How to Choose the Best Health Insurance Plan in India?

Greetings to all the wonderful health investors!

Let us ask you this: “How do you choose from the best insurance plans in India?” Surprisingly, it is not just the choice that makes this a difficult question, but the fact that we are asking you to pick apart the shiniest needle from a haystack full of shiny needles – we are asking you to pick the best from everything that looks like the best.

But how can you possibly separate health plans that all claim to be the best?”, you pretentiously ponder? Well, do not fret; read on to unravel a summary of the best tips and tricks pertaining to picking health insurance plans in India.

Here is, all you need to know about health insurance in India!

What are health insurance plans?

In the simplest sense, health insurance is a subtype of insurance covering some to most types of medical expenditures that may arise due to various diseases and illnesses. These expenses are generally related to treating diseases that directly affect your health or expenses that arise when diagnosing your illness. For instance, doctors’ consultation charges, pharmacy bills, hospital room rent, various diagnostic tests like MRIs, CTs, radiograms etc., are all typically covered under a health insurance plan.

The need for health insurance

Long story short: healthcare in India is not cheap. And if that is not a good enough reason, here are a few more that might change your mind:

  • Health insurance provides a much needed financial back up when dealing with daily uncertainties of life in general.
  • Having the ability to be reimbursed for any medical treatments can allow you to pay closer attention to your health rather than just avoiding it for the umpteenth time.
  • Health insurances are a vital part of financial planning for starting your career or starting a family. It takes an awful lot of immediate burden off of your wallet in the long run.
  • For the more accounting savvy readers, payments made towards health insurance premiums are eligible for major tax deductions pertaining to section 80D of the Indian Income Tax Act.
  • Health insurances come with additional benefits and coverages such as ambulances, day-care surgeries, routine health check-ups, vaccinations, etc.

The right time/age to buy health insurance

As a matter of fact, there is not any particular age for investing in your health. Although it is useful to note that health insurance premiums get more expensive the later you choose to invest in them. This is usually due to an increase in associated risks such as age, place of residence, medical history, etc. Even if there is no one best age group – the earlier, the better, but this is also variable across health insurance plans in India, and the better ones offer a smaller gap.

The basic health insurance plans

There are four common types of insurance plans that the Indian market tends to invest in:

  • Individual Health Insurance is used to cover the medical expenses of an individual or a group of members. Although the group premium is typically higher when compared to family plans, an individual can use the insured benefits of the group by himself in these plans.
  • Group Health Insurance provided by an employer offers limited sum insurance that is revoked upon termination from or leaving the organisation.
  • Family Floater Health Insurance provides coverage for all family members, including spouses, parents and children. Unlike individual plans, a single sum insures the whole group.
  • Senior Citizen Health Insurance provides medical coverage for people above the age of 60. These premiums are much higher than the rest but also provide many benefits. 

Key factors to check before buying an insurance plan ?

Health premiums vs Critical illness coverage

India’s best health insurance plans will often include an option for critical illnesses or at least urge you to take it up. These plans pay you a fixed sum of money if you are ever diagnosed with a critical illness. These include cancers, heart attacks or multiple organ system failures. But this is not to be confused with terminal illnesses – critical illnesses may or may not be terminal, but the sum insured for both as per the plan does not change.

Health premiums vs Emergency coverage

Most health insurance policies do not allow coverage for motor vehicle accidents or maternity among other expected health issues. These must be purchased separately with a base premium or as a stand-alone health insurance policy. It is also important to note that many policies have a cap on the room rent and sub-coverages for particular diseases. These amounts vary according to your place of hospitalisation and the kind of medical procedure you undergo, which are often out of your hand during accidents.

Daycare and alternative medicine coverage

Most health premiums offer returns for pre and post hospitalisation periods, up to 60 and 180 days respectively. But treatments that do not require you to be admitted into the hospital are not included in this. Therefore, it is always important to check if your policy offers this type of daycare return. In addition, it is also wise to check whether the policy offers extended coverage over alternative treatments such as ayurveda, cosmetics etc.

Pandemics and epidemics

What happens in the case of newly occurred/discovered diseases like COVID-19?

Usually, new diseases are not covered by regular or pre-existing health policies. However, they do allow new policies to be made that specifically cover the short and long term needs of a pandemic disease. In the case of COVID-19 in India, new policies covering telemedicine (phone consultation), payment in instalments, and rapid (>30-day) claims have come up to meet the growing demands.

Premiums covering top hospital networks

When choosing a health premium, it is important to recognise which network of hospitals in your locale is covered fully by the premium you plan to invest in. In the case of an emergency, you may not be able to decide which hospital you are rushed to. But by knowing which hospitals are part of your plan, you can be assured that the treatment and accommodation bills will be settled between only the hospital and the insurance company.

The waiting period of the plan

The waiting period is a sort of dormant period quoted in the plan during which no claims will be admissible. This clause is especially significant if you have a pre-existing health condition. This time usually ranges from 2 to 4 years in Indian insurance plans. But it is generally better to choose policies that have lower waiting periods.

Benefits that increase the sum insured

It is important to invest in premiums that enhance the monetary coverage over time. This can avoid any fluctuations in the sum returned due to repeated claims from the same plan in the same year (e.g. different family members insured in a floater plan undergoing treatment in the same year). So, to avoid overpaying, choose policies that have good No Claim Bonuses and Restoration Benefits.

Final verdict: choosing the best insurance plan

A good health insurance plan covers a sizable portion of all your expected and unexpected medical expenses. It should be the best fit for your lifestyle, if you live alone or with a family, if someone is dependent on you, whether or not your daily life involves major risks and so on. It may be a desirable combination of a few basic health plans or allow for the addition of the extra required coverage. We also advise that you refer to various experts in the field who can guide you through the process, and to use online facilities to compare different health policies to choose what best meets your personal requirements.

FAQs:

Is there a minimum number of claims I can make ?

No, you can make multiple claims. There is only a limit on the total amount you can claim.

Can I get a health insurance plan if I already have a disease ?

Usually pre-existing conditions are exempted from health insurance benefits depending on the insurer. But you will definitely have to wait through the waiting period until you are allowed coverage.

Am I eligible for health insurance ?

If you are 18 and above with no prior medical conditions, health insurance is readily available.

Can I pay the premium in installments ?

Typical premiums are paid per annum, but monthly, quarterly or half yearly installments are also available.

Can I have multiple health insurance plans ?

Yes, you are free to buy as many as you like depending on your needs.

Can I cover multiple people under a single insurance plan ?

Yes, family coverage is available in many forms and covering even distant relatives.

Is it worth to hire a health insurance coach ?

An expert in the field can always offer to find you the optimal deals and fend off the hustlers.

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