Let’s start this guide with a scenario!
Ahmed is a 30-year-old man, the sole bread-winner for a family of four. His family consists of his wife and two kids, all three of them financially dependent on him.
Once during his kid’s illness due to severe chronic condition to his lungs, he had to go through extreme financial hardships to fund the treatment of his child.
Now, if he had a suitable health insurance plan for his family, he could have conveniently financed his kid’s treatment with the coverage amount, right from pre-hospitalisation diagnostics to the cost of medicines until fully cured.
While the importance of a suitable health insurance plan for your family cannot be undermined from any aspect, individuals often miss out on purchasing the right plan to gift their family extensive protection.
So, here are a few tips you can utilise when choosing a health insurance policy for your family.
Know that health insurance plans in India for family come in two broad variants, i.e., individual plans and family floater plans.
In the case of the former, separate insurance policies can be availed in the name of each family member separately, thus allowing a dedicated sum insured for every family member.
For the latter, however, a single policy covers all members in the family, thus enabling the sharing of a floater sum insured for all family members.
You can thus choose one over the other as per your family size, health, income and similar other factors.
You must also check for the illnesses and diseases included in the policy to enjoy maximum coverage. Also, checking the exclusions is equally essential to make sure that you are well-prepared for the instances that fall under the list of exclusions.
The regular insurance plans might also be insufficient when it comes to covering the treatment of certain critical diseases. In this regard, you might have to opt for a critical illness add-on over the base insured amount.
You must, therefore, take these factors into consideration before availing the policy. Also, go through the policy documents carefully regarding the coverage offered and choose accordingly.
Sub-limits in a health insurance policy cap specific expenses to a maximum as specified. Such limits can be expressed as a percentage of the total sum insured or in amount.
Inclusion of such limits in a health insurance plan implies that if you have incurred expenses over and above this cap, the coverage amount will not pay for such additional expense.
For example, if a health insurance plan offering a coverage amount of Rs. 5 lakh comes with a sub-limit of 1% for room rent during hospitalisation, you can receive coverage only up to Rs. 5,000 for room rent charged.
In that case, if you were charged Rs. 8,000 for hospital room rent, the additional amount of Rs. 3,000 will have to be borne by you.
You must, therefore, look for a health insurance plan that does not come with such sub-limits, to maximise its accompanying benefits.
Comparing the premium you have to pay for various health insurance policies is yet another consideration you must make while purchasing a plan for your family.
While accompanying benefits has more weightage when it comes to choosing the right health insurance plan, getting the same benefits at an affordable price is always advantageous. You must, therefore, make sure that you make a comparison of premiums to arrive at the best offer.
You can utilise a health insurance premium calculator offered by insurance providers that allows you to make a comparison of premium payments for various existing policies, along with other benefits like maximum returns, terms of the policy, etc.
A health insurance plan does not provide coverage for all diseases, such as critical illnesses. They further do not offer compensation for availing maternity care and few such other instances.
As these covers do not come integrated with the primary policy, you need to opt for them as add-ons. So, make sure to check for the availability of such add-on coverage options like critical illness cover, AYUSH care and maternity care cover. Also, compare the extra premium amount you will be required to pay under different policies to avail these add-on riders to make a suitable choice.
Other parameters that you must consider before choosing an insurance policy for your family include the insurance provider’s claim settlement ratio, rules regarding policy renewal, waiting period under specific illnesses, etc.
Once you have utilised these tips and made the necessary comparisons, you are good to go for securing your family’s future with the right health insurance plan.
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