5 Things To Consider Before Buying A Health Insurance Plan

Important Tips:
1. Coverage exclusions and conditions
2. Waiting Period of X years
3. Room rent limit eligibility conditions was only this - so that's all you'll get. (Challenging to understand that calculation)

So, are insurance companies trying to confuse you?
Answer is no to some extent. We forget to use our skills while buying insurance and end up paying the price. We research most things before we buy, but not insurance.

Can you overcome the long and Confusing Terms & Conditions?

It's not so tough. Though it's not possible to understand all the fine print, understanding some basic concepts of insurance can go a long way in making a sensible choice.

First and foremost, get a hang of commonly used terms or policy features in health insurance. Each of them pretty much implies the same thing across various plans. Most important ones are- premium, sum assured, no claim bonus, room rent, exclusions. Let's quickly understand the 5 things one must consider before buying a health insurance plan.

1. Premium - This is what you pay
A premium is the "fee" you pay to remain covered in your insurance plan. Normally, good things don't come cheap. The cheapest available plan may not be the best one for you or your family. Always look at the premium in return of the benefits or the coverage you get.
It's not a rule - but by sheer logic, you get wider coverage if you go for a higher priced product. Wider coverage implies more ailments / more situations and more expenses covered.

2. Sum Assured -
Sum Assured is a fairly simple concept, once understood. As the words suggest it means the maximum the insurance company will pay under all possible heads in case of hospitalization.
Sum Assured means Sum Insured or Coverage Amount
Insurance company under all heads combined, pay more than ₹3 lakhs.
So a 3 Lac Sum Assured = Rs. 3,000 room rent limit.
So, if you are not ready to go to a lower category room or not willing to pay the difference, do yourself a favour - select health insurance which has a high room rent limit or better still- no limit! Yes, that's possible. The world is not so unfair. But only if, you don't sign insurance application forms

4. No Claim Bonus - Ensure you get when there is no claim in the policy period. Some companies also reward you even if there is a claim in the policy period.

5. Waiting period & Exclusions - All companies make you wait for a defined period of time, before you are eligible to claim. This is called the "waiting period”. Waiting period is of various types-

  • Initial waiting period of 30 days, you remain out of cover in spite of buying the policy, except in the case of hospitalization due to accidents. You can't fall ill, then buy and then claim.
  • Exclusion waiting period- Once your cover becomes active, certain procedures or disorders are not covered for a specified period of time- usually 2-3 years. Few of them are cataract, fibroids, appendix removal, hernia removal etc.
  • So, the waiting period clause is to defend the Insurance Company from fraudsters. This waiting period can be as high as up to 4 years for conditions which already exist (pre-existing conditions) before buying an insurance plan.


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