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Blog > 10 Things To Consider Before Buying Health Insurance

You want to secure your and your family’s health and financial wellbeing, and purchasing health insurance is a step in the right direction. But when you’re selecting group health insurance or buying an individual health plan, finding your way through to the best plan that suits you is a tedious process. What adds to this intimidating process is the unfamiliar and confusing terminology or as the insurance companies fondly call it Policy Wordings.

The total cover (sum insured) of your health policy is one of the biggest factors that should be driving your decision, however, it is not the only thing that should only thing that you should factor in.

10 important things that you must understand before your buy Health Insurance:

  • Efficiency of claims process: Claim settlement time and claim settlement ratio should be one of the most important factor that must be considered. Higher the settlement ratio and faster the settlement time is generally means that the insurance provider is doing a good job with genuine claims.
  • Co-payment: Co-payment mandates that the policyholder will bear a pre-defined percentage of the claim amount and the rest will be settled by the insurance company, a general clause with most group health insurance policies (your employer provided policy). While you may find an insurance plan to be cheap, it may not offer you compete coverage if it comes with a co-payment clause.
  • Day-care procedures: Day-care procedures are not covered in most health insurance plans. Moreover, to make a medical claim, hospitalization for at least 24 hours is mandatory. Thanks to numerous innovations in technology, today, most procedures do not require hospitalization. Thus, it is best to opt for a plan that covers maximum number of day-care procedures.
  • Network hospitals: Check the list of network hospitals and see if it includes the facilities that you often visit. It is also an important factor to consider if you travel or move cities, because your health insurance should travel with you. Also, cashless facilities can only be availed in network hospitals.
  • Pre/Post Hospitalization: Medical expenses incurred after and/or before hospitalization are called Pre/Post hospitalization expenses. During hospitalization, some part of the treatment extends beyond the hospitalization. Follow-up visits to the doctor, medicines to be taken or follow-up investigations to be done fall under the category of post-hospitalization expenses. Only those expenses relevant to the ailment for which the person has been hospitalized shall be considered under Pre & Post-hospitalisation expenses.
  • No claim bonus: Many insurance companies offer a no-claim bonus/discount, in case, the policyholder has not lodged any claim. In such a case, either the sum insured is increases or the premium decreases or both.
  • Maternity Benefits: in order to manage the rising costs associated with pregnancy, it is important to check whether the policy offers maternity coverage. Before buying a health policy, women need to ascertain four key points: 
                  1)  First, look for the waiting period applicable for claiming maternity expenses
                  2)  second, consider the sub-limit;
                  3)  third, see if the policy covers outpatient expenses related to maternity; and
                  4)  fourth, check the specific exclusion/s(if any) related to the cover. 
  • Free medical checkup: Look for a health insurance policy that entitles policyholders to a free medical check-up. The tests/checkup has no bearing on the premium when policies come up for renewal.
  • Lifetime Renewal: A health insurance policy that can be renewed lifelong, therefore, it doesn’t have any age limit for the renewal. Extremely important factor to consider if you’re planning to cover your elderly parents in your policy.
 Get more info about HDFC Ergo Health Insurance Ltd. (formerly Apollo Munich Health Insurance) products and offerings here:

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