The Right Way to Buy a Health Insurance Policy | Find the Best Health Insurance Plan for Your Family
Finally hit with an unexpected medical emergency. You’re in pain you’re scared and all you can think of is getting the Care Unit but as you head to the hospital some other thoughts creep into you, will I be able to afford it is my group health insurance policy good enough. Does this Hospital provide cash flow statement, etc. Etc. It’s a scenario. No one wants to experience and yet it happens all too often, which is why health insurance is so incredibly important not just As a safety net but as a Lifeline to us and our loved ones, I’m not going to talk about the benefits of health insurance. I’m sure you understand it sufficiently. And so in this video, I’ll walk you through my checklist of important factors one should consider when choosing a new health insurance plan or when upgrading your existing health insurance policy. Let’s begin. It was a year 2008 when I first started working in health insurance and over the next 12 years. I’ve seen how the simple product being offered Offered by just a handful of insurers has become mainstream with tons of features specifications and insurance companies. In fact figure this we now have health insurance for
Importance of Health Insurance
students for newlyweds young families senior citizens people with heart diseases diabetes, and even those who have been diagnosed with cancer. So from a consumers perspective finding a health insurance plan is a headache metaphorically speaking. So we are spoiled for Choice which is why your first Should be to identify your number one need that is why are you really seeking a health insurance policy? Is it to get coverage for an existing illness or is it to cover maternity and child birth related expenses or is it because diabetes and hypertension runs in your family Etc. It’s an important step because every health insurance company will try to tempt you with a high counter features. Oh, we are offering 25 benefits. Another one will say 30. Another says 35 benefits and we’ll get into a never-ending Loop. Poop unless you know precisely what you’re looking for in a plan and how important it is for you which brings me to ditto Insurance who are not only the sponsors of this video, but more importantly they help you access and decode the nitty-gritties of different health insurance plans. So if you’re looking to work with some excellent health insurance advisor, then do visit Tito’s website click on that blue book a free call Button schedule your free phone consultation and be prepared with all your questions and requirements. It’s the question on coverage needs to be looked at from two angles. The first is the amount of policy cover. And while there is no consensus on this the thumb rule you are likely to find everywhere is fifty percent of your annual income for six times a monthly salary. Now. I personally have a problem with this thumb Rule and that’s because no medical emergency is first going to check your income tax returns and that decide whether it should come to you or not in that context and in my view one should try to keep their health insurance. Cover as much as one can afford it. For instance. I have two policies one is a Comprehensive Health insurance policy while the other is a super topper and cumulatively it gives me a coverage of 60 lakhs. But if I were to put a number to it then try to have a health insurance cover of at least 10 lakhs. The second element within coverage is the number of members and here are some things which might be helpful to you. So if you have a young family that is you your spouse your children, and everyone is under 40 years then it makes sense to go for a family floater policy, which is a lot cheaper than taking a health policy in every individuals me. But if there is someone in the family who is above 45 years old, which can include your parents for example, or someone in the family has a pre-existing condition like diabetes any heart ailment Etc. Then it’s better to enroll into multiple policies, which will not only be cost effective but can actually increase the amount of coverage as a
Your Top Requirements
whole. So there are some permutation combinations that eat Be done here, which you can either do it yourself or you can consult an insurance advisor like the ones that did too who can do the mathematics for you. All right. So there are five not 25 just five core components to policy coverage that you need to focus on. The first is inpatient hospitalization, which is the maximum amount you can claim against your hospital expenses. It’s pretty much why we buy a health insurance plan in the first place. And yes while most companies do offer a to lagg-3 lack even a fight. Black group health insurance cover its this coverage amount that you need to be comfortable with because if the Expense goes above this number that it comes from your pocket. The next benefit is daycare treatment that it covers procedures like cataract tonsils chemotherapy. Kidney stone removal Etc typically procedures that can be completed within 24 hours. Now the idea here should be to look for a plan which covers all or at least a high number of daycare procedures and this coverage comes without any amount restrictions from what I have seen the