It will be mentioned clearly in the details of the insurance policy. You must check this and ensure that such exclusions won’t affect the coverage and increase the cost of treatment for you and your family.

  5. Check for “Co-Pay” conditions: Insurance companies often introduce a co-pay feature to save themselves from treatments taken by their insured clients at very expensive hospitals. In such cases, you must pay a certain percentage of the treatment cost from your own pocket, despite the insurance. It is wise to check for such co-pay clause in the insurance document.

  6. Check for sub-limits”: Insurers may also create sub-limits for the treatment of certain disease or conditions. For example: The claim for a knee replacement procedure may be capped by the insurer at a certain amount. You will not be able to claim above this limit and hence, the remaining cost of the treatment would have to be borne by you.

  7. Check for transparency in premium pricing according to age: As you age, the cost of health insurance premium will be higher per annum. It is better to understand the outgo at a later age after retirement. If the insurance policy discloses this transparently, it can help you calculate your health insurance cost as time passes and will put you in a better position to decide the selection of the insurance policy.

While these are some of the factors that you need to consider, it is prudent to avail the services of a financial advisor. If the financial advisor is an insurance agent, affiliated to a certain insurance company, he will be biased towards the policy of his company. However, a financial advisor who is not working for an insurance company will be able to assess and analyse your health needs and identify the best policy to meet your requirements. So, take a wise financial decision today and safeguard the health of your loved ones and you. After all, health is wealth!







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