Health insurance is a financial safety net that protects you in the event of a medical emergency. A health insurance coverage will cover any medical costs you may incur as a result of an accident, illness, or injury.
It is, in essence, a contract between you and your health insurance provider. It means that the insurer will cover some or all of your medical bills in exchange for a price (premium) that you will pay. In most cases, the insurer pays for your medical expenses in one of two ways:
- You don’t have to pay for a cashless therapy. The hospital is paid directly by the insurance provider.
- You can pay for your medical bills initially and then request reimbursement from your insurance company later.
Why Do You Need Health Coverage?
Purchasing health insurance is something that most people do not do voluntarily until it is too late. While there has been an increase in knowledge and intent to get health insurance, it is still not considered a priority. There is still a significant gap between intent and actual purchase.
Healthcare costs are rising faster than medical inflation; health insurance allows you to receive the treatment you need without cutting shortcuts due to a lack of cash.
To top it off, the premiums you pay are tax deductible up to a certain amount!
In a nutshell, health insurance is:
- Allows you to receive high-quality medical care without having to worry about excessive prices.
- Adds a layer of protection from the impact of medical inflation.
- Protect your savings in the event of a medical emergency.
- Most importantly, it helps you to focus on your and your family’s health rather than worrying about astronomical medical expenditures.
When is the best time to get a policy: now or later?
The sooner you start, the better. Let’s look at how to get a health insurance policy at different periods of life:
During the 20s,
When is the ideal time to buy a policy? You’re probably in good health, with few financial obligations and demands. Investing in a health insurance plan when you’re younger has its own set of benefits, such as better sum insurance for a lesser price, no medical checks, and so on.
Most crucially, you are guaranteed renewal of your insurance policy in India even if you file a claim, so by the time you reach an age where such medical costs are anticipated, you will have finished all of the waiting periods to file a claim. And extracover is added to your insurance for free after each claim-free year, which will be many!
in the 30s
This is the time when you’re in your 30s and you’re starting to settle down. You’ll most likely be married, planning a family, purchasing a home, and so forth. Add to it a growing number of lifestyle diseases that are harming the youth. All of these factors must be considered when purchasing a policy at this time. Expect a greater premium and a higher likelihood of winning.
40’s through 60’s
This is the point in your life when your financial responsibilities are likely to be at their highest. You’ll need a larger sum insured, which means greater premiums. Expect longer wait times if you have diabetes, hypertension, or other medical conditions. You’ll also want to think about add-on benefits to make sure you have the extra protection you need. Also, before purchasing the coverage, be prepared to undergo a medical examination. Medical screening is usually required for anyone above the age of 50.
People in their eighties and nineties
You will require a large sum insured with a high premium. A stage of life in which you anticipate receiving long-term care for major illnesses and hospitalization, among other things. Senior citizen health insurance is a good option. Investigate, compare, and select the best option. At this point, most policies include a co-pay provision, which means you will be responsible for a portion of the medical costs.
There are a variety of health insurance policies to choose from.
Individual plans and family floater plans are the two main types of health insurance plans available. In a few words, a family floater policy is “one plan to cover them all,” whereas individual coverage is “different strokes for different persons.” Your decision will be based solely on considerations such as your age, the ages of your children, your medical history, and your budget.
It is critical that you fully comprehend both types in order to make an informed selection that is best for you and your family.
Coverage for each person
An individual health insurance policy is one that is issued in one person’s name. This indicates that the full sum insured is committed to the insured. If you are the policyholder and require hospitalization, for example, the insurer will reimburse your expenses up to the amount covered. Any remaining funds will be available for use for the remainder of the insurance duration.
Floater cover for the whole family
This plan provides coverage for the entire family under a single policy. Floaters, unlike individual health insurance, compel all insured members to split the total amount insured.
For example, if you buy a plan for yourself, your spouse, and your child for INR 4 lakh, the insurer will cover all three of you up to that amount, regardless of who gets hospitalized. Only the oldest family member’s age is taken into account when calculating the premium. This could work in your favor if you’re a young parent with tiny children. You’ll be able to receive coverage for your loved ones at a low cost.
- If you want to cover your elderly parents, instead of purchasing a family floater, purchase separate plans for yourself and your parents. This will be more cost effective. The premium for the family floater option is normally pegged to the oldest person in the family, so if you and your parents are both on the same plan, your premium would almost certainly be greater.
