The cost of hospitalisation has risen sharply over the past few years and is still rising at a fast clip. With rising concerns about health conditions and medical costs, a health insurance policy is becoming mandatory for every individual, right from an infant to an old person. A health insurance policy will cover you for all the medical expenses in case you are hospitalised for some reason.
The biggest problem is to choose the right health insurance policy amidst a plethora of policies available in the market. Listed below are a few parameters which should form the basis of your choosing the particular health insurance policy in their order of importance:
MAXIMUM RENEWABILITY AGE
Though health insurance is important for every individual, it becomes really valuable once a person crosses 60 years of age. Many policies available do not allow one to renew after a certain age. Moreover, buying a policy at that age may be very difficult as health conditions do not remain the same. In case, your insurer does not allow you to renew your policy after a certain age, it means that you will not have any insurance cover, especially when you need insurance the most.
SUB-LIMITS
This means that the overall coverage is broken down into the maximum payable for a particular kind of expense. For example, a few insurance companies now provide that room rent cannot exceed 1% of the covered amount or that fees for doctors/ consultants cannot exceed 20% or 25% of the covered amount. While most of these sub-limits are reasonable, it is better to take a decision after being aware of them. This is a very significant provision as most hospitals charge hugely different rates for doctor's fees and operation charges, depending on the class of the room. For example, an angioplasty for a twin-sharing room in Mumbai where the room rent is, say, 3,000 per day may be only 1,50,000 whereas the same angioplasty for a patient who books a single room with room rent of . 5,000 per day may cost 3,00,000. In most cases, the room rent sub-limit will mean that you will be entitled to a reimbursement of only 1,50,000 rather than the full sum assured of 3,00,000 due to the condition regarding the sublimit for room rent.
CO-PAYMENT
Certain mediclaim policies ask the insured to share the bill with the insurer in a certain proportion. This is called as co-payment. A policy with no co-payment will always be better than a policy with co-payment.
EXCLUSIONS
These may be permanent or temporary. Permanent exclusions means that hospitalisation arising out of the conditions mentioned in the list given will never be covered under a mediclaim policy. Temporary exclusions mean that hospitalisation costs arising out of these conditions will be covered but only after a certain waiting period.
PRE-EXISTING COVERAGE
This can be the most important criterion if you have any pre-existing disease. Almost all health insurance policies will not cover diseases which you already have before buying the policy after certain number of years. This point becomes very crucial in case one is suffering from any pre-existing diseases. Like if you are suffering from diabetes and hypertension, a few insurance policies will cover you immediately for diseases caused due to that on payment of extra premium.
MAXIMUM COVER AMOUNT
In case you are looking for a very high sum assured, (more than 5 lakh), then this may be an important criteria.
Once you have compared all the policies over the criteria mentioned above, you should look at prices of the policies before deciding on a policy for you and family.
