+91-98111-67809Important Thing to Keep in Mind While Buying a Health Plan
Important Thing to Keep in Mind While Buying a Health Plan
Table of Contents
- Important Thing to Keep in Mind While Buying a Health Plan
- Get Expert Advice
- Get Expert Advice
- So What Is Health Insurance?
- Why We Must Have Health Insurance
- What to Keep in Mind Before Buying Health Insurance.
- 1. Cashless Treatment
- 2. Claim Settlement Ratio
- 3. No Claim Bonus
- 4. Waiting Period
- 5. Co-Pay Clause
- 6. Restoration
- 7. Pre and Post-Hospitalization Coverage
- 8. Day Care Facility
- Related Posts
- FAQs
Important Thing to Keep in Mind While Buying a Health Plan
Discover the importance of insurance, understand different types of policies, learn about coverage, claims processes, and even explore emerging trends in the industry.
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Get Expert Advice
Get Expert Advice
Get Expert Advice
Imagine, a sole bread earner of the family has been admitted to the hospital due to his critical health issue, and his wife has no idea of the finances in the family. She is so tense and confused that what has to be done now? What should she supposed to focus on? The hospital bills, her children, house EMI, etc. what should be done in this case? It feels like you are confused too!
No one wants to see themselves in such situations but what happened, if someday you found yourself in such a situation, are you prepared enough for such condition?
When it comes to health, a lot of us ignore this important part of life, we must understand the importance of health and health insurance, like why do we need health insurance? What should one seek before buying health insurance?
So What Is Health Insurance?
It is nothing but protection that covered you to get your expenses which you have already spent, either reimbursed or they get directly paid by the insurance company. For example, there are two possibilities. One is you pay the entire bill and that insurance company will repay the amount to you which is called reimbursement and the second possibility is that the insurance company will directly pay the amount to the hospital which is also known as the cashless.
Whenever we talked about insurance there are two main types of insurance that all must have, that are life insurance and health insurance. Why both?
Life insurance is the replacement of the income of the deceased person but health insurance will give you recovery of the expenses which you had spent on your hospitalization.
Why We Must Have Health Insurance
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Life is an important asset to everyone which is irreplaceable and priceless and unlike all priceless things, it must be kept insured and secure for oneself.
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It also saves savings, imagine one person took a year to earn 6 lakh rupees, it would probably take 2 years to save those 6 lakhs and it would only take almost a week to spend that money on a hospital bill, and this whole money is saved by the health insurance.
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It also deals with medical inflation, imagine a person had taken health insurance 7 years ago, do you think the hospital bill amount would be as same as the current time? No, like general inflation there is a possibility that there will be inflation in medical bills.
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It also helps to fight lifestyle diseases, many people have problems with diabetes, blood pressure, and obesity, which stays with a person lifelong, so it becomes more important to have proper health insurance to fight against these diseases.
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Insure early to stay secure lifelong with a low premium. Age is an important factor in health insurance for the premium amount if a person took health insurance in his early 30s then his premium amount would be much lower than that person in his 40s or more.
What to Keep in Mind Before Buying Health Insurance.
1. Cashless Treatment
Several health insurance plans include cashless treatment alternatives, which mean you may receive medical care at a network facility without paying any amount up to the coverage opted in health plan.
Instead, the hospitalisation expenses are paid directly by the insurance company for the approved medical expenditures. This may be incredibly handy and beneficial in medical situations since it helps you to focus on obtaining the treatment you need without having to worry about financial strain.
It is an important aspect for everyone and one ideally must opt for cashless treatment. Also while choosing a Network hospital it is important to check network hospitals in your area or city before buying a Health policy so that in case of emergency one should be aware of which hospital to approach first that too with cashless treatment.
Every insurance company has its network hospitals for the better treatment of the insured and always keep in mind that the network hospital should be very near to you so that you cannot have trouble while reaching the hospital. Always check the network hospital list of the insurance company in case of any treatment and for a cashless claim.
2. Claim Settlement Ratio
While selecting a health insurance plan, the claim settlement ratio is an important element to consider. It is the proportion of claims settled by an insurance company out of the total claims received during a certain time. A greater claim settlement ratio is typically regarded as a positive sign, indicating that the insurance company has an excellent track record of meeting its responsibilities to policyholders. On the other hand, settlement of claim also depends on policyholder, It is his responsibility to mention all the material facts like any disease, surgery in past and undergoing treatment etc. in the proposal form while purchasing health plan when selecting a health insurance plan, search for an insurance company with a high claim settlement ratio, since this can provide you with confidence in the company’s ability to offer quick and efficient financial aid in the case of a medical emergency. However, it is crucial to remember that the claim settlement percentage should not be the only aspect you evaluate, since there are other key factors to consider like premium rates, network hospitals, and coverage restrictions.
3. No Claim Bonus
No claim bonus is a benefit that is offered by some health insurance plans to policyholders who do not make any claims during a policy year. It is essentially a reward for staying healthy and not requiring medical treatment during the coverage period. Depending on the policy, no claim bonus can take the form of a discount on the next year’s premium, an increase in the coverage limit, or a combination of both. A no-claim bonus might be an excellent method to save money on health insurance premiums while still being healthy and taking care of your health. It is crucial to remember, however, that not all insurance policies include a no-claim incentive, and the terms and circumstances of the bonus might vary greatly between plans. When choosing a health insurance plan, seek policies that give a no-claim bonus and study the policy terms and conditions carefully to understand how the bonus works and what it covers. Imagine you pay for your premium and thankfully you are not hospitalized and from the next year the company will increase your coverage amount by 20 to 50% of the total amount and Depending on the plan you opted.
