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Which health insurance to buy for complete protection? All you want to know

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Mr. Basu’s colleague Mr. Yadav was recently admitted to the hospital and the treatment expenses ran into a few lakhs.

Both of them always had hitherto believed that the health insurance plans provided by their company were sufficient.

Their assumption proved wrong when the policy failed to meet escalating bills.

They decided to get a separate health plan for themselves and began their research.

Well, with so many insurers offering so many plans, zeroing in on one is no cakewalk.

Every plan claims to be the best and every agent recommends a different policy with entirely different features. So, the policy-hunting experience can be overwhelming.

However, there are some things to keep in mind while looking for ‘a complete health cover'. Let’s try and help the two gentlemen in distress. 

Reasonable premiums: The cheaper the premium, the easier it will be on your budget. So, a great policy will never quote you exorbitant charges for extensive coverage.

High sum insured: How extensive the coverage is can be judged by its sum insured. The treatment of many illnesses easily costs a few lakhs. Your policy should be able to cover mounting bills, in case of extended hospitalisation. 

Option to add more family members: You may take a policy as an individual, but when you get married and have kids, you would want to ensure their safety as well with health insurance plans for family. So, you should consider selecting a policy that allows you to add more members.   

Good reputation of the insurer: An accident or an illness of any individual can be a stressful time for the family, and if they have to deal with the additional hassle of their claim being denied, the whole objective of having insurance goes down the drain. Therefore, by reputation, we don’t mean only the brand name. We also mean how seamless is the claim process and how high is the claim settlement ratio. You can gauge the quality of service too, through customer feedback. Also, ensure that the insurer is registered by IRDAI. 

Big network of hospitals: Any insurer offering a great health insurance plan will arrange for cashless treatment, which usually happens when it has tie-ups with a large number of hospitals. When your insurer has a big network, the chances of locating a quality health centre in your vicinity are high.  

Availability of top-up plans: Sometimes, the base plan falls short when it comes to covering the expenses in certain cases. In such situations, where the sum insured proves to be insufficient or gets exhausted, top-up plans kick in. A policy is worth buying if it offers such additional top-up plans at nominal prices. 

Small Waiting period: You may be aware that there is a waiting period after you buy an insurance policy. In this time frame, you are not covered even when you have insurance. So, opting for a plan with a small waiting period is crucial. 

Ease of renewability: The right health insurance plan will always follow IRDA’s rule of offering renewability for lifelong. You see, since the need and use of health insurance increases with age, many insurers are reluctant to renew a policy after a certain age. So, going for a plan where renewability is not an issue is advisable.

More inclusions, less exclusions: There is a huge list of what an insurance policy covers and what it doesn’t. Check if it covers day-care procedures. These are expenses for treatment that doesn’t mandatorily require 24 hours hospitalisation. Similarly, check the list of ailments mentioned in the policy. Often, expenses for the treatment of psychiatric illnesses and critical illnesses are excluded. Read the terms and conditions carefully to see if maternity expenses, AYUSH treatment, ambulance charges, etc. are part of the plan or needs an add-on policy. A bigger list of benefits and a smaller list of exclusions is what you should be looking for. 

Sub-limits: There are other features like room rent capping, sub-limits and co-payment that become a liability in times of need. These features allow the policyholder to use the resources but only to a certain extent. After that, the insurer stops covering the expenses. To stay away from such complications and limitations, opt for a policy that doesn’t insist on them. 

Other features: Apart from the basic benefits, your policy should give you something complimentary like free health check-ups, recovery benefits, discounts on not claiming any claim during the policy period, daily hospital cash and income tax exemption certificate for the premium paid.

However, even if Mr. Basu and Mr. Yadav zeroes in on the same plan, they may not get an identical policy. That’s because premiums are decided on various factors like age, income, medical history, area of residence, nature of the profession, etc. You need to be extra careful to make the right choice and must conduct some thorough research before making the final call.

But if it still sounds like too much work and you want us to suggest something, then you need not look beyond. HDFC Optima Restore Individual Health Insurance Plan. The uniqueness of this health plan is that the sum insured gets reinstated on partial or complete utilisation of the health cover. Your search should end with this plan as it offers a bunch of benefits and fulfils all the criteria that are mentioned above. 

Last we heard, Mr. Basu and Mr. Yadav opted for the Optima Restore Plan too!  

Disclaimer: The above information is for illustrative purpose only. For more details, please refer to policy wordings and prospectus before concluding the sales.