How To Choose Right Health Plan For You And Your Family in India

 

Right Health Plan For You And Your Family in India::

In India, it is crucial to choose the right health plan for you and your family, healthcare costs are skyrocketing, and hospitalization of few days can have huge impact on your pocket. This is where a health insurance comes for help. There are variety of health insurance options available in the market, it can be overwhelming to decide which one is best for you. In this article, we will look into the steps you need to take to choose the right health plan for your family.

What are your needs in healthcare:

This is the first and prime step in selecting correct health insurance plan, it is important that you must evaluate your healthcare needs. It can be based on various parameters like your age, no. of person in family, previous medical history, ongoing medical conditions. You should make list of the services required, such as probable hospital expenses, lab test charges, doctor visits, prescription drugs, and specialist care. This will help you determine the type of health plan and what should be sum insured that will be most suitable for you and your family.

Evaluation of Health Insurance plans in India:

Indian health insurance market is evolving market and it is yet to be matured. All health insurance service providers provide cover for hospitalization only. All plans provide coverage in form of either reimbursement/cashless or other as lumpsum payment. There are mainly two types of health insurance plans available in India –

1.       Indemnity health insurance plans, and

2.       Defined benefit insurance plans.

Indemnity plans, also known as reimbursement plans, pay for the medical expenses incurred by the policyholder up to the sum insured. It also provides cashless facility in case of hospitalization. These type of insurance plans are generally provided by general insurance companies and health insurance companies.

Defined benefit plans, on the other hand, pay a fixed amount in case of specific medical events such as hospitalization, surgery, or critical illnesses. These types of coverage are generally provided as rider (add on cover) by life insurance companies.

You should research the different types of health plans available to you. Each plan has its own benefits and drawbacks, so make sure you understand how each one works and what services it covers.

What need to be compared in health insurance plan:

The next step is to compare the costs of different health insurance plans. Look at the Premiums and terms of premium payment like yearly, quarterly, monthly; deductibles, Disease wise payment capping, Exclusions period, excluded diseases, co-pays, ambulances charges,  out-of-pocket maximums as daily cash benefit for each plan you are considering. Calculate how much you would pay for healthcare services under each plan to determine which one would be the most cost-effective for you. There are several websites which provide better comparison between health insurance plans.

It is essential to keep in mind that lower premiums may mean higher deductibles or co-pays. It may also mean restricted coverage. So, it's important to weigh the costs and benefits of each plan to ensure you choose the one that fits your budget.

How many hospitals have tie up with health insurance provider:

Make sure the plan you choose has a network of healthcare providers, including doctors, hospitals, and clinics, that meet your needs. If you have a preferred doctor or specialist, check that they are included in the plan's network. You can also check if the hospital near your residence is in the plan's network. It will save you time and money in the long run.

Review the Health insurance plan's benefits:

You should look at the health insurance plan's benefits and coverages to ensure they should meet your healthcare needs. For example, if you require certain prescription drugs for 90 days after hospitalization, make sure the plan covers the medications you require for that duration. Check the maximum amount payable for different treatments, and whether pre-existing conditions are covered or not. What is the time duration for which pre-existing health conditions are not covered. Some health insurance plans may also provide additional benefits such as daily cash benefits, maternity care, dental care, or wellness programs.

What are plan's quality and insurer rating:

It is advisable that you should look at the plan's quality ratings and customer satisfaction scores. You can find this information on the Insurance Regulatory and Development Authority of India (IRDAI) website. Check the claim settlement ratio of the insurance provider. This will give you an idea of how likely it is that your claim will be approved if you need to use your insurance.

Take expert advice:

If you need assistance choosing a health plan, you can reach out to a licensed health insurance agent or your state's health insurance marketplace for guidance. An agent can help you understand the complexities of health insurance and provide you with personalized recommendations based on your specific needs.

In conclusion, choosing the right health plan for you and your family is crucial in India's current healthcare scenario. By following the above steps, you can make an informed decision and choose a health plan that meets your healthcare needs and fits your budget. Always remember to read the terms and conditions of the policy carefully before signing up. It is better to be safe than sorry.

What is waiting period in health insurance policy

 

Health insurance is among the fastest growing segment in entire general insurance segment. There are so many health insurer like Star Health & Allied Insurance Co.Ltd. (www.starhealth.in), Niva Bupa Health Insurance Co Ltd.( www.nivabupa.com) The New India Assurance Co. ltd. (www.newindia.co.in) are in market. Every insurer has so many health insurance plans depending upon need of individual. It is important to choose correct health insurance plan depending upon need of individual. While choosing right health insurance plan there are various factors which need to be considered.

It is not only important to choose correct coverage, amount (Sum Insured) but it also important that one should be aware about waiting period in ones health insurance plan.

Every insurer does not cover all diseases from day 1 and there are various diseases which are excluded for certain period. It is important that individuals must be aware that which disease is excluded and for how much period??

Waiting period in health insurance is the amount of time you must wait for your health insurance coverage to take effect. During this waiting period, the insurance company will not cover any medical or treatment costs. Waiting periods are usually used by insurance companies to prevent people from getting health insurance only when they are sick or injured.

The length of the waiting period may vary by policy and insurance company. It can last for days, weeks, months even years and is associated with a particular disease-based hospitalization or waiting period may apply for certain period for all diseases.

For example,

1.      Generally, insurance may have a 30-day waiting period for hospitalization or surgery for all diseases. Generally, these type of waiting period exclude hospitalization due Accidents.

This type of waiting period generally applies to new policyholders and not to those who maintain ongoing coverage with the same insurance company.

2.      Insurance may exclude certain diseases like Cataract, Hernia, Knee replacement, Hypertension etc for specific period i.e. 1 year, 2 year etc.

Additionally, some health plans may waive the waiting period for people switching from similar coverage with other insurers.

There are some diseases which are “generally” excluded in almost every heath insurance for specific time period. Some of them are

1.      Cataract

2.      Mental illness

3.      Congenital external and internal disease

4.      Benign ear, nose, throt

5.      Hernia

6.      Arthritis

7.      Piles, fissure and fistula in anus

8.      Hydrocele

9.      Gout

10.  Skin disorder, and so many other

While purchasing health insurance this is among the most important parameter and one should ask from insurance agent or insurance company about all details of waiting period like

1.       What is waiting period at inception?

2.       Which disease are excluded?

3.        What is time duration of exclusion for each and every diseases appearing in waiting period of plan?

4.       Is there any rider, add-on to cover all disease from day 1?