Critical and important features to look for in Health Insurance

Investing in the right health insurance scheme goes a long way in protecting your health and wealth. It allows you and your loved ones to live a life free of any financial stress, knowing that your wellbeing is safeguarded. You can get prompt access to excellent facilities in times of urgent medical need if you have an appropriate health insurance plan.
But how do you really decide which is the optimum plan for you and your family?
With many options available to us today, making this decision has become that much more difficult. Health insurance is not a one-size-fits-all product! It can vary between individuals and families depending upon personal dynamics and requirements. Health insurance is a lifelong investment; hence it becomes more crucial that you get the best plan for your family members and yourself.
The decision making becomes easier once you have determined the type and amount of cover you are looking for, either for yourself or your family. At this stage, there are certain critical and important features to look for before you finalize and invest in a health insurance policy:
Basic offer: Check for all the basic features in the health insurance plan, i.e., whether it takes care of all hospitalization expenses (pre, during and post), alternate means of treatment, day-care procedures etc. These would form part of the base policy.
Optional features and benefits: A lot of benefits are offered by means of optional cover, which is over and above the basic plan. Opting for these would mean higher premium. However, if your expectation gets covered via add-on cover then it would be wise to choose it at the time of purchasing your health insurance plan. Many plans cover maternity benefits, critical illness treatment, daily hospital cash and accidental expenses via add-ons or riders.
Easy access to healthcare: Find out how many network hospitals you can get quick access to within your area. This becomes crucial at the time of seeking medical attention, whether planned or unexpected.
Waiting Periods: All health insurance policies specify time periods from start of policy for some health conditions, during which medical claims cannot be settled. These are called waiting periods. The insured member can submit claims for payment release or settlement only once the waiting periods are over. Many policies define waiting periods for pre-existing diseases and some even for specific medical conditions.
Exclusions: Health insurance policies also come with a list of exclusions, meaning conditions or treatments that won’t get covered under the plan. The insurer will not be liable to pay for any claims related to excluded conditions / treatments.
Payment-related conditions: A lot of health insurance policies come with conditions related to medical expenditure. For example, Co-payment clause (wherein a specified percentage of expenses will have to be borne by the policyholder), Sub-limit (wherein some diseases / treatments might mention an upper cap on permitted expenses) or Deductible (wherein expenses up to a certain initial amount has to be borne by the policyholder and the insurer will pay for claims above that initial amount, up to the sum insured amount).
Value Adds: Check whether your health insurance offers some extra perks, like free health check-ups, domiciliary hospitalization etc.
No-Claim Bonus: Find out whether the shortlisted plan provides a bonus for not raising any claims in a given year, and to what extent.
Restoration benefits: Quite a few plans allow the sum assured to get restored or reinstated in case the claims exhaust the coverage amount within the year.
Customer Service: How convenient, efficient and fast is the claims settlement process of the chosen insurance company.
These are some of the key features to keep in mind. Of course, health insurance is a complex product that comes with numerous terms and conditions, often too lengthy and difficult to understand. That’s where SANA.Insure can guide you with SANACheck – a health check for your health insurance policy. If you have purchased a health insurance plan, you can get it thoroughly examined by entering some basic details on SANACheck. Our system will be able to help you identify the critical and important features in your health insurance policy: more than 40 of them!
These features are explained in basic terms for easy grasp. Besides, they are highlighted in red, amber and green so you can visually distinguish between the poor, average and good features in your policy.
SANA.Insure makes buying health insurance super easy – Just select multiple plans, compare across 40+ features and purchase the best fitting plan online! Our dedicated Claims Help Desk is manned by experienced Relationship Managers who assist you end-to-end with your claim submission and settlement. Log on to sana.insure to find your Partner-In-Health today!
Wish you a healthy and happy life!