Your family’s health insurance is a vital safety net; protecting your family’s finances in the event of a medical emergency. Given India’s increasing healthcare costs at 14%, it’s important to have a correct policy to avoid paying a huge out of pocket expense. With an understanding of your family’s unique healthcare needs, you can compare different plans in order to make a decision. Having the right health insurance policy for family can give you some peace of mind that you’re all set to deal with any unexpected medical problems you may come across.
How to choose the right family health insurance plan in India? Here are top 11 tips and tricks to ensure you invest in the best possible plan:
1. Assess Your Family’s Healthcare Needs
Start first by considering the medical necessity for each family member. Think about age, what existing health issues you have, and the health risks involved. For example, if you have elderly parents you’ll want the best health plan for parents which include coverage for certain age ‘related illnesses’ and pre-existing conditions. Similarly, if you have young children, make sure the plan includes pediatric care and vaccinations.
2. Choose Between Individual and Family Floater Plans
Choose whether you want to buy individual health insurance policies or a family floater plan. Family floater policy covers all family members under a single sum insured, thus it might be effective. Nevertheless, if a family member has special health issues that need to be fully covered, an individual plan may be more appropriate
3. Determine the Adequate Sum Insured
It’s also important to carefully pick a sum insured that is high enough to cover the healthcare expenses during inflation. For example, healthcare facilities in the city consider the metropolitan areas to have more treatment costs than urban or rural communities. Make sure that the sum insured is large enough to pay for multiple hospitalisations if necessary.
4. Evaluate Coverage and Benefits
Examine the scope of coverage offered by the policy. Essential features to look for include:
● In-patient Hospitalisation: Payment for illness or injury leading to hospitalisation.
● Pre and Post-Hospitalisation Expenses: Pre and post hospitalisation medical costs.
● Maternity and Newborn Cover: This is important if you plan to have a family.
● Domiciliary Treatment: Coverage for treatments at home, if unable to be done in hospital.
It is important to ensure the policy covers various medical scenarios to provide comprehensive protection.
5. It is also Advisable to Know the Waiting Period Clause for the Pre-existing Diseases
The only big issue that most health insurance policies have is they have waiting periods for pre-existing diseases which are about 2 to 3 years. To ensure that a policy covers events as soon as possible, choose a policy with the shortest possible period that can be issued after applying for the coverage in case any member of the family has pre-existing conditions.
6. The Individuals Should Understand Co-payment and Sub-limits
● Co-payment: This policy clause allows the policyholder to make a contribution on a percentage of the claim amount. Policies with co payment may attract low premiums but the actual amount one has to pay at claim level is high.
● Sub-limits: Different policies have a ceiling on some expenses such as room rent or IC charge. You should understand these sub limits as they come into play once you are admitted at a hospital.
7. Look at the System of Cashless Hospitals
They have tie-ups with hospitals so that the policyholder can avail the cashless option with respect to the policy. Most empanelled hospitals for medical treatment all around including the ones in your area are always helpful in enabling you access those facilities without having to use little money on initial deposit.
8. Meaning of the Claim Settlement Ratio
The claim settlement ratio is defined as the actual number of claims settled to the overall number of claims filed. The higher ratio indicates that the management of this aspect of claims is done efficiently by the insurer. To avoid such incidences in the future, look for that particular insurance company which has a higher claim settlement ratio.
9. Look for Additional Benefits
Some health insurance policies offer extra benefits that enhance coverage:
● No-Claim Bonus: Claims free period upscaling of sum insured from by 1%.
● Free Health Check-ups: The insurer contributes to the employee’s medical expenses through free medical check up from time to time.
● Restoration Benefit: Restoration of the sum insured as soon as it has been paid out where it has been lost in the course of the policy period.
10. Compare Premiums and Affordability
The most important thing is to find a policy that fits your budget, but avoid cutting coverage for lower premiums. Get online comparison tools to compare different policies based on coverage, benefits and premiums. This approach gives you the best value for your money.
Look out for lifetime renewable policies. This will provide continuous coverage regardless of age, which is particularly important as health needs increase with age.
When it comes to choosing the right health insurance policy for a family, there are many factors that one should consider carefully – such as healthcare needs, what’s covered, and financial aspects. With proper information and by following these tips, one can select a plan that provides for all of one’s health and financial needs.