In India, there are many insurers who sell health insurance plans. Selecting the right health insurance policy can be a difficult task. In this article, we will focus on a few factors that must be considered while availing a health insurance plan.
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1. Individual Cover or Family Floater Cover
If you buy an individual health insurance policy, it covers the hospitalization expenses of a single person, (the policyholder). It’s always advisable to buy family floater health insurance plans, which cover the hospitalization expenses of the entire family (including you).
If you buy separate policies for each of your family members, then the premium paid on the multiple policies will be higher than the family floater cover. Under family floater, sum assured can be utilized by an entire family.
Insurers offer both Individual Cover and Family Floater Cover. So, while availing health insurance, you should consider your and family's needs. If you have a big family, it is advisable to buy family floater cover which covers the entire family's hospitalization expenses.
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When opting for the sum insured, it is vital that you consider the healthcare costs in your city of residence. If you live in a metro city, you will require a higher cover than compared to an individual who resides in a tier-2 city.
Opting for a sum assured that's too low, would be of hardly any benefit to you, in case of a major hospitalization. Opting for a very high sum assured will mean high premium payments. Thus, it is essential that you choose an optimum sum assured when purchasing a policy.
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Insurers have introduced the co-pay clause. Under this clause, the policyholder has to pay a part of the hospitalization expenses, out of his own pocket. For instance: If the policyholder has opted for 20% co-pay, the insurer will pay 80% of the hospitalization expenses. The remaining amount has to be paid by the policyholder.
Co-pay could be voluntary or a compulsory component of the health insurance policy. Opting for co-pay could reduce the premium amount. Opt for co-pay, only if you have the means to pay your share.
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4. Waiting Period
Health Insurance policies will have waiting periods. Usually, waiting period is applicable for some specific and pre-existing diseases. Pre-existing diseases are those diseases you have at the time of availing the insurance policy. The waiting period ranges between 2 to 4 years. It is advisable to avail a policy with less waiting period.
5. Maternity benefits
Maternity hospitalization costs have gone up rapidly with the rise in medical expenses. So, it is very important for women to buy a health insurance policy that offers maternity benefits. One should consider the waiting period applicable for claiming maternity expenses. The policyholder should also check whether the policy covers outpatient expenses.
6. Network hospitals
Network hospitals are the hospitals which have partnered with the insurers. These hospitals provide some additional benefits to policyholders such as the cashless hospitalization facility. Before purchasing the health insurance policy, it is very important to check the network hospitals under the plan.
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