How To Compare And Choose The Best Health Insurance Plans

Choosing the best health insurance involves assessing needs, understanding terms, comparing coverage and claims, and checking insurer reputation and digital services.

Nobody plans on falling sick. But when the going gets tough on your health parameters, a solid health insurance plan is all that makes a difference for you and your family. The market is inundated with a bazillion plans --each offering different features, premiums, and benefits. In this scenario, choosing the best health insurance in India can feel like a huge task and at times overwhelming too.

But don't worry, in this article we shall break down everything you need to know about a health insurance plan that fits you and your family. Read on to compare and choose a health insurance plan that suits your needs, budget, and future goals.

1. Start With Your Needs

At the very onset, you have to first decide your and your family's requirement. Before diving into brochures and setting your mind on online comparisons, think about what you actually need from a health insurance plan. For example, a 25-year-old who has no major health concerns will need a very different plan vis-a-vis a person aged 45 years and has a family of four. It is very important to customise your plan based on your life stage. This will help you get maximum value from your policy.  Consider the following parameters:

• Your age and health status
• Family medical history
• Whether you're buying an individual plan or family floater
• Any health issues you had before getting the policy
• Hospitals of your choice (or healthcare providers)

2. Understand the Important Insurance Terms

Knowing your exact requirements is like winning half the battle. Here are some basic terms you should familiarise yourself with:

• Sum insured: The maximum amount the insurer will pay in a year.
• Premium: The amount you pay, annually or monthly, to keep the policy active.
• Co-payment: The percentage of the bill you’ll pay from your pocket.
• Waiting period: The time you must wait before your policy starts covering certain illnesses.
• Network hospitals: These are hospitals where you don't have to pay out of your pocket, thanks to the cashless claim benefit.

3. Use a Health Insurance Premium Calculator

Once you are clear and certain about your requirements regarding a health insurance policy, your next step would be to figure out how much it is going to cost you. And the best way to do this is very simple - just use the health insurance premium calculator on the insurer’s website.

All you have to do is:

1. Head to the insurance company's website or app
2. Fill in details like your age, gender, city of residence, number of family members you want to cover, in case it’s a family floater plan.
3. Choose your sum insured, for example, Rs 5 lakh, Rs 10 lakhs, or Rs 20 lakhs.
4. Select any add-ons or riders, like critical illness cover or maternity cover
5. Click 'Calculate' to view your estimated premium instantly

4. Compare Coverage and Benefits

After you have shortlisted policies that suit your budget, you can compare the coverage and benefits viz:

• Room rent limit: Some policies cap or limit room charges while others offer private room coverage.
• Daycare treatments: Check if treatments like chemotherapy or dialysis are covered.
• Pre- and post-hospitalisation: Good plans cover costs like diagnostic tests or follow-ups before and after hospitalisation.
• Maternity benefits: A must-have if you’re planning to grow or start a family.
• Restoration benefit: Great for family floater plans because it refills your coverage after it’s used.
• Domiciliary treatment: Covers treatment at home when hospitalisation isn’t possible.

5. Check the Insurance Company's Claim Settlement Ratio (CSR)

As a smart health insurance buyer, before you choose a plan, you must check how well the insurer handles claims. The Claim Settlement Ratio (CSR) shows the percentage of claims the insurer has successfully paid out. Claim Settlement Ratio reflects majorly on the credibility and dependability of an insurer. A CSR above 95% is a solid sign that an insurer's claim process is a smooth one.

You can find this information on the IRDAI website or directly on the insurer’s website or mobile app. While you're there, also look into how quickly they process these claims and whether they offer cashless treatment at hospitals you trust.

6. Hidden Clauses

Another very important aspect that requires your attention is 'Hidden Clauses'. Sub-limits are limits within the policy on things like cataract surgery, joint replacements, or even routine lab tests because small details like these can make a big difference when you need to file a claim. You must thoroughly inspect what’s not covered in the policy such as:

• Cosmetic surgeries
• Injuries caused by self-harm
• Alternative treatments, unless the policy clearly includes them
• Disease-specific waiting periods

7. Don't Ignore Add-ons

Many insurers offer add-on covers or riders like critical illness cover, personal accident cover, OPD (Outpatient Department) cover, and hospital cash allowance, to name a few. These add-ons come with a higher premium but these are worth your consideration, if you really think you will require them in future.

8. Digital Services & Customer Experience

Insurers with strong digital platforms make your health insurance journey much more manageable. And in today’s digital world, convenience becomes extremely important. Check if the insurer offers:

• Online policy renewal
• 24/7 customer support
• Mobile app for claim tracking
• Easy access to policy documents and service history

9. Look at What People Are Saying

Make due diligence, take some time to read customer reviews on independent platforms regarding your insurer. While every insurer may have a few negative reviews, consistent complaints about delays or poor service are a major red flag.

In case you’re applying for a policy through an agent or broker, you can also ask them to walk you through real case studies or customer experiences so you can get a better picture of the insurer's service.

Bottom Line

There’s no such thing as a one-size-fits-all policy. The best plan is the one that works for you, whether that means more coverage, a lower premium, or faster claims process. Take your time to explore all the options, ask questions, and choose a plan that gives you peace of mind by making sure you and your family are protected.

(This article is from the Brand Desk. User discretion is advised.)