understanding of which they care is covered and for what amount is particularly. Important when evaluating senior citizen health insurance plans and these often have a restricted list of day care treatments the third benefit pertains to the room rent and this is explained in the policy document either as a maximum permissible amount or the type of room offered now some health insurance plans have no capping on room rent, which is the most ideal situation some other plans offer a single private room and other policies allow a limit of up to one or two percent of the policy, sir. Richard for example if a policy allows for only 1% of the sum insured then the maximum room rentals ability or a 3 lakh rupee policy comes to just 3,000 rupees a day, which may not be sufficient in most hospitals across Metro Zack Tier 1 cities the other issue with room rent, which a majority of policyholders ignore is that the kind of room rent you take up has a big bearing on the percentage of claim that is eventually paid out to you. This point is important. So let me explain this with an example so Get my health insurance policy has a sum insured of five lakh rupees and it allows a daily room rent of up to one percent. So that’s 5,000 rupees a day. Now when I reach the hospital I notice there’s a nice spacious private room that’s available for 10,000 rupees a day and just like how you would do it. I also instruct the hospital staff to put me in the bigger room with a mental assumption that I’ll pay for that extra 5000 rupees from my own pocket. So say I was in the hospital for six days at the hospital bill Capo. That rupees which I was okay with because I believed my insurance policy would take care of most of the song but what came as a shock to me is when the hospital informed me that the insurance company had agreed to pay only one lakh 5000 rupees and that I had to pay the remaining ninety five thousand rupees. You see what had happened here is that when I upgraded myself to that ten thousand rupee room, basically everything doubled that is the doctors. He had doubled the cost of surgery was now twice the medicines the test the food everything. Was built at Double the rate and because my health insurance policy was picked for the costing structure of a 5000 rupee room rent. The policy applied a pro rate of 50% on all related expenses, which drastically brought down my claim about. It’s an estate that many policyholders makes so as a practice either opt for a health insurance policy that doesn’t have any supplement or room rent or kindly stay within the room rent limit that was stated in the policy document the fourth benefit one has Consider when evaluating a policy are the coverage amounts for pre and post hospitalization expenses. Now one might typically see an eligibility of 30 and 60 days. But where you need to be attentive is on the amount of pre and post hospitalization coverage that the plan offers again. Some plans would go up to 100% of the sum insured which is most ideal but then there are also plans that offer just 10% and I even came across one plan that will be a maximum of just 3,000 rupees in Post hospitalization expenses which is like next to nothing. And finally your coverage schedule is likely to have some sub limits which is a cap on the amount of expense of policyholder. Can’t lie. Now many health insurance plans have supplements. You generally find this on certain procedures like cataract might be ten maybe fifteen thousand rupees per I maturity expenses
Health Insurance Policy Coverage
almost always have some sub limit to it the same goes with dialysis psychiatric treatment organ transplant. Etc so these five elements inpatient hospitalization Day Care procedures room, rent pre post hospitalization and sublimate on certain procedures form the core of a health insurance cover and it’s something one should examine very carefully. If you’re getting good value from this video then please do give this video a thumbs up and if you aren’t a subscriber yet they do consider becoming one as I can then serve you videos as soon as they are released and also share with you. Some investing strategies tips and stories that are continually Post in the community section. I have broadly The section as exclusions, but there are three important parts to this. The first is the waiting period and almost every health insurance policy will have one this waiting period can be for a year two years four years even six years and it’s sort of a hibernation period during which certain types of claims will not be admissible. Additionally. There are some particular illnesses or some specific situations like maternity, for example, where a different set of waiting periods might apply. So I’m just saying it again firstly there is a waiting period Within the main policy that is applicable for most kinds of hospitalization. And then there is a set of other waiting periods for specific situations or illnesses. All of which will be listed in the policy document. So don’t forget to read that of course as a thumb rule the lower the waiting period the better it is but if you don’t have any pre-existing illness then the waiting period is not something you need to be bothered about much a second point to consider other co-payments, which is that share of the claim that needs to be
