After witnessing the financial hardships your neighbors went through on their son’s hospitalization, you have decided to opt for Buying Health Insurance. But on seeing the wide variety of mediclaim policies that are available in the market, you find yourself confused, worried and desperate for some sort of help!
In your search for an affordable health Insurance, there is a very high possibility that you end up focusing on the premium cost alone and ignore the other requisites such as exclusions (diseases not covered), policy sub limits and so on. Most times, even Health Insurance agents desist from giving out full information in regards with a mediclaim policy, the best option in times like this is to opt for a knowledgeable Health Insurance Broker!
But in case, you aren’t willing to opt for a Health Insurance Broker, here is a list of things that you must keep an eye out for when you are looking to buy Health Insurance in India,
Insurance Payment Options
Payment options are the first thing that you should look out for, other than the Premiums, when you want to buy a mediclaim policy. You must check whether the Health Insurance Company prefers the ‘Cashless’ method of payment or prefers to reimburse your dues after the claim has been filed for.
Though most Health Insurance companies now-a-days offer the Cashless facility as a payment option, it is best if you inquire beforehand as the cashless mode of payment offers you a hassle-free route of claiming your due.
What to look out for: Health Insurance Companies that favor the Cashless mode of payment.
Network Hospitals is a group of hospitals that have tied up with a Health Insurance Company or a TPA (Third Party Administrator). The main benefit offered by the Network hospitals is that they offer top quality service 24/7 which comes in handy in case of emergencies. Another benefit provided by the Network Hospitals is that they offer the cashless facility that lets you get admitted for free and thus reduces the financial burden on you during the hospitalization.
What to look out for: Opt for a health Insurance Company that has a higher number of Network Hospitals which again include a high number of reputed hospitals.
List of Policy Exclusions
Another important thing that you must pay attention to when buying Health Insurance in India is the List of Exclusions. This list contains the medical conditions that won’t be covered by the Health Insurance Company in their mediclaim policy. As of now the fixed exclusions are Dental Cosmetic Surgery and alternative therapies such as acupressure, acupuncture, yoga, massage, aromatherapy, reflexology and naturopathy.
What to look out for: A health Insurance Company that offers fewer exclusions.
Many Health Insurance Companies have a ‘Waiting Period’ when it comes to Pre existing Illnesses – Illnesses that the Insured had prior to buying the mediclaim policy. The Waiting Period is mainly between 1-4 years, varying from company to company. One must remember to choose the Health Insurance Company judiciously, as in case of a change to another Health Insurance Company, the waiting period will be lost i.e. if an insurer has completed 2 years of his 4 year waiting period and moves onto another company, the 2 years won’t be taken into account and he will be faced with an entirely new waiting period!
Another waiting period would be the ‘initial waiting period’, which requires the insured to wait for a certain period of time from the commencement of his policy until the first 30 days.
What to look out for: Health Insurance Companies that offer a lesser waiting period. (in terms of years when it comes to pre-existing illnesses)
It is important that you inquire about policy sub-limits before you buy the mediclaim policy as these sub-limits break the amount to be paid into smaller fractions wherein the Health Insurance Company bears some of the cost, while the insured bears the rest.
For E.g: Many Health Insurance Companies have a cap or a sub limit on the room rent, i.e. they will only an x amount for the room rent, while the insured has to pay the remaining.
While these are just pointers, which if followed, should prevent you from buying the wrong mediclaim policy. It would be a much better option if one were to avail of the services of a good Health Insurance Broker than to just rely on these pointers.