12 Factors Policy Buyers Must Consider When Buying Health Insurance

Health insurance is one of the best solutions to cope with the expenses of medical issues. But people may avoid buying health insurance unless they need a financial backup for medical treatment. Instead of buying insurance at the last minute, one must be prepared with adequate coverage to ensure a smooth sail through the medical emergency. Let us help you get started with health insurance plans before medical contingency hits. Here are things to consider before buying health insurance.

health insurance plans
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Which things to consider before buying health insurance?

A health insurance plan is a contract between you and the insurance company. Here, the insurer agrees to bear a part of your financial burden when you face a medical emergency. Thus, you must choose the best health insurance policy and the company wisely.

1. Inclusions and exclusions of the plan

The coverage of the health insurance plan (inclusions) and the conditions against which you cannot make a claim (exclusions) determine the scope of the policy. You must have total clarity about both before purchasing health insurance. Being unaware of the coverages can lead to an increase in out-of-pocket expenses. And being unaware of the exclusions can lead to claim rejection.

2. Opting for health insurance at the earliest

Buying health insurance early in your life is good. You don’t want to go scouting for ideal health policies when you have crossed a certain age. You will likely make fewer claims now as compared to when you are older. Remember that now is the right time to buy health insurance if you have not done so yet.

3. Choosing the right health insurance company

The insurance company plays an important part when it comes to health insurance. The claim processing speed varies from insurer to insurer, and thus you must select only the best one. Nowadays, it is easy to go online and search for a reliable health insurance company thanks to the internet. Go through their customer reviews to know more about the services offered.

4. The waiting period

The waiting period is the time when you cannot raise a claim against the health insurance plan. It is usually applicable to pre-existing diseases and maternity benefits. It can stretch from 9 months to a few years, depending upon the insurance company and the plan that you are looking to purchase. So do check the applicable waiting period on your health insurance plan before buying.

5. Policy premium and sum insured

You pay a premium to purchase a health insurance policy with a certain coverage. The higher and more comprehensive the coverage, the higher the premium amount. Understand the details about the coverage and the premium amount thoroughly while buying health policies.

6. Daycare procedures

Nowadays, certain medical treatments take a day to complete. Thus, it is important to ensure that you cover such treatments under your health insurance plan. These are small medical procedures like cataracts, tonsillectomy, etc.

7. Specific treatments and diseases

Medical insurance plans list some specific illnesses and treatments for which coverage is available after a specified duration. For instance, in many plans, coverage for piles, fistula, hernia, etc., is available only after the first 2 policy years. These ailments are called specific diseases. Reach out to the insurance company if you are unsure about this coverage.

health insurance plans
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8. Alternative treatments

These are non-allopathic treatments like Ayurveda, Yoga, Unani, Siddha and Homeopathy (AYUSH). Many health plans allow these non-allopathic treatments’ coverage up to a specified limit. AYUSH treatments have gained importance during the COVID-19 pandemic, and many people prefer these over standard allopathic medicines.

9. The availability of add-on covers

Add-ons are optional coverages available with health plans for increasing the scope of coverage. You can choose any suitable add-on to customise your health insurance plan. Note that every add-on cover requires an additional premium added to the premium of the base policy.

10. Pre/post-hospitalisation coverage

Pre and post-hospitalisation include any tests, treatment, doctor visits, etc., conducted before or after the hospitalisation. Different insurance companies have different terms and conditions regarding pre and post-hospitalisation. Check if your policy offers this coverage.

11. The co-payment clause

As per the copay clause, the policyholder is bound to pay a predefined percentage amount of the hospital bill. Therefore, such policies cost less and offer less compensation as you have to pay a considerable part of the hospital bill. Make it a point to study this clause in detail if you decide to opt for it.

12. The abundance of network hospitals

Consider the company’s claim settlement approach before buying a policy. Also, check if the insurer has a wide network of hospitals to avail of cashless treatment. This will allow you to spend much less money during medical treatment.

The importance of health insurance cannot be overstated today considering the environment that we live in. Hence, it is important to consider these factors when you are getting health cover for yourself or your family. 


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