According to a WHO report from 2011, Indians spend about 70% of their income on healthcare on an average, which is substantially higher than other Asian countries.
40% of families from the lower-income group have to borrow money to meet these exorbitant costs which further worsens their economic condition.
A huge portion of the population is annually pushed to poverty due to the lack of social security or health insurance.
Barely 17% of the Indian population has health insurance and poorly made decisions can further render this insurance useless.
Be a smart Buyer
You are repeatedly told to read everything in your policy documents before committing to a policy.
This is not only to make sure that you understand the payment and premiums inside out and know all terms and conditions.
This will aid you at the time when you need insurance the most and you will know all the facilities that will be offered.
It is not only foolish to not avail the facilities you’re paying for, but it is also a waste of money since your premium includes these.
Therefore, to get the best health insurance, you not only have to focus on the comparison of health insurance plans, you also have to know all the features of the plan.
What benefits should your health insurance policy offer?
Instead of just premiums and policy terms, here are some things you should look for while comparing health insurance policies.
Domiciliary/ Treatment at Home
Traditionally, health insurers only let the insured make a claim after 24 hours of hospitalization.
However, realizing the requirements, some insurers offer a number of Daycare treatments up to 500 for injury or disease.
Insurers nowadays also cover ‘domiciliary hospitalization’ in case the treatment is availed at home due to various reasons, such as the condition of the patient or the unavailability of rooms.
Daily Hospital Cash Allowance
During hospitalization, there are many expenses which aren’t put on the bill. Some of these may be covered by the insurance company.
Some insurance companies offer coverage for things other than the course of the mainstream treatment. This allowance can be utilized on travelling expenses or food and even for hospital visits.
While this isn’t offered by all insurers, it is definitely something to look for while getting an insurance policy since it further helps control the expenses incurred in the course of a treatment.
In case your insurance offers this allowance, you must make use of it.
Health insurance should not just cover hospitalization but also take other medical expenses into account.
Further, ambulance fees and other expenses may also be reimbursed by the insurer.
These may be consultation fees, the cost of medicines, or pathology reports and tests.
Some insurers offer reimbursement of outpatient expenses, as they should, and this should be kept in mind while buying a health insurance.
The expenses incurred while one is pregnant, or even after delivering a baby, can be exorbitant.
Not only do these include doctor’s consultation fees and hospitalization charges but also check-ups, medications, tests, etc. - both prenatal and postnatal.
Young persons should definitely consider a policy that offers to cover maternity expenses; they might not know yet, but the medical expenses incurred during and after pregnancy can be very high.
Simple and efficient claim process
While most health insurance policies today offer cashless benefits, what happens when the hospital one goes to is not under the network of the insurance company?
It is imperative that the claim settlement procedure of your insurance company is simple and easy.
The claim procedure should be easy to comprehend and should not have a long waiting period. The status of your claim should be made known to you from time to time.
Insurance companies have caught on to the importance of this lately and offer quick and efficient reimbursements and claim settlements to their customers, in time spans as short as 24 hours.
For this, you should check out the claim settlement ratio of the insurance company before buying a policy.
What to check for in your health insurance policy?
Other than the basic benefits your policy should offer, it is also important to check the policy documents closely to know about the following features.
While the sum assured offered by the insurance company is the total amount the insurance will cover, often, there are sub-limits placed on expenses like room rent, outpatient expenses, ambulance charges, etc.
Knowing these is important to see if the sub-limits on these expenses are reasonable. Otherwise, you will be in for a rude shock at the time of claim for any expense above the sub-limits will have to be incurred by you.
The insurance company should have an extensive network of empaneled hospitals, and these should be close to your house so that you can rush in case of an emergency and claim cashless benefits with ease.
Wellness and Value Added Benefits
Insurance providers acknowledge that preventing depreciation of health is very important; moreover, it saves them a lot of money in the long run.
This is why insurers often offer wellness services, such as discounted gym memberships and discounts on regular check-ups.
They may also offer value-added services such as telephonic consultation or health newsletters which will further help the customers in staying healthy.
In conclusion, your best and most useful resource for understanding your health insurance and all its terms and conditions is your awareness.
Doing your research and staying up-to-date with new plans, as well as value-added services, is what will help you make the best out of your health insurance.