How to Choose the Right Health Insurance Plan: A Complete Guide

Choose Plan Type

The first step is to decide the type of insurance you want. If you have a family dependent on you, then you can opt for family health insurance that provides coverage for your whole family, which includes your spouse, parents, and children. If you wish for an insurance plan that covers your individual requirements, then go for individual health insurance.

Pick Sum Insured

In health insurance, the sum insured is the maximum coverage you get at the time of an insurance claim. Pick a sum insured that covers all your healthcare expenses to avail better coverage.

Select Basic or Comprehensive Coverage

Insurance with basic coverage charges a lower premium but doesn’t include the important features that are necessary for an individual. It is wise to go for an insurance plan with comprehensive coverage that covers major and minor medical procedures.

Avoid Co-Payment Insurance Plans

Before signing your insurance policy, check if there is a co-payment clause. In a co-payment insurance, you are responsible for bearing a certain percentage of the total medical expenses, while the balance will be compensated for by the insurer. Plans with co-payments have a low premium, but they increase your financial burden.

Go for A Shorter Waiting Period.

The waiting period is the period between the date your insurance is accepted and the official date when your risk protection starts. You cannot raise a claim for medical expenses incurred during the waiting period. So opt for a shorter waiting period so you can get your risk protection as soon as possible.

Avoid Policy Plans with Room Rent Limit

Most health insurance plans have a hospital room rent limit, and any exceeding balance has to be paid by you. Plus, you don't have the option to choose which type of hospital you stay in. Hence, pick an insurance policy that has no limit on hospital room rent.

Opt for Free Annual Health Check-ups

Insurance companies now cover preventive health check-ups, so make sure the insurance plan you take offers free annual health check-ups.

Avoid Sub-limits on Certain Diseases

Some insurance providers have sub-limits on certain critical diseases, where the insurer will pay a certain amount as per the limit mentioned in the policy. If the medical treatment costs exceed the limits, then the balance amount has to be paid by you. So, pick an insurance plan that doesn’t have sub-limits on diseases.

Check Policy Exclusions & Riders

Riders are additional coverage you get along with the existing protection you get. Carefully read your policy to check the exclusions, and inform your insurance provider if you wish to add certain benefits as riders. Do note, your overall premium will increase if you opt for additional riders.

Check Insurer’s Claim Settlement Ratio & Incurred Claim Ratio

Before you decide to go with an insurance provider, check the insurer’s Claim Settlement Ratio (CSR) and Incurred Claim Ratio (ICR). CSR will help estimate the chances of claims being settled, while ICR represents the insurer’s ability to pay claims. CSR of 95% is considered good, while 80% to 90% ICR is considered favorable.

Choose a Plan With Lifetime Renewability

You will need health insurance the most in later years of your life, hence make sure the plan you choose has lifetime renewability features.