Merely having a health insurance is not the criteria, possessing the right health insurance plan will help you to reap the benefits when needed the most, says Harjot Singh Narula
Illustration: Dominic Xavier/Rediff.com
Health is wealth: We all have heard of this proverb. In this era of competition, rat race and sedentary lifestyles, health has been compromised to a large extent. It is one of the major reasons along with other allied factors that have led us towards diseases and ailments. It is a myth that only elderly people are prone to more diseases, but nowadays we all have come across many incidents where youngsters in their 20s or 30s have suffered cardiac arrest, cancer, brain stroke or other severe illnesses which come uninvited.
Also, the medical inflation gives us another reason to prepare ourselves financially for any uncertain eventuality which requires ample amount of financial resources to cure or treat the illness or medical condition. However, before you plan to buy a health insurance for yourself or your family, it is important to have a sneak peak regarding certain dos and don’ts before buying a health insurance policy.
Research and analyse
A thorough research is required before you make a final plan. There are a plethora of health product options which are available in the market. It becomes difficult to choose or zero down on a single plan. It is always prudent to take out time and research in depth about the health plan. You may take help of insurance experts, your kith and kin who have a health policy, online comparison portals, read expert, market and customer reviews about the specific plan.
The detailed scrutiny of the products will enable you to shortlist few best health plans to choose from. The final decision based on the research will enable you to buy the right health plan.
Check on the inclusions and exclusions
It is important to check the scope of the policy coverage and policy exclusions. Every company’s health plan’s design and scope are different like some health plans include ayurvedic treatment, some don’t.
Some plans offer inbuilt maternity benefit, some don’t. Some health plans have certain caps and sub-limits on room rents; some don’t impose any such limit. Some health plans include domiciliary hospitalisation, some don’t. It is imperative to assess your requirement and accordingly opt for the much needed health plan.
Check for network hospitals
It is important to see the empanelled hospitals under the insurance company’s list of network hospitals. A cashless treatment can be availed if a policyholder is admitted to a network hospital.
Non-network hospital treatment is usually not cashless and the money spent on treatment need to be reimbursed by the policyholder. Also, some insurers apply co-payment clause, if treatment is undertaken in a non-network hospital.
Read the waiting period clause
To get a treatment under a health plan, there are specific waiting period clauses which are part of the health policy like any medical pre existing condition may be included under the scope of health plan after a waiting period range of 2 to 4 year basis the specific health plan.
There is a specific waiting period of 2 years for which a policyholder has to wait to get the treatment for particular surgeries like cataract, joint replacement, hernia, tumour, ENT disorders, osteoporosis, etc. The lesser the waiting period, the early the health insurance benefits will come into action.
Read the policy wording/contract
It is highly important to sit back and read your policy wordings. If you are not aware of many of the insurance jargons, it is advisable to get it screened by some expert or known person. If you think that there is a disparity between your understanding (regarding the benefits, inclusion and exclusions and other conditions, of the health plan) from the actual offering, you may get it cancelled in a free look period.
Free look period is a 15-day or 30-day time limit given to the customer to change her/his decision if s/he is no satisfied with the policy. Beyond that it becomes difficult if you change your mind.
Conceal any material facts
It is important that you should disclose all the material facts like your age, medical condition, medical history, occupation, family history, place of residence, etc., correctly in the proposal form. On the basis of your disclosure, the insurance company assesses the risk in your application and takes a decision to grant or reject a health insurance proposal. Hiding or concealment of facts may prove fatal at the claims stage.
Hesitate to ask questions
Ask numerous questions from the company’s representative or agent until you are satisfied with the proper understanding of the health plan you intend to buy. You may take the advice of online insurance experts or various online platforms to seek appropriate answers to your questions and prevailing doubts.
Simply buy because your friend has bought
Need and requirement of a health plan are different for different individuals or family. What your relative or friend has bought might not fit in your landscape.
It is good to take feedback, but blindly following the decision of others is not prudent.
Delay your decision
Health insurance plan bought at an early stage will help you to get the plan at the lowest prices.
Also, there is a low probability of a claim arising under the policy due to any illness which will make your case easily accepted by the insurer.
Delay in buying the plan may result in rejection or paying a higher premium for a minimum coverage amount.
Merely having a health insurance is not the criteria, possessing the right health insurance plan will help you to reap the benefits when needed the most. Spare some time to take a right decision rather taking a short decision. Be healthy and stay safe!
Harjot Singh Narula is founder and CEO, ComparePolicy.com