Smart Strategy for Choosing the Best Health Insurance Plan

The second wave of the Covid-19 pandemic might finally be waning in India, but thousands of new cases are still emerging every day. Besides the physical and emotional distress, sky-high hospitalisation and medical bills for the treatment of coronavirus are leaving many families on the brink of bankruptcy. With no other avenue to cover these unprecedented expenses, they are dipping into their savings or restoring to extreme measures such as mortgaging their homes, selling precious jewellery and taking high-interest loans. 

Amid all this, the importance of a comprehensive health cover cannot be overstated. Once perceived as an option, health insurance is now deemed a necessity by people of all age groups and backgrounds. While health insurance will financially prepare you for unforeseen medical emergencies, choosing the right plan that caters to your specific needs is crucial. There are a few factors you should consider before making the choice. Let us have a look. 

Does it match your profile? 

With a plethora of options available today, picking the health insurance policy that’s best suited for you may seem daunting. To start with, your age, current address, employment status and existing medical conditions are important factors to consider while buying a plan. For example, as your chances of facing health-related adversities increase with age, it’s advisable to opt for plans with high coverage benefits if you are in your 40s or 50s. Similarly, hospitalisation bills tend to go higher in metros as opposed to Tier II and Tier III cities, which mean you can either go for a zone-specific cover, or a pan-India cover for a higher premium. 

What type of coverage does it offer?

With medical expenses hitting the roof, it’s never been so important to ask the insurer about the kind of coverage you need. First and foremost, the health plan you choose should cover the actual cost of treatment. Plans that offer lump sum payouts should be considered only after ensuring treatment expenses are paid. Medical inflation is another critical factor to take into account while choosing the coverage amount. For example, a health cover of Rs 10 lakh may seem redundant now, but it might help you avoid out-of-pocket expenses 10-15 years down the line. 

Does it include sub-limits or co-payment options?

Healthcare policies can have sub-limits on specific treatments or/and room rents. While plans with a sub-limit clause are comparatively cheaper with a lower premium, you may be faced with a nasty surprise later. Sub-limits not only restrict the quality of care, but can also leave you scrambling for cash in case of a medical emergency. For example, if under the sub-limit clause, there’s a 50 per cent cap on cancer treatment, and the total treatment cost comes to around Rs 10 lakh, the additional Rs 5 lakh will be an out-of-pocket expense for you. In the same way, co-payment clauses mandate that the insured party must cover a certain percentage of the claim settlement, which can again cause a financial crunch. Ideally, you should choose policies that allow you to opt out of sub-limits, giving you a better assurance for coverage. 

Need for a holistic approach to health insurance 

As the incidence of lifestyle diseases continues to be higher, it has become imperative to choose a comprehensive health plan that goes beyond just treatment and hospitalisation coverage to address daily healthcare needs such as doctor visits, unlimited tele-consultations, diagnostics, medicines, fitness classes, nutrition counselling, mental health sessions and disease management. 

Such an all-inclusive approach not only provides financial security for medical expenses but also helps in protecting the overall health and wellbeing of the insured. Unlike traditional financial institutions, new-age health insurance providers aim to create a complete health and wellness ecosystem through their custom-made, comprehensive and affordable solutions that can empower people to live a healthier lifestyle. Modern insurers also ensure that their plans are easier to comprehend so that people can buy, manage and track their health coverage, book appointments, initiate claims and more in a faster and hassle-free manner. 

The writer is co-founder & CPO of Vital

DISCLAIMER: Views expressed are the author’s own, and Outlook Money does not necessarily subscribe to them. Outlook Money shall not be responsible for any damage caused to any person/organisation directly or indirectly.