How to choose a Medical Insurance Policy that’s right for you

Would you drive a car without insurance? Would you travel abroad without international travel insurance? Then would you spend the rest of your days going about your life without a medical insurance cover? Sacrilege right? Of course, because if you did, people would think you’ve lost your marbles!

Choosing the right medical policy for yourself and your family is of prime importance. Image by Gerd Altmann from Pixabay 

Needless to say that today, every family member needs to have medical insurance. There could be several reasons why an individual or a family may opt for a medical insurance policy – it could be from securing the wellbeing of their loved ones to also availing of tax benefits. Saving on tax at least prompts earning members of a family to look up options for sound medical policies for their dependants and the elderly.

According to the latest Indian Brand Equity Foundation report (IBEF), India is expected to be one of the top three healthcare markets with an estimated CAGR of 22.87% during 2015–20. Due to the increasing awareness regarding preventive healthcare, there’s a rise in the demand for medical insurance policies in India.

In a recent article by The Economic Times Wealth, ‘ Why women need adequate insurance cover’, it was discussed how men opt for a term cover for themselves, leaving their wives ‘inadequately insured’ even when she’s a contributing member of the family. Interestingly, at the time of planning long-term goals, both their incomes are taken into consideration but not while taking a medical insurance cover. But thankfully, with awareness, things are changing for the better where even women are taking an interest and securing their lives as well. 

With a wide choice of medical policies now available in the market, it makes it far easier for anyone to look up multiple options with a mere click of a button. Sudhir Sawant, a Wealth Advisor at Money Mind Wealth Creation in Mumbai, offers a few parameters that can help you choose a policy that’s just the right one for you – 

1. Sum Assured (Hospitalisation)

Before signing up for a policy check for the ‘Sum Assured’ in the case of hospitalisation, this is a pre-determined amount that an insurer promises to pay to the policyholder in case of any untoward incident. For instance, if the policyholder dies, the insurer is expected to pay the Sum Assured to the nominee, thereby concluding the policy.

2. Tax Benefit

A tax benefit is by far one of the main reasons why people opt for a medical insurance policy. While it should not be the sole reason to opt for medical insurance, but it is good to know that you can get a tax exemption up to a maximum of INR 25,000 under Section 80D.

3. Cashless

Opting for a cashless medical insurance policy can be of great help, especially during exigencies when you’re travelling or otherwise. During the course of hospitalisation or emergency, the policyholder can avail of the medical facilities with the insurance company directly settling the bills. This works for both planned and emergency medical cases as well.

Medical Insurance – an act of love and responsibility towards yourself and your family. Image by Gerd Altmann from Pixabay 

4. Network Hospitals

Before signing up for a medical insurance policy, do check for the network hospitals that are covered by the insurer. Before a planned hospitalisation, submit a request within 72 hours for the insurer to verify the same. However, do check for Third Party Administrator (TPA) in case of emergency cases.

5. Waiting period for pre-existing disease

pre-existing disease could be any health-related issue faced by the policyholder before taking up a policy. In most cases, insurers are not too eager to sign up with an individual with a pre-existing disease as the likelihood of getting treatment by them is higher. But that doesn’t mean one cannot get insurance, but this is where you need to do some research based on the ‘waiting period’, which can range from two to four years. 

6. No Claim Bonus

Most insurance companies offer a no-claim bonus when a policyholder has not filed for any claim after having purchased insurance. In such cases, check for the percentage of the bonus, which could be ranging between 5% which gets added to your Sum Assured.

Medical Insurance gives you peace of mind and pocket in cases of emergency medical attention. Image by ElasticComputeFarm from Pixabay 

7. Others

Do read the fine print or ask your wealth advisor/ insurance agent whether aspects like OPD, One-Day Hospitalisation (for cataracts and other one-day minor surgeries) are covered in the insurance policy. 

There are over 15 to 17 medical insurance policies in India. Small details such as these help you make a more sound and informed decision as to what policy to opt for, whether it gives you the worth of an expense that is absolutely necessary for you. 

Before signing off, Sudhir adds, “If the customer is not satisfied with their current health insurance company, they can avail the portability facility and port his policy to another Health insurance Company (just like a mobile phone portability service).

Tanya Munshi

Contributor: Tanya Munshi

Writing Mentor & Founder of The Lifestyle Portal.

The Lifestyle Portal

Tanya is a graduate in Sociology from Sophia College, Mumbai, a post-graduate in Communications and Media from SNDT Women’s University in Mumbai and holds a Master's Degree in Journalis & Mass Communications from Chandigarh University. A former writing mentor and a seasoned lifestyle writer, Tanya writes columns on The Lifestyle Portal of life and living.

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