7 Factors to Compare Before Selecting a Health Insurance Plan

Illnesses and accidents can sneak up on us when we least expect them. That’s where health insurance comes to our rescue like a guardian angel. Having health insurance is like having a superhero that shields you from the financial challenges of unforeseen medical expenses. 

A health insurance plan is a contract between you and an insurance company, where you pay a set amount as the premium, and in return, they cover certain aspects of your medical bills.  

Now some may wonder, “Why should I bother with health insurance? Can't I just rely on a healthy lifestyle, routine check-ups and doctors' visits when needed?” Well, let’s give you a few solid reasons why health insurance is an absolute game-changer for anyone and everyone. 

1️⃣ Financial Protection
We all know how unexpected medical bills can burn a hole in your pocket, especially if it involves an emergency or critical care. You also run the risk of debt, especially if you don’t have a cushion of savings handy. With a health insurance plan by your side, you can be assured that a major part or even all of your expenses will be covered.  

2️⃣ Access to Quality Healthcare
Top-notch healthcare facilities often come with a hefty price tag. Having health insurance is like having a VIP pass to a wide network of hospitals and healthcare providers. With a health insurance plan, you can opt for the best medical care and treatment without worrying about your finances. 

3️⃣ Peace of Mind
Imagine how good it feels to wake up every morning, knowing that you have a safety net to catch you in case of a medical emergency. Health insurance can give you that unmatched feeling by ensuring maximum financial security. 

4️⃣ Tax Benefits
Guess what? You can save on taxes when you buy health insurance! Section 80D of the Income Tax Act states that the premiums you pay for health insurance are eligible for tax deductions up to a specific limit and that too depends on your age. 

While selecting a health insurance plan, it's easy to get lost in a maze of offerings available both online and offline. But worry not! We're here to provide you with comprehensive guidelines on how to proceed and compare the top health insurance plans. Read on to understand how you can select the best health insurance plan in India for your needs! 

1️⃣ Identify the Type of Policy
The first step is to set your goals and pick the type of policy accordingly.  For example, if you're a single person and want to cover only your own medical expenses, choose individual health insurance. But if you have a family with narrow age groups and no one suffering from chronic medical conditions, you can consider family floater plans that provide healthcare insurance for your entire family under a single policy.  You can also opt for top-up plans if you already have a basic health insurance plan. This will help enhance your coverage by providing additional benefits in case of emergency care or critical illnesses at a nominal additional cost.  

2️⃣ Check Coverage and Premiums
Now that you've finalized the type of insurance you want to get, it's time to take a look at the coverage and premiums in detail. Consider your medical history, current health conditions, and any ongoing treatments or medications while shortlisting plans according to the coverage. Low premiums often come with lower sums insured and fewer benefits. So, consider all factors and decide on your policy and premiums accordingly. Always go through the fine print and read all the terms and conditions to ensure you get the best deal.  

3️⃣ Review the Copayment Structure 
Copayment is a cost-sharing arrangement between you and the insurance company. It determines your out-of-the-pocket expenses when you avail of certain medical services or treatments.  For example, if a health insurance plan has a 30% copayment for hospital expenses, you have to pay 30% of the approved claim amount. Your insurance provider will cover the remaining amount. While some plans have mandatory co-pay, others may give you the option to choose a co-pay, providing you with an opportunity to choose a low premium.  Plans with higher copayment amounts often come with lower premiums. So, check your budget and consider the copayment options carefully before making your decision. If possible, buy a policy with no or a low copay.

4️⃣ Verify the List of Network Hospitals
Now it’s time to check if your preferred hospitals and specialists are part of the plan's network. Access to familiar doctors and known hospitals can ensure convenience and comfort. It also helps with getting better facilities, including easy reimbursements, lower out-of-pocket costs, and easy access to emergency care. For instance, if your chosen hospital is part of your insurance’s network, you can simply head there to receive quality medical care in familiar surroundings from doctors of your choice. 

5️⃣ Check Waiting Period and Grace Period

• Waiting period: It is like waiting in a queue before you can avail the benefits of your insurance plan. This is outlined by insurance companies to manage risks and avoid fraudulent claims, and they can range from a few months to a couple of years. There are 3 main types of waiting periods. If you have pre-existing conditions or require immediate coverage for a specific treatment, look for plans with a shorter waiting period. For example, if your health insurance plan comes with a waiting period of 24 months for coverage of pre-existing conditions, you have to bear all expenses related to treatment for those conditions, until the waiting period is completed.  
   
• Grace Period: This time period provides some flexibility in paying your premiums. It’s the extra time policyholders get beyond the due date to pay their premiums without any penalty or policy lapse.  For example, let's say your health insurance premium is due on the 1st of every month. If you miss the due date, you usually have a grace period of 15 to 30 days to make the payment. During this time, your policy remains active even if you pay the premium later. 

6️⃣ Consider Benefits/Features
These are bonus benefits that provide extra protection and coverage beyond the basic policy. The following are a few add-ons that you may consider: 

👉 Maternity cover: If you're planning to start or expand your family, it will provide coverage for prenatal care, hospitalization during delivery, postnatal care, and sometimes even newborn baby expenses. However, it is important to note that some plans may offer in-built coverage for these expenses.   

👉 Critical illness: This add-on pays a lump sum payout upon diagnosis of a covered serious illness. You can use this amount to seek specialized treatment and manage expenses not covered under your regular health insurance plan. 

👉 Accident cover: Accidents can happen anytime, anywhere, and this add-on can ensure additional compensation in case of accidental injuries, disability, etc. However, some plans may offer in-built personal accident coverage where these expenses will be covered.  

👉 Restoration benefit: It reinstates the sum insured amount once it's exhausted during a policy year. Suppose you have already utilized your sum insured entirely or partially for a specific condition but still require further treatment or hospitalization for a different illness within the same policy year. In such cases, if your policy has a restoration benefit, the insurance company will cover your medical expenses for the new treatment.

Apart from these, there are several other popular benefits such as OPD benefits, wellness programs, and more - available with different plans. 

7️⃣ Read Customer Reviews
After considering all the parameters and shortlisting health insurance plans, it’s time to check the insurer’s performance. You can check the Insurance Regulatory and Development Authority of India (IRDAI) website for public disclosures and review annual reports for detailed insights into claim settlement, solvency margin, etc. Apart from these factors, you should also consider checking customer reviews. These reviews offer insights into real-life experiences and help you assess the overall service quality and support you can expect from your insurance company. Visit online platforms and social media groups and ask friends and family.

Choosing a health insurance plan can get difficult and you might find deciding the one plan that suits your requirements confusing. To make this decision (and life!) easier, you should consult an advisor for detailed information about the best health insurance plans and get personalized guidance. 

At Beshak, you can schedule a free 1-to-1 call with some of the best financial advisors in the country. We are an independent community platform where you can also discuss your insurance-related queries or compare the best insurance plans in India to make an informed decision about your health insurance.