Medical advancements may surely be making our lives longer, but that doesn’t take away from the fact that this longevity does not come free of cost, neither does it come at a cheaper price. Skyrocketing hospital bills post a simple treatment; have already made us realize the significance of buying Health Insurance Policies for ourselves. However, don’t you think your parents need them too, given that they are more susceptible to illnesses? Besides, for all those years they have spent on your wellbeing, don’t you think, it’s time to pay back?
Great, if you were way ahead to realize this and have done an extensive research to spot the best policy for them. But are you sure you haven’t missed out on any significant point before choosing a suitable policy for them? To help you, we have listed down below some crucial aspects of a health insurance plan that you need to check before making a final settlement.
1. Room Rent Limit
All Health Insurance Policies come with a specific limit on hospital room rents. This limit may differ from plan to plan. It’s up to you to decide whether you want to opt for a plan with a base room or a higher category room. The premiums for both the categories of the plans will vary. Besides, the room rents are rising by 14% year on year. So before buying a policy, check the room rents in your native hospitals for base and higher category room and then take a decision depending on your parents’ medical requirements.
2. Co-payment Clause
Under a Co-Payment Clause, the insured is required to pay a certain percentage of hospitalization expenses for every claim. Let’s say, the policy has a 10% co-payment feature. In this case, the insured person will be liable to pay 10% of the total claim on each hospitalization before filing for a claim with the insurer. The percentage of co-payment varies from 10%-30%. Having said that, choose your policy with lower percentage of co-payment or no co-payment at all even if you have to pay a slightly higher amount of premium.
3. No Claim or Cumulative Bonus
In simple words, if you do not raise any claim with your insurer in a particular year, then you’re eligible for a No-Claim-Bonus the next year. This is also referred to as Cumulative Bonus. Under no-claim-bonus, when you do not make any claim on your policy in a particular year; there would be an increase in your sum insured amount for the succeeding year. This increase may vary from 50%-100% over a period of 5-10 years depending on the policy you’ve chosen.
4. Sum Assured
While buying a health insurance policy, you must realize that the cover chosen today will be inadequate tomorrow given the rising inflation & medical expenses. So, purchase a plan that takes care of both inflation and the rising medical expenses i.e. the plan with a higher Sum Assured amount.
5. Entry Age and Renewal Age
Some policies let individuals enter up to the age of 65 or 70 years, while other policies can be bought at any age provided the person is in a healthy condition. Despite the varying criterions on the entry age (as discussed), all the policies are renewable for a lifetime.
6. Pre-Existing Diseases
Usually, pre-existing diseases are covered in a policy after first 4 years of the policy being active. However, some policies cover them after 2-3 years at a higher premium amount. If the pre-existing disease is severe, they may not get covered at all.
7. Pre-Policy Medical Check-up
Pre-Policy Medical Check-up is mandatory, if the policy seeker has reached a certain age (usually above the age of 40-45 years) or if the coverage amount is high (For example, 8-10 lakhs). The check-up is necessary to have a hassle-free claim. Insurance Regulatory and Development Authority of India (IRDAI) makes it compulsory for the insurer to bear 50% of the expenses incurred on pre-policy medical check-up. However, some insurers bear more than that to lower financial burden of the policy seeker. Some insurers insist the policy seekers to bear the cost initially and later when the policy becomes active, 50% to 100% of the cost is reimbursed.
But it is important for you to know that most of these parameters differ from case to case, and can be generalized only to a certain extent.
We advise our customers to take up a thorough research and choose a plan after considering and understanding all of its aspects.
For any further clarification or query, feel free to reach us at 86559 86559 or firstname.lastname@example.org.