Health insurance is the need of the day due to expensive medical costs. It enables you to easily cope with health and financial emergencies without breaking your savings. It lets you avail of the best treatment and prevents an unexpected illness or injury from wrecking your health and finances.

However, when it comes to choosing health insurance, it is wise to exercise due diligence and purchase a policy that has all features and can give you wide coverage.

Here are 8 things to keep in mind while choosing a health insurance policy.

1. Policy Coverage

While searching for health insurance, consider the policy coverage benefits. The policy you tend to buy must cover the expenses related to:

  • Pre-hospitalization and post-hospitalization
  • Room rent and ambulance charges
  • Consultation fee and costs of medicines
  • Daycare procedures (diseases that don’t require 24 hours of hospitalization)
  • Domiciliary expenses (treatment taken at home due to unavailability of beds in hospitals or other reasons)

With these coverage benefits, you may focus on your speedy recovery instead of worrying about treatment expenses.

Also, read Why Is Mediclaim Policy Necessary For Your Parents Above 60?

2. Network Hospitals

Before selecting a plan, check cashless network hospitals with the insurance company. At the time of a medical emergency or hospitalization, hospitals in the network offer a cashless option to the policyholder i.e. the insurer settles the medical bills directly with the hospital. And the policyholder doesn’t have to pay anything to the healthcare provider.

It is advisable to opt for an insurance company with a high number of network hospitals. Also, check whether there is a network hospital in your area or in the city you frequently travel.

3. Individual Vs. Family Floater

While searching for a health insurance policy, make sure whether you should go for an individual policy or a family floater cover. An individual plan is suitable if you want to cover yourself. On the other hand, a floater based plan will be suitable if you want to cover your family. Doing so will enable you to reduce the premium rates. Under a family floater policy, your entire family members can be covered under a single sum insured, whereas, in an individual-based policy, you need to buy a separate policy for every individual member.

4. Maternity Benefits

No doubt, pregnancy costs have skyrocketed. So, it is vital to choose a plan that comes with maternity benefits. If you are planning a baby, it is good to choose a plan which covers maternity expenses. For this, look into the waiting period applicable for maternity expenses claim. Make sure there is no co-payment or sub-limit clause. It’s better if the policy covers outpatient expenses too.

5. Simple and Fast Claim Process

Remember, the simpler the claims process and the faster the settlement of the claims, the better it is for you. Keep these two factors in mind when it comes to selecting a policy. Good customer support is an added benefit you should look for.

6. Compare Quotes Online

Before opting for a plan, it’s strongly recommended to compare health policies online. This helps buy a plan that meets your needs. There are online premium calculator tools wherein you can get an estimated premium of health insurance based on your age, medical history, location and the number of members to be covered. Collect the best quotes online and then compare them to arrive at a decision.

7. High Claim Settlement Ratio

Claim Settlement Ratio (CSR) is the ratio of settled claims of the total claims raised in a given accounting period. If the CSR of an insurer is 85%, it means the insurer has settled 85 claims out of 100 claims filed. It is advisable to always go for an insurer with a high claim settlement ratio (CSR).

8. Incurred Claims Ratio

Incurred Claims Ratio (ICR) indicates whether or not an insurer is in a good condition to settle any medical claim. It is an exact rate of claim settlement incurred to the net premium collected for a given accounting period.

For instance, if an insurance provider has 90% ICR, it means it spends Rs. 90 for every Rs. 100 earned as premium. Thus, Rs. 10 is the profit of the insurance company.

If the ICR is over 100%, it means the insurer has suffered a loss. Always, buy health insurance from an insurance company is in a good condition.

These are 8 things you should keep in mind when shopping for health insurance. With this, you will be able to get maximum cover at a minimum premium.


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