- Date 12 Jan 2018
- Category Insurance Knowledge Base
For Your Knowledge
A health insurance plan is an essential part of financial planning in this era of skyrocketing medical costs. Medical inflation has been aggravating at its full spree which makes it all the more important to buy a Health Insurance plan which could sponsor the hospitalization and medical treatment bills or expenses.
It is important to evaluate and look for the following parameters to get a best health plan for you and your family.
1. Check for the Waiting Period Clause
You must be feeling care free after taking an insurance, but your health insurance comes with a waiting period clause for specific conditions. There is an initial period clause which says that any hospitalization claim will not be admissible in first 30 days of the policy commencement apart from accidental hospitalization.The pre-existing diseases or conditions are also not covered immediately after you purchase a policy.There is a waiting period ranging from 2 years to 4 years as per the plan conditions in the industry. Also, there are certain surgeries and treatments like hernia, cataract, joint replacement, etc. which can be treated after a specific waiting period of 1 or 2 years.
So,it is important to check the waiting period clause before you finalize the health plan.
2. Check for Sublimits
There are certain capping or sublimits in your health plan which says that the specific kind of expenses are paid by the insurance company upto a specific limit and beyond that the insured or customer has to bear them at his own. For example: Room rent charges are capped on per day basis for different health plans. Some health plans also come with a mandatory co-pay where the portion of the admissible claim is to be borne by the insured and the remaining is paid by the insurance company.
Check for the sublimits in your health plan to avoid any last minute surprises at the time of claim.
3. Check for Network Hospitals
The insurance companies offering health plans have certain empaneled network hospitals with whom they have a tie up. Any hospitalization or treatment taken in the mentioned or specified network hospital list is done on the cashless basis subject to policy conditions.
Check for the list of network hospitals of insurance company and ensure you have network hospitals of the insurer near your place of residence in case of any emergency hospitalization. Also, a treatment in non-network hospital may not offer cashless treatment and some insurers have a co-pay clause if you take a treatment in non-network hospital.
4. Check for the Claim Process
Different insurance companies have different claim procedures. Some settle or administer claims through Third Party Administrators (TPA’s) and some have their own in house claim settlement unit to foster quick and hassle free claim processing. Also, check the claim settlement ratio of the insurer you intend to buy a health plan from to have a clear picture on the number of claims settled by the insurer.
It is important to have a handy information on claims procedure to have a smooth and hassle free treatment in the times of hospitalization.
5. Compare & Buy Online
It is important to take a right buying decision which can be done by comparing the available health insurance plans online. You can compare the price, key features, policy benefits, value added benefits, eligibility, exclusions,etc. of multiple health insurance plans to make a right informed choice of your own without any interference of the agents. Buying online health insurance plan is a hassle free process which required least documentation and quick policy processing. There are certain online portals which will enable you to make an easy comparison and will assist you in choosing the right Health insurance plan.
Online buying of the health plan is economical as companies offer discounts on premium for buying a policy online. The reason for an insurance policy to be cost effective if bought online is because the intermediary cost of the premium component is removed. When there is no intermediary in between, Co.’s save on the commission and policy issuance cost, which the Co. transfers it to the customers.
Do evaluate your need and make a right buying decision by checking the above stated parameters.