- In addition, if you have a sick family member who is expected to claim a large portion of your insurance, an individual coverage may be the better choice.
Consider These Factors When Choosing a Health Insurance Policy
Here are some crucial factors to think about while selecting a health insurance plan. Remember to purchase a comprehensive health insurance plan that is best suited for you and your family.
1. Coverage Comprehensiveness
Consider the cost of medical procedures now, the rate of inflation, and your present needs when determining the amount of coverage or ‘Sum Insured.’ Every year when you renew your policy, reevaluate the coverage you require.
The premium you pay is determined by a number of criteria, including the amount of coverage you choose (sum insured), your age, your medical history, the type of plan you choose, and so on. When weighing your alternatives, search for an insurance carrier that provides you with the majority of the features and benefits you want at the best available price. Premium is crucial to consider, but it should not be the key reason in making a purchase.
3. Understand what is and is not included.
When purchasing a policy, make sure to read the fine print to see what’s covered and what conditions prevent you from filing a claim. Having clarification now saves you the time and aggravation of later claim rejections.
4. Sub-limits on room rental
The maximum room rent coverage allowed under your health insurance policy is specified by the room rent limit. The restrictions for room rent and capping vary per health insurance company, and will be explicitly stated in the policy document. Make sure you understand how the room rent limit works before purchasing a health insurance coverage so you can make an informed decision. Consider this issue in relation to the type of room and hospital you wish to visit.
5. a hospital network
Look for a list of hospitals that accept cashless payments as part of the program. Choose an insurance that covers a large number of hospitals. If you travel regularly, you should also look into worldwide hospital networks.
This provision allows you to save money on your health insurance premium by agreeing to pay a fixed proportion of all claims filed during the policy year. If you choose co-pay, you can choose the percentage you want to commit right from the start.
7. Waiting time
This is the time frame in which claims will be rejected. The waiting periods for certain policies vary. The waiting period is longer for cases involving pre-existing conditions. Choose an insurance with the shortest possible waiting period.
8. Illness that is life-threatening
Critical illnesses such as heart attacks, strokes, and cancer are becoming more common. The expense of treatment for many life-threatening disorders is also extremely significant. It is recommended that you select a health plan that will cover these costs if they arise. It is an additional cost, so please consider your needs and purchase it if you can.
9. Bonus with no claim (NCB)
This is the bonus you get from your insurance company if you don’t file a claim during the policy year. The bonus could be in the form of a discount on your next year’s insurance premium, or it could be a bigger sum insured for the same price. Make an informed decision!
10. Procedures for day care
Certain medical operations, such as cataract surgery, can be completed in a single day and do not necessitate hospitalization. As a result, it’s critical to understand whether such therapies are covered by your insurance plan.
11. Treatments that are different
Ayurveda, yoga, unani, siddha, and homoeopathy (AYUSH) treatments are increasing popularity and are becoming favored therapeutic options for many individuals. Alternative treatments are now covered by most health insurance plans. If you prefer Ayurveda to allopathic medicine, make sure your insurance covers it.
12. The insurance company’s reputation
Consider claim settlement ratios, solvency ratios, customer service, product portfolios, and other criteria.
What Your Insurance Doesn’t Cover: Exclusions
Here are some frequent health policy exclusions. However, check and understand the exclusions before making your decision, as they vary from insurance to coverage.
- There are a few pre-existing conditions that you should be aware of.
- Non-prescription medications
- War, terrorism, and suicide-related injuries
How to Purchase a Policy
The simplest way to purchase your coverage in today’s digital age is to go online and do so:
1. Get complete information about the many health insurance products that are available based on your needs. At a time and place that is convenient for you, research and compare insurance.
2. It’s a complete do-it-yourself (DIY) project. Even if you require the services of an agent, you can do so online in only a few clicks.
3. If you’re looking for a basic health insurance policy, buying it online might save you a lot of time – and in this time-starved day, time is money.
4. There is no need for paper or physical signatures.
You may have heard that health is wealth, however given the unpredictable nature of life, in addition to excellent habits and a healthy lifestyle, good health requires some riches or money. And having health insurance can make it much easier to get that money when you really need it.