Things to Consider While Buying Health Insurance

Important Update (Dated May 30, 2024) – Good news for Health Insurance policyholders! According to the Master Circular on Health Insurance Business 29052024 rolled out on May 29, 2024 by IRDAI, insurers are to decide on the request for cashless claims within 1 hour of receiving the request. Also, the final claim is to be granted within 3 hours after the policyholder’s discharge from the hospital. Insurers have been directed by IRDAI to establish necessary systems and procedures for this process by July 31, 2024.

 

The Master Circular on Health Insurance Business 29052024 circular is available here - https://irdai.gov.in/document-detail?documentId=4942918

Things to Know Before Buying Health Insurance

• Scope of Coverage

An essential aspect to consider before purchasing health insurance is to assess and evaluate the scope of coverage. Many buyers simply get the policy based on the premium quote and consequently end up limiting their health insurance coverage. Therefore, it is crucial to consider the scope of coverage, such as the sum insured, cashless facility, convalescence benefit, pre and post hospitalisation, etc. Moreover, it is recommended to avoid comparing insurance policies solely on premium rates. Ensure you get the best features and a high coverage limit to stay protected against any medical emergencies.

• Room Rent Capping

Some health plans have restrictions or upper limits on the hospital room rent, while others may not have any such restrictions. With skyrocketing medical costs, hospital room charges are also becoming increasingly expensive. Hence, it’s best to compare the hospital room rent generally offered to patients with the eligible room rent cap under health insurance. Try to look for a plan that allows for the highest room rent limit or a plan with no room rent limit. This will help you ensure that your health policy can cover the hospital room cost without you having to shell out more money for room rent.

• Cashless Hospital Network

Cashless hospitalisation is a facility that makes hospitalisation a seamless experience as far as payments are concerned. All you need to do is show your health insurance card and your hospital bills will be settled directly by the insurance provider. However, the cashless facility can only be availed at selected network hospitals. So, before finalising a health insurance plan, check if the insurance provider has a wide network of hospitals. Another one of the most important points to consider while buying health insurance is the type of network hospitals offered by your insurer. Choose to buy from an insurer that has the best hospitals under their network so you can get the highest level of care.

• Claim Settlement Ratio

Claim Settlement Ratio or CSR tells you the probability of your health claim getting cleared in the future. This value is estimated by taking the total insurance claims settled by the insurer against the total claims filed by policyholders. So, a higher CSR percentage assures you that your claims would not be wrongly held back. Many policyholders opt for reputed Claim Settlement Ratio. Though you shouldn’t shortlist insurers only based on CSR, it is one of the most crucial things to consider while buying health insurance

• Co-Payment

Co-payment or copay is a portion of the claim amount that you need to bear from your own pocket. Generally, co-payment is expressed as a specific percentage of the claim amount. By opting for a high co-payment, you can reduce your health insurance premium and vice versa. However, remember that co-payment in health insurance is a big responsibility to bear as you need to pay for it. So, it is generally advised to go for plans that offer a very low or zero co-pay, so you can keep your hospitalisation expenses at the minimum. At times, some insurance providers include the health insurance co-pay clause discreetly, so look out for the co-payment clause before finalising the policy.

• Lifetime Renewability

Lifetime renewability is another factor to consider before buying a health insurance plan. In case your plan doesn’t allow renewal after a certain age, consider opting for another policy. Lifelong renewal is an important feature because most people experience deteriorating health with increasing age. If your health insurance plan has lifetime renewability, you don’t have to worry about buying a policy when you grow old, which can be very costly. Instead, you can continue with the coverage available with your insurer by renewing every year and being worry-free about age-related restrictions

• Pre and Post Hospitalisation Expenses

Pre and post hospitalisation coverage is a lifesaver as it includes various expenses incurred before and after hospitalisation. These include ambulance charges, doctor fees, tests, medicines, and many others. However, some insurance companies have different terms and conditions when it comes to the number of days covered and other aspects. The extent of pre and post hospitalisation expenses is one of the most important things to consider before buying health insurance,

• Exclusions

Exclusions are certain aspects of health insurance coverage that aren’t covered under your policy. To understand your insurance plan better and ensure you have sufficient cover, it is recommended to read through your policy document. Knowing the exclusions and terms and conditions of your plan can greatly help to avoid any last-minute claim issues. So, before finalising your health insurance plan, you should also consider the exclusions.

• Maternity Cover

In case you are buying a family plan for yourself and your whole family, or you are an individual who needs maternity coverage in the future, then it is important to buy a maternity insurance. Most general insurance plans do not have this plan by default, but you can choose to buy the maternity add-on cover or choose a plan that offers maternity cover included.

How to Buy Health Insurance?

Now that most services have become online, you can also buy a health insurance plan online while sitting in your home. Check out the steps given below to buy health insurance at Bajaj Markets:

 

• Step 1: Visit the health insurance calculator page on the Bajaj Markets website.
• Step 2: Enter your personal details and contact information on the page.
• Step 3: A set of health insurance options will appear on the screen.
• Step 4: Choose a plan that fulfils all of your requirements and check the premiums.
• Step 5: Select any add-on covers you may need.
• Step 6: Upload the necessary documents and make the insurance premium payment online.
• Step 7: Your health insurance will be activated shortly and details will be sent to your registered email.

Read More: Difference Between Copay, Deductible and Coinsurance

Wrapping it Up!

Now that you are aware of what factors you need to consider when buying health insurance, it is time to purchase one today! Due to the uncertainty in life, you never know when an urgency might come your way. So, estimate your insurance premium quote with our health insurance premium calculator now! Browse through the health insurance policies available at Bajaj Markets to make the most of your money. You can avail speedy claim settlements, easy renewals, add-on covers, and more just with us!