Buying health insurance for the first time? We have you covered

Post-pandemic, there are no more doubts about the significance of health insurance. If not anything, basic individual health insurance. There is no doubt that health insurance tops the priority list for everyone. The right health insurance plan can take a substantial amount of financial stress away from you. That is why you must look at all the available options.

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However, with so many types of health insurance plans and unfamiliar terms, it can be challenging for first-time buyers to purchase the policy that suits their needs. Worry not, for in this article, we have compiled a list of things all first-time health insurance buyers need to remember while purchasing their policies.

Tips for first-time health insurance buyers

Here are a few points you must remember while buying your first health insurance.

Type of policy: The first thing you should do while selecting between health insurance plans is to understand your requirements. Do you want to buy individual health insurance for your family members or a family-floater plan? A family-floater plan will cover all your family members in a single plan. The individual health insurance plan is more expensive than a family-floater plan. If you want to insure all your family members, a family floater plan is more economical and you would also get a larger sum insured. On the other hand, if you are only buying health insurance for yourself, you can purchase an individual health insurance plan.
Sufficient sum insured: One of the most important factors to consider while selecting your individual health insurance is the amount of sum insured. Remember, you may not be able to increase once you have submitted the claim. While selecting the sum insured, your goal must be to select a plan that will give you maximum protection under your financial strength. A higher sum insured attracts higher premiums. Therefore, select a plan that fits your budget while offering you the best coverage.
Wide coverage: Apart from looking at the sum insured, also look at the extent of the coverage offered by your policy. The aim should be to get comprehensive coverage. Check whether the policy provides the following coverage for Covid-19 treatment, AYUSH treatment, Preventive health check-up, ICE fees, day care treatments, outpatient department (OPD) cover and others. The idea is to choose a health insurance plan that provides coverage beyond hospitalisation coverage.
Easy claim process: Check the reputation of the insurance provider you are considering for your health insurance. Do they have a good reputation? Are they known for their quick claim settlement process? Every insurance provider claims to provide easy and fast claim processing but it may not necessarily be true. Check customer reviews and talk to people who have bought health insurance from them to determine this.

Cashless cover: The cashless cover is another important feature your health insurance should have. Having cashless cover means you do not have to pay the treatment cost by yourself and apply for reimbursement. Your insurance provider will directly deal with the hospital. This cover provides a hassle-free and paperless experience as you do not have to worry about maintaining every invoice and every form to submit for claim processing. You can concentrate on getting better.
Network hospitals: In extension to the previous point, also check the list of network hospitals provided by your insurance provider. The cashless facility is only available at the network hospitals. Ensure that the hospitals are near where you live. In case of a medical emergency, you will go to the nearby hospital and not the one that falls under your insurer’s network list.
Find an insurer who has a nearby hospital in their network hospital. Also, check whether the insurer has multi-specialty hospitals in their network. It will also allow you to get better specialised treatment if required.
Waiting period for pre-existing conditions: Most health insurance policies have a cooling/waiting period before covering pre-existing or critical conditions. The waiting period can be two years or more. According to IRDAI, pre-existing conditions are defined as any disease/illness diagnosed two years before or up to 48 months from the purchase of health insurance. Some examples of pre-existing conditions with a waiting period include diabetes, psychiatric illness, cataract, thyroid, and osteoporosis.
Deductibles: Many health insurance plans have a deductible or copay policy. This policy means that your insurance provider will only pay your medical costs after a certain set limit has been paid by you. For example, let’s say your policy has a deductible amount of Rs. 1,00,000 and your claim is of Rs. 4,00,000. You will have to pay Rs. 1,00,000 out of your pocket first. Only then the insurer will pay Rs. 3,00,000.

It is recommended to choose a health insurance plan that does not have this policy. This can be incredibly useful during emergency hospitalisation. However, plans without a deductible policy can be expensive.

Room rent restriction: Health insurance plans have a restriction on room rent. Some insurers provide 1% of the sum insured as the room rent. Carefully check the room rent restriction provided by your health insurance policy before purchasing it. Also, check whether the plan has any sub-limits or not.
Policy exclusions: Apart from knowing the inclusions and features of your health insurance, carefully go through the exclusions. This will help you understand the coverage better. Many health insurance plans do not provide cover for eyesight correction, undisclosed medical conditions, cosmetic surgery, or dental surgery.

Buying health insurance for the first time can be intimidating. However, we hope this blog helped you understand the things you should prioritise during the process. Make sure that you compare multiple health insurance plans before settling on one. Go through all the policy terms and conditions carefully. Remember to pay your renewal fee on time. Save a digital copy of your policy for convenience and you will be good to go.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.