A health insurance plan is an essential part of financial planning in this age of skyrocketing medical costs. Medical inflation has escalated to an all-time high, making it all the more important to purchase a health insurance plan that can sponsor hospitalization and medical treatment bills or expenses.
It is important to evaluate and look for the following parameters to obtain the best health plan for you and your family.
1. Check the Waiting Period Clause
You should feel worry-free after taking out insurance, but your health insurance comes with a waiting period clause for specific conditions. There is an initial period clause that says that any claim for hospitalization will not be admissible in the first 30 days of the start of the policy, except for accidental hospitalization. Pre-existing illnesses or conditions are also not covered immediately after purchasing a policy. 2-year to 4-year waiting period based on industry plan terms. In addition, there are certain surgeries and treatments such as hernia, cataract, joint replacement, etc. that can be treated after a specific waiting period of 1 or 2 years.
Therefore, it is important to check the waiting period clause before finalizing the health plan.
2. Check Sublimits
There are certain ceilings or sub-limits in your health plan that say that the specific type of expenses are paid by the insurance company up to a specific limit and beyond which the insured or the client has to assume them on their own. For example: room rental charges are capped per day for different health plans. Some health plans also come with a mandatory co-pay where the part of the allowable claim is borne by the insured and the rest is paid by the insurance company.
Check the sub-limits of your health plan to avoid last-minute surprises when making a claim.
3. Check network hospitals
Insurance companies that offer health plans have certain network hospitals tied together with which they have a link. Any hospitalization or treatment taken in the list of hospitals in the network mentioned or specified is carried out without cash subject to the conditions of the policy.
Check the list of hospitals in the insurer’s network and make sure you have hospitals in the insurer’s network near your place of residence in case of any emergency hospitalization. Also, treatment at an out-of-network hospital may not offer cashless treatment and some insurers have a co-pay clause if you take treatment at an out-of-network hospital.
4. Check the claim process
Different insurance companies have different claim procedures. Some settle or administer claims through Third Party Administrators (TPAs) and some have their own internal claims settlement unit to encourage fast and smooth claims processing. Also, check the claims settlement rate of the insurer you want to buy a health plan from to get a clear idea of the number of claims settled by the insurer.
It is important to have useful information about the claims procedure in order to have a smooth and uncomplicated treatment during hospitalization.
5. Compare and buy online
It is important to make a correct purchasing decision which can be done by comparing the health insurance plans available online. You can compare the price, key features, policy benefits, value-added benefits, eligibility, exclusions, etc. of multiple health insurance plans to make an informed decision on your own without any interference from agents. Buying a health insurance plan online is a hassle-free process that requires less paperwork and fast policy processing. There are certain online portals that will allow you to make an easy comparison and help you choose the right health insurance plan.
Buying a health plan online is cheap as companies offer discounts on premiums for buying a policy online. The reason why an insurance policy is cost effective if purchased online is because the intermediate cost of the premium component is eliminated. When there is no intermediary involved, the Company saves the commission and the cost of issuing the policy, which the Company transfers to clients.
Evaluate your need and make a correct purchase decision by checking the parameters indicated above.