Health insurance is one of the most essential insurance policies to have considering the sharp increase in the occurrence of health problems at an early age and medical treatment getting more expensive day by day, can leave a person or family devastated with enormous medical bills.

In India there are a total of 34 insurance companies registered with IRDA offering variety of Health Insurance plans so we need to have a clear understanding of our requirement before selecting the health plan.

So, let’s review the factors to look for in a health insurance policy.

1. How much cover do you need – A family floater policy with 5 to 10 lakh cover is quite sufficient in most part of the country. However, it may not be adequate if you live in bigger cities, where cost of medical treatment is significantly higher.
2. Use a Top Up Policy – You can enhance your health insurance cover at low cost through a super top up plan. These plans can also be used to complement your employer provided group health plan.
3. Choose a plan with life time renewability as some plans offer limited renewability and you will require a health plan the most during the later years of your age.
4. Network Hospital coverage – Always prefer an insurance provider that has a wide network of Hospitals across the country and more so in the city of your residence.
5. Company’s Reputation – Always select an insurer with good reputation and high customer base in Indian Market.
6. Claim Settlement ratio – Always choose an insurer that has a high claim settlement ratio.

Apart from these it is always pertinent to settle for the policy that provides the maximum benefit from below list.

• Waiting period for Pre-existing illness – Most policies have waiting period of 1 to 4 years for pre-existing illness, choose the one with minimum waiting period or if you or any one from your family is suffering from pre-existing diseases consider health insurance plan with PED coverage from day 1.
• Pre and Post Hospitalisation expenses – At least 60 & 90 days, preferably more.
• Room Rent capping – Many companies set a ceiling on room rent which will have a cascading effect on overall claim settlement. Prefer a policy with No Room Rent capping
• ICU Room Rent – Prefer a policy with No capping
• Reload or Restoration option – Should be at least 100% of basic SI, preferably unlimited.
• No Claim Bonus – Preferably higher in percentage in the initial years with min limit of 100% or higher
• Domiciliary (Home) Hospitalisation – This facility helps seek treatment at home when there are problems pertaining to mobility or non-availability of Hospital beds, prefer a policy with no sub limits or higher limits
• Day care treatment / procedures – Prefer a policy with all day care treatments covered.
• Co-payment – Should be nil
• Road Ambulance charges – Covered with higher limits
• Air Ambulance charges – Covered with higher limits
• OPD expenses – Prefer a policy with inbuild OPD expense covered or at least should have an option of add on cover or Rider.
• Non-Medical Expense covered – Prefer a policy with inbuild feature or an option of add on cover or Rider. This will reduce your claim disallowance significantly.
• Daily Hospitalisation Allowance – Prefer a policy with inbuild feature or an option of add on cover or Rider with higher daily limit with higher no of days.
• Critical Illness benefit – Should have an option to choose SI.as add on or Rider
• Ayurveda / Homeopathy treatment – Should be covered up to SI
• Addons like Zone upgrade and maternity cover – Should be available
• Bariatric surgery – Should be available
• Organ doner expense – should be available
• Psychiatric illness – should be available
• Complimentary Annual Health Check-up – Should be available

Most Important factor is choosing the plan as per our need and at a competitive price as prices can vary significantly among the companies for same type of product.

A qualified financial planner is competent enough to help you choose the Right company, suitable policy, adequate cover and to make it cost effective for you.