What Do People Look For In A Health Insurance Plan?

What Do People Look For In A Health Insurance Plan?


Health insurance is essential due to increased disease rates and medical expenses. Many companies in India offer a variety of health insurance products. Each plan has its own USPs. If you need a health plan, the options may be overwhelming.

First, you must find the correct insurance plan. Next, discover the ideal policy.

Selecting an insurance company –

Consider these things while choosing a family health insurance plan:

1. Plan for variety:

Compare a company’s plans and USPs. Certain companies offer different types of coverage options. To locate the correct coverage, choose a company offering various options.

2. Claim settlement ratio*:

The claim settlement ratio* shows the company’s financial year’s claim settlement percentage. A more significant proportion means the company is persistent in settling claims—an insured-friendly factor.

3. Claim-based loading:

Some firms would raise your renewal premium if you made claims in the past. Premiums rise. Avoid such firms.

4. Reviewing:

Finally, read consumer reviews. Most insurers post consumer reviews. View them, talk to family members and your friends about their insurance. To determine the ideal firm, ask about their claim experience.

Selecting a plan –

Selecting a plan is the most crucial step after choosing a family health insurance plan. Multiple insurers offer many programs. However, policy selection is vital.

Thus, here are some tips:

1. Coverage benefits:

First, determine your coverage needs, then choose plans that meet them. If you’re expecting, seek plans with maternity coverage. Avoid such plans if your family is complete. Second, seek additional features to expand coverage, such as sum insured restoration, high cumulative bonus*, value-added benefits, annual health check-ups, etc.

2. Customisable:

Choose plans with customisable coverage features. Health insurance add-ons permit this by allowing you to customise your coverage.

3. Premium:

The premium amount matters. Compare premiums to coverage. Compare premiums from insurers with similar policy benefits. Check the balance of coverage and premium.

4. Sub-limits:

Health plans may contain sub-limits on room rent, ICU room rent, AYUSH coverage, domiciliary treatments, etc. Sub-limits may limit coverage and cause out-of-pocket costs.

5. Copayments:

Health insurance may have copayment provisions for many reasons. Copayments require you to pay part of each claim out of pocket. A 10% copayment implies you pay 10% of every claim.

Common copayment terms apply, such as:

  • If the insured is over 61 at insurance purchase,
  • If you acquire the policy in a lower-tier city and receive treatment in a higher-tier city,
  • Certain diseases and treatments

Ideally, avoid co-payment health insurance policies. If the clause is inevitable, such as in senior citizen plans, choose a lesser copayment plan.

How much coverage is right?

Your health plan needs an ideal total insured to meet medical costs. Health insurance plan is only worthwhile if the sum insured is high. The correct sum insured is easier than you believe. Just examine these factors:

  • Number of policyholders
  • Whether any member has a pre-existing ailment.
  • Hospitalisation* and medical treatments that may cost money due to their frequency.
  • Rising medical inflation

Most insurers compute the appropriate sum insured based on income, expenses, existing coverage, and covered people. A simple formula estimates the optimal requirement:

Sum insured = 50% of your annual income + 3 years of hospitalisation costs

Health insurance is affordable since insurers also provide monthly, quarterly, or semi-annual instalment premiums. Super top-up programmes provide coverage while lowering premiums.

Advice: It is wise to evaluate your benefits and premiums price of the insurance by checking health insurance premium calculator online.

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