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June 13, 2024

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7 Features You Must Have In Your Health Insurance Policy

3 min read

7 features you must have in your health insurance policy

Picking the ideal policy can be challenging because many different health insurance options are available, each with a different set of features of health insurance. Here is a list of factors to take into account before selecting your health insurance plan:

  1. Room Rent Limits

Choose health insurance with no room rent or room type limits to ensure most of your network hospital bill is covered. Without such limits, your insurance will cover a proportionate share of your bill, even if you stay in a room exceeding the limit. For example, if you stay in a room that costs INR 12,000/day while your policy has an INR 5,000/day limit, your insurance will contribute to the bill proportionally. So, in a 10-day network hospital stay with a total bill of 12 lakh rupees, you might believe that you only need to pay the 7,000 rupee difference, which is 70,000 rupees.

However, this is untrue; the insurance company will subtract the proportionate costs, so the approved bill will be 5 lakhs (12 X 5/12) rather than 12 lakhs. You were unaware of how health insurance functions, and your plan could have been better. Health insurance plans with no room rent and no room type restriction will cost a little more, but this feature is essential.

  1. Pre And Post Hospitalisation Cover

Health insurance encompasses pre- and post-hospitalisation expenses, including diagnostic tests, medications, and follow-up care. While standard policies often provide 30-day and 60-day coverage, seeking policies offering extended health insurance coverage of 60 and 180 days for comprehensive benefits is recommended. Claims are subject to terms and conditions set forth under the health insurance policy. *

  1. Don’t Forget About The Sub-Limits

Sub-limits are coverage restrictions in health insurance plans, akin to claim caps for specific medical expenses. They can be percentage-based or fixed for various treatments or illnesses, such as room rent or cataract surgery. Some policies, albeit slightly costlier, offer higher or no sub-limits, providing more comprehensive coverage. *

  1. Waiting Periods

Health insurance doesn’t cover all conditions or treatments immediately. Pre-existing conditions often have a 2- to 4-year health insurance waiting period. Understanding these exclusions and waiting periods is essential. Some policies offer shorter waiting periods, but situations like diabetes and hypertension may be covered with a higher premium from the start.

  1. Hospital Network And Claim Resolution Procedure

Ensure your insurance policy covers your preferred hospital network, as most insurers offer a cashless claim process at their network hospitals. If you seek treatment at a non-network hospital, you’ll need to pay the bill and file a reimbursement claim, which is less straightforward than a cashless claim.

  1. Daycare Facility

Many procedures that once required hospitalisation can now be completed in under a day. These procedures are referred to as daycare procedures. Radiotherapy, chemotherapy, and dialysis are a few examples of daycare procedures. Claims are subject to terms and conditions set forth under health insurance policy. *

  1. Co-Payment Option

You will only be responsible for paying a portion of the total bill if there is a co-payment feature. For instance, if the co-payment is 20%, you will be responsible for paying 20% of the total bill. Although this lowers your initial premium, the cost of hospitalisation will undoubtedly be higher. Opting for a policy with no co-payment is always advised. Claims are subject to terms and conditions set forth under health insurance policy. ##

*Standard T&C Apply

##All savings are provided by the insurer as per the IRDAI-approved insurance plan. Standard T&C apply

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.

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