10 things to keep in mind while buying health insurance cover

6 MinsMay 13, 2020

Are you one of those who have purchased a health insurance policy only to avail of the tax benefit allowed under Section 80D of the Income Tax Act? While buying the health cover is commendable, take a close look at your policy to see if it meets all your needs. Health insurance constitutes a critically important part of financial planning. If you buy a health insurance policy only for saving taxes, without too much thought about the features, benefits, conditions, etc, then there are chances that it could fall short of meeting your and your family’s requirements.

Here is a checklist of a few factors you need to consider while selecting a suitable health cover:

insurance cover

1) Buy health insurance early

When you are young, healthy and earning a decent salary, the world seems to be your oyster. People don't tend to give too much thought to issues like health insurance. But the fact is that this is exactly the time when you should consider buying a health insurance policy. Insurance premia rise as you get older. However, if you buy the policy at an early age, you are locking in a lower rate of premium leading to significant savings.

2) Buy a policy even if your employer provides a health cover

Today, most large companies provide group health insurance coverage to their employees. Even if you work for such an organisation, it makes sense to buy an individual health cover. There are several reasons. Firstly, most group insurance covers offer a limited sum assured. This may be insufficient given the expensive medical procedures and high hospital charges today. The second reason is that under group employee health insurance, you are covered only so long as you work for that employer. If you leave the job or once you retire, you are no longer covered. Someone buying their first health insurance policy at an older age will have to fork out a much higher premium than someone who is renewing their existing health cover.

3) Opt for Family Floater Plans

If you have a family always opt for a ‘family-floater’ plan that covers the entire family. In choosing the sum assured, opt for a balance between a higher amount and how much you can afford. Even if the premium for a larger sum assured may seem expensive, remember that most likely your income will increase over the years and the premium will become more affordable. The larger cover will come in handy when you are old and more prone to health emergencies.

4) Check exclusions

All health insurance policies exclude certain diseases from their coverage. While the regulator has been pushing insurance companies to standardise the list of diseases that can be excluded, it is still different from company to company. Given the uncertain times we are currently facing, make sure you check the list of exclusions to avoid any issues in your moment of need. Do specifically check that “Pandemics” are not part of the exclusions in the policy you choose.

5) Know the pre-existing period

All insurance policies have a waiting period before which they will not cover several diseases. Be aware of this before you zero in on the policy. Some companies may have a waiting period of one year, while in the case of others it may be as long as four years. Know the conditions beforehand to avoid nasty surprises in the future.

[Also Read: Benefits of a family floater health insurance policy]

6) Check for room-rent capping

Hospital charges such as doctor’s charges, operation theatre charges, etc are linked to the rent of the room you select. If you choose a room with a higher rent, these charges too will increase. If your health insurance policy has a cap or limit on room rent, then you will get reimbursed only to the extent of the charges allowed for that particular room rent amount, even if your total hospitalisation expense is lower within your sum assured. To avoid this choose a policy that does not have a cap on room rent.

7) Check the network hospitals

All health insurance companies have tied with a network of hospitals where their customers can be treated in a cashless manner. Check the network of hospitals being offered by the insurance company and ensure that they cover a wide geography. If you shift cities for your job, then your health cover should be available in the new place too.

8) Kind of coverage

It is important to understand the kind of coverage you buying in your health plan. Earlier most health insurance policies would pay the reimbursement only if you were hospitalised for 24 hours. But today a lot of medical procedures do not require hospitalisation, thanks to the advancement in medical technology. So, to avoid losing out on your claim on this account, ensure that your policy includes day-care procedures as well as pre and post-hospitalisation expenses. This will include any treatment done before and after the hospitalisation.


9) Check the claims process, settlement time and ratio

Check the insurance company's claims process and ensure you understand it clearly. Similarly, check the settlement time and ratio. You would want to opt for an insurance company that is faster in settling claims and has a higher ratio of claims settled. This information is available on the Insurance Regulatory and Development Authority of India (IRDAI) website.

10) Use top-up plans and riders to enhance your coverage

You can buy a top-up health plan to enjoy a higher sum assured at a lower cost. This will kick in when you exhaust the limit on your base policy. There are a host of riders or add-on benefits you can choose from. Some of these are critical illness rider which pays a lump sum in case you are diagnosed with a critical illness, hospital cash rider which pays an allowance for each day of hospitalisation, accidental death benefit rider which pays a lump sum in case of an accident over and above the hospitalisation charges, maternity rider for any maternity related expense and so on. Choose the one that meets your specific needs.

Axis Bank has tied up with TATA AIG Health Insurance and Aditya Birla Health Insurance to offer you a wide spectrum of health insurance plans that suit your needs. To know about the health insurance plans offered by Axis Bank in association with these companies, click here.

Disclaimer: This article is for information purpose only. The views expressed in this article are personal and do not necessarily constitute the views of Axis Bank Ltd. and its employees. Axis Bank Ltd. and/or the author shall not be responsible for any direct / indirect loss or liability incurred by the reader for taking any financial decisions based on the contents and information. Please consult your financial advisor before making any financial decision.