Friday, May 21, 2021

How to Buy Medical Insurance in India: Quick Tips

1. Minimum coverage of 6x your monthly in-hand salary, but nothing less than Rs. 5 Lakhs

2. The insurer should have most big brand hospitals of your city in its cashless network

3. Pick the insurer with a higher claim settlement ratio (above 90%)

4. Check if you want a policy for self (individual) or floater (including family members). If there is someone in the family with health issues, take an individual policy for them and do not club them in floater.

5. Waiting Period on the policy is the initial 2-3-4 years when certain illnesses will not be covered. Check this and the list of illnesses to see if you have any chances of getting any of these soon.

6. Based on your needs in the next few years, you may want to consider coverage of:
- existing illnesses
- maternity and childcare needs
- day care procedures
- critical illnesses

7. Critical illness coverage - specified 20-30 diseases where the sum assured is paid on diagnosis and submission of bills for claim is not required - take a cancer coverage if you have family history of the disease - serious illness coverage can be taken separately with a life insurance instead of health insurance for a cheaper premium

8. Room Rate: Check if they will give you an individual room and not a bed in the general ward; also room rate may normally be defined as a % of the total cover, or be defined as a cap. Eg 1% of a 5L policy or a cap of 3k per day. If hospitals around you charge more per day, please insist on a higher room rent. Other medical expenses may be linked to room rent. Thus, you may have to co-pay all expenses in proportion to room rent coverage by the insurer.

9. Co-Payment: You ideally want no or lower co-payment

10. Pre and Post Hospitalization expenses should be covered for 60 to 180 days

11. No claim bonus will enhance coverage at a low cost for future years

12. Zonal coverage covers only in a particular city, and Pan India covers treatment anywhere in the country

13. Reasonable and customary clause reimburses as per rates in other hospitals around you, which may be cheaper - so avoid

14. Between a Top up and Super Top Up, buy the latter - you can buy from another insurer on the base policy

15. If you are in employment, and leaving the service, convert your existing group insurance plan to an individual plan so that you don't have a waiting period in the new policy that you take
16. Purchasing a health insurance also gives you tax saving deduction under section 80D of the Income Tax Act