Unsure about what factors should be considered while buying health insurance? Here are a few thumb rules.

Start early

The prime rule to buying health insurance is to start early. Since the likelihood of pre-existing ailments such as blood pressure, diabetes is on the lower side while you are young; insurers would give you a policy easily too. In addition to that, the premium would also be lower.

For example, if you take a cover of Rs 2 lakh at the age of 25, the premium will be approximately Rs 2,338 whereas the same cover taken at 30 years will cost you Rs 3,283 for a year. This is why, for the benefit of a better cover, an early start is advisable.

Increase your sum

To ensure that you are making sufficient provision for any unforeseen hospitalisation, it is important that you increase your sum insured by 10-15 per cent each year. This is important because of the rapidly increasing rate of medical inflation. For example, cardiac treatment would cost anything between Rs 3 lakh and 5 lakh today. Adding an inflation rate of 15-20 per cent would mean it could see an increase of anything between Rs 45,000 and Rs 1 lakh, the following year. This would be a substantial amount to shell out in case of inadequate health cover. To cover this increased cost, it would be prudent to increase the sum insured accordingly.

Most working individuals are covered by a group health policy provided by the employer. However, you should not purely rely on the benefits of the group cover offered to you. The drawback of this mediclaim offered by your employer is that, it may be neither sufficient in terms of sum insured nor long-term, as these benefits are lost upon quitting the job. It is therefore important to have an individual health insurance beyond a group cover, as this will ensure continuity, irrespective of a job switch.

Evaluate your insurer

These days, with a large number of insurers present in the domain of health insurance, customers have multiple options to choose from.

While taking a decision, it is advisable to track the insurer’s premium pattern over a period of 5 years, at least. This will allow you to get an idea of the frequency at which there is an increase in the premium charged. If the amount charged as premium is low, make sure you check the coverage that is being offered. Besides that, it is advisable to look into the claim settlement procedure offered by the insurer. This means, you should consider their procedure, and most importantly, the time in which a claim is settled. It is also recommended to make previous enquiries regarding the mode of claim settlement i.e. whether it is handled in-house or through a third-party administrator.

In addition to the above mentioned, consider the co-payment applicable on the policy, as this would help you bring down the premium, although you would have to share the cost in case of a claim. You should also consider the spread of network hospitals, value added services such as discounts and offers on OPD, diagnostic tests offered by the insurer.

Currently, the biggest advantage for customers has been introduced in the form of health insurance portability. This suggests that even if you are not satisfied with the services being provided by your current insurer, you have the option of switching over to another insurer, whilst retaining benefits such as waiting period.

comprehensive cover

Although a vanilla hospitalisation cover is important for everyone, it is suggested to enhance this cover with plans such as critical illness, hospital cash, and so forth. Furthermore, it is better for you to opt for top-ups instead of multiple policies, as this gives you the option of enhancing your sum insured. Not only does this offer you better benefits, but it is also useful to cover very high medical expenses.

(The writer is Head-Health Administration Team, Bajaj Allianz General Insurance.)

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