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Health Insurance: The Only 3 Steps to Remember While Considering One

Don't let medical bills be a monster under your bed! Navigating the world of health insurance can feel overwhelming, but fear not, we've got you covered because we're about to break down the crucial steps into a bite-sized, three-point plan.

Health Insurance: The Only 3 Steps to Remember While Considering One

Thursday April 11, 2024 , 4 min Read

In today’s whirlwind of uncertainties, health insurance isn't just a safety net; it's a lifeline. With soaring medical costs, the right health insurance plan isn't a choice but rather a necessity. But how do you navigate this labyrinth of options to find the treasure that's right for you? Fear not! We've distilled the essence into three crucial steps: picking your insurer, ensuring must-have features, and considering good-to-have extras.

Step 1: Pick an Insurer – Your Safety Net's Weaver

Selecting the right insurer is like choosing the best captain for your ship in tumultuous seas. Here's how to ensure you're in capable hands:

  • Track Record: A sturdy ship has weathered many storms. Look for insurers with a track record of 10 years or more; they're proven navigators of the insurance sea. A 5 to 10-year history? Decent, but tread with caution. Less than 5 years? You might be boarding a rickety boat.
  • Claim Settlement Ratio(CSR): High CSR means the insurer is generous in sharing your financial burden. Aim for 90% or above for smooth sailing; 80-90% is manageable but under 80%, you're likely to get soaked.
  • Hospital Network: An extensive network of over 8000? You're covered across vast seas. 5000 to 8000? Decent coverage. Below 5000? You might find yourself marooned.
  • Incurred Claim Ratio (ICR): Ever wonder how quickly your claims get settled? A good ICR reflects an insurer's efficiency in resolving claims. Look for plans with a 3-year average ICR between 55% and 75%. This indicates a healthy balance between claim payouts and premium collections and a faster turnaround time for your reimbursements.
  • Volume of Complaints: Low complaints signify smooth sailing with consistent, reliable service. These insights can often be gleaned from IRDAI reports or platforms like Ditto, ensuring you embark with a trusted captain.

Step 2: Must-Have Features – Your Lifeboat Essentials

In the vast ocean of health insurance, some features are like lifeboats; you hope you never need them, but they're vital when disaster strikes:

  • No Co-pay: Think of co-pays as small out-of-pocket expenses for every doctor visit. While they might lower your premium initially, they can add up over time. So, prioritise plans with no co-pay to avoid bill shock.
  • No Room-rent Restriction: Imagine needing specialised care in a higher-tier room. With no room-rent restrictions, you won't have to worry about exceeding a pre-set limit and digging into your savings.
  • No Disease-wise Sub-limits: Some plans put a cap on coverage for specific illnesses. This can leave you financially vulnerable if the treatment costs exceed the limit. Opt for plans with no disease-wise sub-limits for comprehensive coverage.
  • Low PED Waiting Periods: Pre-existing disease (PED) waiting periods determine how long you have to wait before your plan covers pre-existing conditions. A lower waiting period ensures you get the healthcare you need sooner.
  • Pre & Post-Hospitalisation Care: Medical expenses don't magically disappear before and after hospitalization. Choose a plan that covers pre and post-hospitalisation costs, saving you from unexpected financial strain.
  • Restoration Benefit: This superhero feature is a lifesaver, especially for family plans. It essentially replenishes your coverage amount after a claim is made, ensuring you have sufficient funds for future medical needs.
  • Daycare Treatments: Don't underestimate the cost of short-term medical procedures. Look for a plan that covers daycare treatments (under 24 hours) to avoid any financial surprises.

Step 3: Good to Have Features – Your Compass and Map

While not deal-breakers, these features can enhance your coverage like the cherry on top:

  • Domiciliary (at-home) Cover: This covers medical expenses incurred if you need treatment at home under medical supervision.
  • Free Annual Health Checkups: Preventive care is key! Plans with free annual health checkups can help identify potential health issues early on, saving you money and hassle in the long run.
  • Alternative Treatments Cover: Navigate towards holistic healing with coverage for Ayurveda, Yoga, and more.
  • Loyalty Bonus & Wellness Discounts: Rewards for smooth sailing; a bonus for your journey's continuity and wellness incentives that keep you in shipshape.

Choosing the right health insurance in 2024 is akin to setting sail on a well-mapped journey. With these three steps, you're not just choosing a safety net; you're ensuring that when storms hit, you have the best possible protection. Remember, the calm seas never made a skilled sailor, but with the right insurance, you're always ready to navigate through life's storms.

Engage with this guide, use it as your compass, and you'll find that understanding and selecting health insurance can be a smooth sailing experience. Whether it's the peace of mind from having comprehensive coverage or the financial security during health emergencies, the right health insurance plan is your lifeboat in the vast sea of life. Let's embark on this journey together, navigating towards a healthier, more secure future.

Edited by Rahul Bansal