How do you select the best insurance plan? Some plans boast of a comprehensive cover while others
highlight their cheaper premiums. Some plans provide unique benefits while others have great
discounts. Which plan, among such features, is the best? How should you buy the perfect policy
for your needs?
A difficult question, isn’t it? What is the solution?
The answer to this question lies in proper planning and research. There are certain points which
form a checklist which helps you in buying the correct health insurance plan suitable to your
needs. The points which form the checklist are highlighted below:
- Is the coverage level sufficient?
Every health insurance plan available in the market differs in the context of the coverage it
offers. While the basic tenets of the coverage remain same, their absolute limits vary.
Furthermore, health insurance plans also boast of additional unique coverage options like
maternity cover which is available in certain plans, restoration of the Sum Assured if it is
exhausted, no sub-limits, coverage for alternative treatments, etc. So, before you opt for any
plan, its scope of coverage should be your primary focus.
Also, you need the weigh what features you may need and then choose the plan as over-burden of
features is also not necessary.
The limit on covered expenses: #SubLimits
We often tend to overlook this tiny detail when we buy the plan and later regret at the time of
claim. There are certain expenses which have a limit on them. For instance, the limit on ambulance
charges, sub-limits on room rent, limits on specific surgeries, etc. are inherent in most health
plans. You should check these sub-limits to assess whether the limited cover wouldn’t be hard on
your pockets at the time of claim.
Check the waiting period: #WaitingPeriod
Some health insurance plans have a limited period exclusion for certain ailments. This exclusion
period is called a Waiting Period and different plans have different waiting period. For example,
ailments like fissure, piles, hip-bone replacement, etc. have a 2 year waiting period before it is
However, if you have any pre-existing ailments, like diabetes, hypertension, etc., you should
look for the plan with the lowest waiting period or buy specialized plans designed to cover your
Cashless claim facility: #GoCashless
Cashless Claim is a direct settlement of the bill between the hospital and the insurance company.
Though most health plans have a cashless settlement of claim, the same should be checked before you
commit to the plan.
Network of Hospitals: #NetworkofHospitals
Also, the Network of Hospitals, i.e. places where the Cashless Claim is available needs to be
checked so that you are mentally prepared where to go in case of an emergency!
Entry age (minimum and maximum):
This particular point is applicable if you are opting for a family floater plan. Family floater
plans have a limit on the maximum age of dependent children and parents and in-laws if applicable.
You should check for this as there may be a need to include family members at a later date.
Gone are the days when after reaching a certain age your health cover lapsed. Thanks to the regulation
passed by the Insurance Regulatory and Development Authority health insurance plans have become
renewable for the entire lifetime. Now you can renew your plan without any maximum age limit.
However, some plans still have a limiting age on renewal and such renewability feature should be
List of Exclusions: #ExclusionList
Every health plan has a list of expenses which are excluded from the scope of coverage. Though the
exclusion list is more or less similar, some facets might differ.
For instance, dental expenses other than that in an accident, maternity coverage in some plans,
pregnancy related ailments, etc. are excluded from some plans while covered in others. So, this
exclusion list of the plan should be checked before you buy the plan.
Additional Benefits: #Add-onRiders
While checking the policy, it makes sense to opt for certain necessary riders as additional benefits
at an additional cost so as to increase the scope of coverage and increase the benefits of the
The last but not the least point in your checklist should be the premium rate which the plan is
charging for the cover provided. It should be competitive and justified in comparison with other
These are the important pointers which should form the fist of your pre-purchase policy checklist.
Every policy you consider should pass this checklist and only then you can ensure the best coverage
in your health insurance plan.