How to compare Health Insurance Policies?

How to compare Health Insurance Policies?

 

You have decided to buy a health insurance policy and have opted for the online mode since you get multiple choices, instant results and you can make the final choice without being pressurized by ‘friendly’ agents or whoever. But there is a glitch… When you started out, you thought it would be an easy decision to make but with 21 insurance companies selling health insurance and so much of data available, you are finding it difficult to make a decision. Also with the different parameters available, there are some policies which are great in one aspect but bad in others…

Firstly, get the advice of a Health insurance Broker- The reason that we are asking you to do this is because even with all the options available, it is not very easy to select a product. A health insurance broker has the expertise and the knowledge to give you the most neutral advice to choose a product suitable to your needs. Even when all the policy conditions are mentioned in the policy, finer insights (for ex., some health insurance companies have increased their premiums three times in the last 2 years) is something only a broker can provide you with. Unlike agents/financial advisors who represent a given insurance company, brokers represent you and deal with all insurance companies; therefore, their advice is unbiased. What’s more, this service is rendered free of cost to the customer! So consult a health insurance broker to help you choose a product suitable for you.

Now, we give you the important parameters you must focus on while comparing health insurance policies.

Co pay: Please pay attention to this term in your health insurance policy since it can be an important differentiating factor in policies. ‘Co pay’ means there will be a division of allowable expenses between the customer and the health insurance company. If there is a 10% co pay on all claims, you have to pay 10% of the expenses and the company will pay 90% of the expenses. Generally senior citizen and some floater plans have ‘co pay’. It is wise to check if the product you choose has aco-payment condition.
Limits on certain treatments: There are many treatments which have been capped by health insurance companies to reduce their outgo in event of overcharging by hospitals. For example in Star Health’s Family Optima, Cataract is paid upto a limit of Rs.12000 and to Rs.10,000 in National’s Varishta mediclaim So you need to check the policy to see if the policy has such limits and which are the diseases which are capped.
Waiting period for Specific diseases: There are many diseases like hernia and procedures like tonsillectomy and knee replacement surgery that are covered only after 2 years of buying the policy and continuing cover without a break with the same insurance company. You need to check the policy wordings of the policy online to find out. Dedicated Health Insurance brokers with a website of their own make wordings of all health insurance policies of all insurance companies available in one website.
Pre-existing diseases covered after: Pre-existing diseases are those which you might have been afflicted with before buying the policy and are generally never covered at the onset of the policy. These are covered after a waiting period of 1 to 4 years. You must choose a policy with the least waiting period for pre existing diseases to make sure that you are not denied insurance claim when you need it most.
Room rent: In many policies there are sub limits or limitation on the amount that can be claimed for a particular expense. In this case, many companies cap the maximum amount charged for room rent. If you have a 1% limit on room rent on a policy of 1 lakh, you can only claim room rent upto Rs.1000 per day. This can be especially limiting if you live in a metro with high hospital room rent costs.

A further variation of this is that, while some policies limit only the room rent, some others limit all expenses dovetailing the room rent limit. Hospitals charge different fees for same service depending on the grade of room one is admitted in. The same X-ray will be charged less for someone in a twin share room vis-à-vis someone in a deluxe room. The more restrictive polices not alone limit the room rent, but pay other expenses only to the extent applicable to an room occupancy as per limit.  Thus, consider your cover amount and ask yourself if the limits are reasonable for you. There are many policies that do not have room rent limits, or which have a greater percentage, you can choose from one of these.

Claims Loading: This is another vital parameter that you should know about. For every year you claim, in some policies you will be charged an additional amount (loading) at the time of renewal, depending on the percentage of the cover amount that you claimed. You may face even a 5-200% hike in your premium based on the loading rates of your policy. So before choosing a policy, check whether it has claims loading.
Maximum Renewable age: This is a very important parameter that you mustpay attention to. It indicates the age beyond which the insurance company will not offer you renewal of your policy. Many policies have a maximum renewable age of 65 or 70 after which finding a new policy would be extremely difficult. So choose a policy that either has a lifetime renewal option or a higher renewable age.

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