Last Updated on August 11, 2023 by HBW2
Any health insurance plan can be a good plan if it fulfills your needs. A good health insurance plan will not be decided on the basis of premium only. In fact, a plan with a higher premium may not be always be what you need. Some key points are discussed here for your knowledge which will help you to select the best health insurance plan.
Maximum health coverage – Always prefer a plan that offers maximum health coverage and maximum amount for the treatment. As the cost of medical expense is increasing nearly 15% per year.
Incurred claim ratio (ICR) – The ICR indicates an insurance company’s ability to pay a claim. For an example, lets say an ICR of 90% implies that the company has spent Rs. 90 on claims for every Rs. 100 collected as premium. An ideal ICR range recommended by experts is between 60 – 90%, which indicates a healthy settlement of claims by the insurer against the premium collection.
Co-payment – Most insurance company don’t charge anything till the age of 65. After that, it is generally 10-20% of the total bill claimed. After 65 years of age someone would be treated more often and apply for claims. So prefer those providers who provide all or most of the claimed bill.
Hospital Network- Network listed hospitals are cashless, non-network is reimbursable. Go for a policy that has the most number of hospitals in its network.
Whom to choose standalone or general insurance- There are 2 types of Insurance providers. These are Standalone and General Insurance companies. It is observed that Standalone is better than General Insurance providers because of the faster approval process in regard of claim request.
Pre existing illness- In case of chronic illness if company offers less waiting period is good. Generally they take 3-4 years to cover the pre existing illness.
Buying online/ from an agent – If you are well in doing online things comfortable then you can go for online. You have to arrange the documents in one place and the dedicated customer support will guide you to do the required work. If you are not comfortable in online then go to an insurance agent. He will guide you to buy the policy. Either way, you will be paying the same premium.
No claim bonus- In case you do not claim, insurance companies provide a bonus by increasing your coverage on renewal or decrease the amount of premium. Increase in your coverage is very useful instead of decrease the amount of premium as the medical costs keep rising by almost 15% every year.
Restore Benefit – Restoration benefit is an add-on feature in health insurance policies that provides an additional sum insured amount after the primary sum insured is exhausted in a policy year. Restoration benefit is a feature that reinstates the total sum assured if it is used up in any given policy year. However, the premium for policies with restore benefits is also high.
No sub limits – Most insurance policies come with sub-limits on per day medical expenses, room rent in case of hospitalization etc. Consider those plans that offer the highest slab on room rent or other health care expenses. For an example If there is no sub limits in your policy then you can choose a suite over AC room.
Entire family over individual – If you are a family person, it is better to opt for a family floater plan which covers your family. In this plan anyone can utilize the total cover during medical treatment.
Choose according to your location- The another important aspect is the base cover, make sure you are taking a cover that is adequate based on cost of healthcare in the city or town you are residing in. If you are residing in a metro choose a higher plan.
Apart from those, some other factors should also be kept in mind when you are selecting any plan. If more of these factors meet your need that will be very good.
~Cashless hospitalization.
~Ambulance and emergency services expenses
~Pre and post hospitalisation
~Maternity expenses and Vaccinations
~Critical illness treatment like cancer
~Regular health check ups
After knowing this basic information, you could visit any of the insurance company websites or aggregators to choose a cover. Some good options out there are plans from Care Health Insurance, HDFC Ergo Health Insurance, ICICI Lombard, Bajaj, Star Health, Niva Bupa etc.