Health insurance is a big decision with several variables to consider, and in this blog, we will present a checklist with five of the most important variables that you need to consider while you decide “How to choose best health insurance plan” that suits you the most.

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Let’s get started on How to choose best Health Insurance Plan.

Number One :

Always buy a health plan that fits your top requirement. Health insurance has evolved dramatically over the last ten years with a range of insurance products with different features and specifications.

There are health insurance products suitable for students, couples, young families, senior citizens, people with heart diseases, diabetics, and even plans for people who have already been diagnosed with cancer.

How to choose best Health Insurance Plan
Different Health Insurance Products

It is easy to get lost in choices, so your first aim should be to identify your number one need.

Is it covered for an existing illness that you already have, or is it coverage for maternity and childbirth as you’re planning to get married or have a child? Or is it the availability of treatment abroad?

Once you’re clear about this, you can then decide on the coverage that you need. While there is no established thumb rule, it is a good practice to go for a minimum of six times your monthly salary.

So if your salary is $20,000, you should consider a plan of at $100,000, which can also go up to about $500,000 of coverage.

Number Two:

Find a cashless hospitalization network that covers the top hospitals in your city. Point blank, you cannot opt for a health insurance plan which does not offer a cashless service.

Cashless service means you can have your medical treatment done without having to pay bills yourself, and the bills will be directly settled by the insurance company with the hospital.

While all insurers offer cashless service, not all hospitals are part of an insurer’s cashless network.

How to choose best Health Insurance Plan
Cashless Service

Since cashless is a pretty good thing to have and the cashless network varies from insurer to insurer, do make sure that you look through the insurer’s cashless hospital list and that your city’s most popular hospitals are available in that list.

Remember to look for the best hospital in the city and not merely the total number of hospitals in your city, because 90% of all hospitalization is planned, which means you want to go to the hospital that offers you the best health care.

Number Three:

Read the fine print and seek out the exact coverage offered. There are five core components to policy coverage.

  • First, inpatient hospitalization coverage, which is pretty much the reason for buying a health insurance plan, which is the maximum amount up to which you can claim against hospital expenses.
  • Second, day-care treatments are procedures that take less than 24 hours at a hospital, for example, cataracts, tonsils, chemotherapy, kidney stone removal, etc.   Look for a plan which covers all day-care treatments without restrictions, or plans which cover a high number of day-care treatments.
  • Third, room rent is the cost or type of the room that shall be allocated to you as per the plan chosen. Some plans have no capping on room rent, some offer a single private room, while some allow a limit of up to one to 2% of your summer share. It is important to know which type of room and what is the maximum allowance on the hospital room so that you can plan your insurance needs accordingly.
  • Fourth, pre and post-hospitalization refer to the reimbursement of any expenses before and post-discharge that are directly attributable to the illness or injury for which the policyholder was admitted. You might typically see a pre and post-hospitalization eligibility of 30 and 60 days, respectively, but some plans put limitations on the coverage amount. You might want to check for these and stick with plans that offer you the most coverage on this.
  • Fifth, your coverage may have some sub-limits. A sublimit is a cap on how much a policyholder can claim. For example, we saw a sublimit of 1% on room rent.
Best Health Insurance Plan
Room Rent Sub Limit

Some plans have sub-limits on certain procedures, like Cataract might have a 10% limit per item. Maternity expenses always have a sublimit with a cap on normal deliveries and a separate cap on caesarean deliveries.

These elements form the core of your coverage :

  • In-patient hospitalization
  • Day-care room rent
  • Pre-post-hospitalization
  • Sub-limits for certain procedures

These should be examined carefully while considering any health insurance plan.

Generally, health insurance companies offer a lot more features like daily allowance, domiciliary, hospitalization, companion benefit, physiotherapy allowance, et cetera, but we have kept these aside as these do not need to have coverages.

Number Four:

Examine the plans and their waiting period, co-payment, and exclusions. The waiting period is a sort of a hibernation period during which any claims made will not be admissible.

The key waiting period you need to look for is for pre-existing illness if and only if you have an existing illness.

Key Waiting Period in Insurance

Some insurers offer a four-year waiting period, some three years, and some even offer a two-year waiting period. As a rule, the lower the waiting period the better it is.

Additionally, also look out for co-payments, which are a share of the claim that needs to be paid from your pocket.

Co-payments are generally triggered in senior citizens or specific need plans, so it is important to read the policy wordings before buying one.


Number Five:

Identify benefits that enhance your sum Insured the cost of medical treatment is on the rise and hence it is wise of us to look for health insurance plans which enhance your coverage over time.

This is done in two ways.

  • First, no claim bonus or NCB as it’s popularly called is a way by which insurers reward policyholders for having a claim-free year with an increase in some insure ranging from 5 to 50% at the same premium level. This way you can accumulate enough NCB to increase your sum insured by up to 100%. Different insurers have different rules on applying NCB but have a check on this.
  • The second way by which insurers enhance some insured is through a feature called restoration under this benefit. If you were to consume your entire sum insured then the insurer would add some more coverage without taking any additional premium. This applies to any claims which are for an unrated illness like NCB. There are different rules for different insurance companies, so do read the policy wordings.

For a more in-depth understanding of this concert-net go for policies that have a good NCB and a good restoration benefit and there you have it.

No Claim Bonus (NCB)

If you push the core of your health insurance research around these five steps we just explained there is no reason why you won’t have a very powerful health insurance plan.

It is also important to mention some variables that did not make our top file list such as OPD expenses, worldwide cover, wellness services, health check-ups, and in-house claim settlement.

These might be important in some scenarios but come into the fray only after the top five considerations are satisfied while you decide How to choose best Health Insurance Plan for you and your family.

Hope you liked our Article on “How to choose best Health Insurance Plan”, please read our other article on “How to choose best term insurance plan