March 21, 2023

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Health Insurance Guide for First-Time Buyers

Health insurance guide for the first-time buyer | UPMC MyHealth Matters

In recent years, the Indian health insurance market has shifted its focus to simplifying health insurance coverage by digitising the entire purchase process. The following health insurance checklist will assist you in selecting the best policy:

1) Individual or Family-Floating Insurance

One of the critical requirements is whether or not the health insurance plan is for you and your family. You can get an “individual” health insurance policy for each family member or a “family-floater” policy to cover everyone under one plan. The family-floater insurance is a fantastic form of protection because it allows the total coverage to be shared among family members. With your health insurance top-up, an individual can opt for a family-floater policy. *

2) Coverage Quantity 

The amount you are qualified to file a claim against your coverage is an important consideration when selecting a health insurance plan. The insurer will only pay the insured amount. It may not be able to raise coverage after a claim has been filed, so be sure you select a sufficient level of coverage. *

3) The Scope of Protection

Ensure comprehensive coverage when you get an all-inclusive health insurance policy. You should evaluate the policy based on the value of its benefits relative to the cost of its premium. *

4) Cashless Medical Coverage

Cashless medical coverage provides a financial cushion in the event of an unplanned hospitalisation that requires immediate finances. Whether the stay is planned or unplanned, cashless hospitalisation provides a convenient and paperless experience. *

5) Pre-existing-conditions waiting period

There is a waiting time or cooling-off period before serious illnesses are covered by health insurance. In addition to evaluating health insurance premiums, you must compare waiting periods for pre-existing diseases or disorders and understand what is top-up in health insurance. The Insurance Regulatory and Development Authority of India (IRDAI) defines pre-existing disease as any condition, accident, or illness diagnosed within 48 months or two years before acquiring a health insurance policy. Choose insurance without serious illness sub-limits for complete coverage. * #

6) Limitations on Room Rental

Modern digital insurance businesses are changing the sector with innovative features, increased room rent caps and health insurance top-up plans. Choose a plan without sub-limits for room rent to avoid unpleasant surprises during the claim settlement process. *

7) Deductibles/Coinsurance

Choose deductible-free insurance. Copayments only apply if medical costs surpass a threshold. No-copayment, no-deductible plans cover emergencies but cost more. To maximise claims, choose a plan without limits. Check if health insurance top-up is possible. *

8) Exclusions

Every sort of insurance policy includes some exclusions. When selecting a plan, you must review the list of exclusions. This will prevent unanticipated medical expenses for a service already covered or the realisation after treatment that the policy does not cover the specific sickness. *

9) Insurance Company’s Reputation

You may find economical, comprehensive insurance policies when shopping. While purchasing insurance, the amount covered and price are not the only criteria. Know the insurer’s reputation and customer service. Check the insurer’s claim settlement process and several legitimate claims. This details the insurer’s network and efficiency. The insurer’s offers are online. Policyholder evaluations and ratings will show the company’s reputation. *

10) System Hospitals

It would help if you lived near hospitals. Accessing a nearby hospital for medical help is more accessible. Find cashless hospitalisation at a nearby, chosen hospital as it helps in emergencies. Multi-speciality hospitals in the insurer’s network are also beneficial. Consequently, you’ll obtain excellent specialised treatment. *

11) Ability to Increase the Coverage Amount

Medical expenditures are rising. Therefore you must adapt. Choose family-wide health insurance. What’s enough today may not be tomorrow. Upgrades let you boost coverage if medical costs climb. *

* Standard T&C Apply

# Visit the official website of IRDAI for further details.

‘Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.‘