• Questions you must ask before you buy health insurance

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    Buying a health insurance policy is certainly a big decision. Since health insurance coverage focuses on your financial well being, you must consider your options carefully before you subscribe to a specific policy cover. With the overwhelming number of choices available in the market right now, it could be a little tricky to zero in on one single policy that meets your all expectations. The right way to choose a policy is to consider your specific needs first and search for a policy that satisfies these needs.

    You must consider a lot of factors once you have decided to buy a suitable health insurance policy. The following list gives you a set of questions that you must ask yourself before you pick a health insurance cover:

    1. What kind of health insurance policy do I need?

    This is the basic question that you must ask before purchasing a health insurance policy. There are different types of health insurance covers that you must consider before you can come to a final decision. There are individual covers, family floater covers, critical illness covers, disease-specific covers, etc. One type of policy cover need not necessarily be the alternative to the other. For instance, you may have a family floater cover and a critical illness cover simultaneously as they both serve different purposes. You must carefully evaluate your insurance requirements before you can choose a policy.

    2. How much coverage do I need?

    Once you have zeroed in on a policy, you must decide on the value of coverage you need. Most of the top insurers in the market have flexible sum insured options. The premium charges for these covers increase based on the sum insured amount chosen. You need to choose the coverage value wisely to ensure that you have adequate coverage for emergency medical requirements.

    3. How much should I spend for insurance coverage?

    The answer to this question basically comes down to how much you can afford. Moreover, this should also be based on your existing health condition and family medical history. If you have higher requirements, you need to spend more to ensure proper financial security.

    4. Are there enough network hospitals in my location?

    If you are not financially well enough to take care of your medical expenses, you may not be able to wait till your expenses get reimbursed. In these situations, cashless treatment could help you out. Cashless treatment is offered only in the network hospitals of an insurer. Before you buy a health insurance policy, you must make sure that there are enough network hospitals in your vicinity.

    5. What is the waiting period for pre-existing illnesses?

    As per the IRDAI regulations, the waiting period for pre-existing illnesses cannot exceed 4 years. However, there are many health insurers that offer shorter waiting period for pre-existing illnesses. It is always better to have shorter waiting periods if you are suffering from any pre-existing health conditions. This is one of the factors that you must check when buying a health insurance cover.

    6. Will this policy cover day care treatments and OPD treatments?

    Most of the top health insurers in the market now provide coverage for day care treatments and OPD treatments. The list of day care procedures covered by a health insurance policy will be provided in the policy document. If you need coverage for a specific day care treatment, you need to check the policy document provided by your insurer. Also, check out the sub limits set by the insurer for specific conditions.

    7. Should I contribute towards a claim?

    Certain health covers have mandatory copayment requirements for people over a certain age. For instance, a policy may require 20% copayment for policyholders over the age of 65. In this case, you must pay 20% of every claim you make from your own hand. Check out the conditions regarding copayment before you sign up for a policy.

    8. Will I get coverage for medical examinations?

    Coverage for medical examinations and diagnosis comes under OPD treatments. Only a few health insurance companies in the market provide coverage for OPD treatments. If this coverage is a major requirement for you, you must consider this at the time of buying the policy.

    9. How good is the customer service in a health insurance company?

    Most of the top insurance companies in the market operate a dedicated customer service to take care of the needs of their customers. The official website of an insurer will have the information required to reach the company’s customer care. You can check out the reviews from existing customers to understand the quality of service provided by an insurer.

    10. How can I make a claim?

    With the advancement of technology, the claim settlement process has been simplified by most health insurers. If you want cashless treatment, you can go to the network hospital directly and file a cashless claim from there. The hospital staff will provide you with the paperwork and guide you with the process. The company must be notified ahead in order to proceed with this. For reimbursement claims, you have to submit all the medical bills and proofs to the insurer following your treatment. You can contact the customer service of your insurer if you have any doubts in the process.

    11. Will I get coverage for non-medical expenses?

    A health insurance company is not liable to provide any compensation for non-medical expenses incurred by the patient. Expenses related to food, travel, or personal comfort will not be reimbursed by the insurer. If non-medical expense is a big concern for you, you may take an add-on cover for daily hospital cash to get cash allowance during the days of your hospitalisation.

    12. What are the conditions not covered by my mediclaim policy?

    Before you sign up for a policy, you must know the exclusions listed out by the policy cover. The exclusions for most health insurance policies are pretty standard. However, some covers may exclude certain specific features like day care treatment or pre/post hospitalisation expenses. Make sure that the exclusions in your health insurance policy are acceptable to you.


    Buying a health insurance policy requires careful consideration as it is something that provides financial security in a time of uncertainty. Before you sign up for a policy, you must be aware of the benefits offered by it. Proper research can guide you in choosing the right medical insurance policy cover. The questions listed here will help you proceed in the right direction and conduct adequate research before you finalize a health cover.

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