4. Waiting Period
Always seek a low waiting period because it is the most important thing in insurance. At least 30 days initial waiting period is given in the health insurance policy except for emergency hospitalization. For emergency hospitalization, you could apply for the claim within 30 days of the policy buying date. 30 days waiting period is applicable in all health plans but pre-existing waiting period varies from Plan to plan, if one has any illness should opt for less pre-existing disease waiting period.
5. Co-Pay Clause
Co-pay benefits are also an important factor to choose Health plans, co-pay is also known as co-payment, it’s the percentage of the claim amount which you agreed to pay at the time of claim. Imagine you have a cover of Rs 5 lakhs which have a co-pay clause of 20%, now suppose you have been admitted to the hospital and the total bill amount comes to around Rs 2.75 lakh, now there is a 20% of co-pay clause you have to pay 20% of the 2.75 lacks, so 55000 is going to be paid by your pocket and the balance is paid by the insurance company. The percentage of the co-pay could vary from company to company. One should opt for no co-pay policy, although the premium with co-payment policy is comparatively less but percentage of claim is to be paid by the insurer at the time of claim.
6. Restoration
Restoration benefits are also an important factor to choose Health plans. Imagine a person has a family floater health insurance policy of Rs 500000 and the person suffers a heart attack and the hospital bill ran up to Rs 450000. Now the wife of that person suffers an illness at the same time and got hospitalized. Now, what will happen because the person has already utilized all the coverage amount of the policy? How will the other members stay protected? Here comes the restore or recharge benefit, it helps you out when you or your family ran out of coverage amount and needed an additional layer of protection. It restores the coverage amount for all the family members to give them health coverage.
7. Pre and Post-Hospitalization Coverage
Pre and post-hospitalization coverage is an important feature to look for when choosing a health insurance plan. It refers to the coverage provided by the plan for medical expenses incurred before and after a hospitalization.
Pre-hospitalization includes a blood test, MRI, CT scan, consultancy fee, etc. and on the other hand, post-hospitalization can include therapy expenses, medicines, consultancy fee, etc. always check that these expenses must be given in your policy.
8. Day Care Facility
Day care facilities are also an important factor to choose Health plans because Medical science has improved a lot and nowadays surgeries are possible through lasers and patients get discharged in a few hours such surgeries are also covered in Health plans where 24-hour hospitalization is not required. Day care facility coverage is a common benefit provided by many health insurance plans and can be highly beneficial in terms of providing financial assistance for medical treatments that would not necessitate an overnight stay in a hospital, such as a dialysis, chemotherapy, cataract surgery, and tonsillectomy.
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FAQs
What Is Health Insurance, and Why Is It Essential?
Health insurance is a financial protection plan that helps cover the costs of medical expenses. It can be in the form of reimbursement or direct payment to healthcare providers. Health insurance is crucial because it provides financial security in case of unexpected medical emergencies, ensuring that you or your family won’t face crippling medical bills.
What's the Difference Between Health Insurance and Life Insurance?
Health insurance and life insurance serve different purposes. Life insurance provides financial support to your family in the event of your death, while health insurance covers medical expenses incurred during your lifetime. Both are essential, with health insurance safeguarding your financial well-being in case of illness or injury.
Why Should I Get Health Insurance Early in Life?
Obtaining health insurance at a younger age offers several advantages. Firstly, it results in lower premium costs. Secondly, it ensures that you have coverage in place to combat unexpected medical conditions as you age. Additionally, early enrollment helps protect against medical inflation, as hospital costs tend to rise over time.
What Should I Consider When Buying Health Insurance?
Several factors should be kept in mind while purchasing health insurance:
- Cashless Treatment: Opt for plans that offer cashless treatment to ease the financial burden during emergencies.
- Claim Settlement Ratio: Look for insurance companies with a high claim settlement ratio, indicating a track record of honoring claims promptly.
- No Claim Bonus: Consider policies that offer no-claim bonuses, providing discounts or increased coverage for staying healthy.
- Waiting Period: Choose plans with short waiting periods for pre-existing conditions, enabling you to get coverage sooner.
- Co-Pay Clause: Understand co-pay clauses that require you to pay a percentage of the claim amount and opt for policies with no co-pay if possible.
- Restoration: Seek plans with restoration benefits to ensure continued coverage if the initial coverage is exhausted.
- Pre and Post-Hospitalization Coverage: Ensure that your policy covers pre and post-hospitalization expenses.
- Day Care Facility: Verify if day care facilities are included for treatments that do not require extended hospital stays.
How Do I Find the Right Network Hospital for Cashless Treatment?
When choosing a health insurance plan, research and check the list of network hospitals in your area or city. It’s crucial to have a nearby network hospital for easy access during emergencies. You can often find this information on the insurance company’s website or by contacting their customer service. Knowing the nearest network hospital can help you receive timely and hassle-free cashless treatment.
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