Topic 4: 9 Things you Should Know Before Buying Health Insurance

Health insurance becomes the necessity of life because health issues are the reality of present life.

A health issue doesn’t come by knocking so, it is better to safeguard yourself before the arrival of such situations. A health insurance policy is only one solution to do this.

A health insurance policy doesn’t provide any shield against health issue but provides protection from the unbearable financial burden. In the medical emergency, a health insurance covers all your medical expenses hospital, treatment, surgery and provides a financial cushion.

9 Points To Consider Before Taking Health Insurance Policy

1. Individual Vs Floater Health Insurance
Floater health insurance plan covers the entire family members under a single policy. On the other side, a single person health insurance policy comes under an individual health plan. You can go with anyone. Ask your agent about what would suite you and your family the best.

2. Make A Requirement List & Compare With Policy
There are many health insurance companies having the same feature or having a little bit different. It becomes very difficult to decide, where you should go. Make requirements list that you are looking in an insurance policy. Compare the requirement list with the features of your shortlisted policies. The policy who fulfill more requirements will win the race. Or, just take the help of an advisor.

3. Coverage is More Important Than Premium
Some health insurance charge lesser premium but they have some hidden clause like providing health insurance up to the age of 40-45 years. Don’t go with any such plans because the chances of suffering from any major health issues start after the age of 45-50 years. It is too good to have health insurance policy who cover for a longer period. No doubt, the premium of these policies is higher but will prove beneficial in long run.

4. Pre- Existing Disease
Pre-existing disease means already suffering from any disease at the time of buying a health insurance. For such a situation, there are two types of insurance policies. First one, who don’t cover pre-existing disease at all. In this case, you can never claim for medical expenses arising due to pre-existing disease. The Seconds one, who don’t cover pre-existing disease from the first day of the policy but accept after a waiting period, say 3-4 years. In this case, you can claim for pre-existing disease only after the completion of a waiting period.

5. Hospital Room Rent Capping (most important) Hospital room rent capping is the most important thing that you should know. Insurance companies restrict the room rent up to a certain limit, in most of the cases, it is 1% of the sum assured of the policy. On the other hand, the hospitals charge for the room according to the type of room selected i.e. general, private, deluxe etc. In case of costlier than the capping limit, the insurer deducts not only the additional room rent charges but also deduct a portion of other medical charges in proportion to the room rent.

6. Flexibility of Policy
Flexibility arises a question, can a company changes their terms at the time of emergency? If a person has a health insurance policy which offers only cashless claim settlement.  One day he gets a heart attack and in an emergency, he has to admit in a hospital that doesn’t come under cashless network with the insurer. In such situation, whether the insurer pays reimbursement or rejected the claim. Sometimes, in a similar case, the insurance company doesn’t pay any claim because of their terms & conditions. So, make clear all such facts at the time of buying the policy.

7. Claim Settlement
In most of the health insurance policies, the claim is settled down by TPA (third party administrative). In TPA, Health Insurance Company only sold the policy. All claim related work like claim settlement and collecting claim documents is done by TPA. In such a case, search for the TPA and try to find out the how efficiently it works. You can find this from the old clients of the insurance company or from the hospitals that are within the network of TPA.

. Buy a health insurance policy as earlier as possible
It is often seen that people finding their dream policy that has less premium, high cover, less claim settlement time, no further processing & so on. But sometimes they become too late. They might cross-age limit or get suffered from some disease which will never be covered. So buy health insurance policy at the early stage.

9. Top-Up Health Plan
Anytime you feel that your current sum assured limit is falling short, you will have an option to a top-up health plan. A top-up health policy provides an additional coverage. It is for reimbursement of expenditure which arises out of single illness beyond the limit of the existing cover. The top-up plans are advisable in need of increasing the health insurance coverage because the top-up plans are cheaper than the basic health insurance.


Health insurance is about to save you from financial burden of the hospitalization and not for providing financial security to your family. Keep all these points in your mind while buying a health insurance policy and listen to what your advisor advises you!
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