oodbye. For example, let’s say the approved came amount comes to 50,000 Rupees and if there is a co-payment of 20% on the policy, then the insurance company will pay you only 40,000 now from what I have seen co-payments are generally triggered in senior citizen plants or in special plans like the ones related to diabetes or Cardiac Care, but surprisingly there is a 5% copay in even a mass-market plan like the arugula and Jimmy health insurance policy. And finally we have the exclusions and Most health insurance policies have some prohibitions things like any treatment done solely for cosmetic purposes non allopathic treatments pregnancy and childbirth is excluded most policies injuries or illness due to drug or alcohol abuse experimental treatment self-inflicted injuries Etc. And while these might seem pretty standard it’s always good to read through these before considering the health insurance plan point-blank. You cannot opt for a health insurance plan, which does not offer. Were a cache service so cashless means you can get your medical treatment done without having to folk any money and the insurance company will directly settle your medical bills with the hospital and while all insurers offer a cashless service not all hospitals are part of an insurance gaseous Network. In fact of the 70,000 or hospitals we have in our country insurers offer cashless in anywhere from 4,000 to 10,000 hospitals. It’s a number that varies from insurer to ensure a but don’t be surprised. If you see some weird things happening here, for example, a few years back max. Bupa policyholders could not Avail cashless treatment in Max hospitals due to some contractual issue between the two parties now something like this can be a problem which is why I’ll advise you to do two things firstly check. If there is a decent count of hospitals in and
around your locality your PIN code which are a part of the insurance cashless Network and secondly ensure that your city’s most popular hospitals are also available. In that list for instance, I reside in Delhi and so I’ll search for hospitals like indraprastha Polo Max super speciality. So gangaram hospital all India Institute of Medical Sciences, BLK, super speciality Etc. So remember it’s not the count of hospitals. You should be interested in but look out for the best hospitals in the city because 90% of all hospitalizations are planned and it’s in your interest to get the best health care your insurance can buy and to Avail it on a cashless basis. The final element to consider is of course the premium which would come only after you’ve narrowed down the list of insurance plans for the earlier five variables. Now some points are very obvious. The older you are the higher the premium. If you have a pre-existing illness, then you have to paint more higher some in short means higher premium. So is the case if you opt for a lower waiting period and specific benefits like maternity OPD International cover all expensive and all this gets out. Up to the policy premium. So the more you ask for the more you’ll have to pay which is why nailing down the core requirements. The must-have is so important. Once you have a list of three or four health insurance plans that fit within your requirements, then that’s when you can compare the premiums and also measure those plans again some good to have features like the no-claims bonus consumables cover restoration of some insured annual Health check-up Etc. Actually the no-claims bonus is a decently important features who keep an eye on On that now health insurance premiums in India are not expensive when compared to the rest of the world. But we Indians love a discount to 3. So here are some things you can look at one. If you don’t have a pre-existing disease, then you can opt for a higher PD cover which would save you for 25 percent in premium. Secondly, you can offer co-payment which can bring down premiums by eight to twelve percent. You can look at plans that offer a five to ten percent discount to non-smokers. You can pay for multiple. Years to even three years and get a discount on the premium. There are insurers offering a renewal discount if you maintain a healthy lifestyle and finally there are discounts which are offered on the basis of your credit. Score’s the city you live in and that also loyalty discounts. If you are an existing customer, so check with the insurance company or an insurance agent who can give you a better idea of what’s available. But remember premium comes after you have an absolute Clarity on the fitment benefits, exclusions claim and the cash, sir. And once you put everything together in a table like this, there is no reason why you would not. Figured out a
Health Insurance Premium
solid health insurance plan for yourself and your family so pull out a couple of hours over the weekend to review your health insurance needs and if you want some help with that, then you connect with the folks at the do for a free consultation. The fact remains health insurance is an important part of our personal finance portfolio. And I sincerely hope you found this video useful. Thank you for your time. Do hit the like button kindly share this video with your friends and I’ll see you three days from now until then.
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