Health insurance is no longer a luxury—it’s a necessity. With rising medical costs and unexpected health emergencies becoming more frequent, having a reliable health insurance plan has become crucial. But with so many policies in the market, how do you choose the best one?
Here are six expert-backed factors you must consider before buying a health insurance policy for yourself and your family:
1. Choose a Plan That Matches Your Needs
Every family and individual has different medical needs. Are you buying insurance for your aging parents, young children, or just for yourself? Pick a plan that provides coverage tailored to your medical history, age, and lifestyle. For instance, if you have a family history of chronic diseases, consider a plan that includes critical illness coverage.
Read how to match your health plan to your family’s needs
2. Prioritize High Claim Settlement Ratio
A company’s Claim Settlement Ratio (CSR) reflects how trustworthy it is in settling claims. A higher CSR (preferably above 95%) indicates that the insurer is more likely to approve your claim without unnecessary hassle. Before buying, always verify the insurer’s CSR through the IRDAI (Insurance Regulatory and Development Authority of India) website or trusted sources.
3. Go Beyond Just Hospitalization Coverage
Good health insurance doesn’t only cover hospitalization. Look for comprehensive plans that include OPD (Outpatient Department) expenses, prescribed medications, diagnostics, home care, and even teleconsultations. This ensures that day-to-day medical needs are also taken care of—not just major treatments.
4. Read the Exclusions Carefully
Each policy has certain exclusions—medical conditions or treatments that are not covered. This could include pre-existing conditions for a certain period, cosmetic surgeries, or alternative treatments. Always read the exclusion list carefully to avoid surprises later when you need the coverage the most.
Understand what health insurance exclusions mean
5. Check Pre and Post-Hospitalization Benefits
Medical expenses don’t start or end at the hospital gate. The cost of diagnostic tests, consultations, and post-operative follow-ups can also be high. Ideally, go for a plan that covers at least 60-90 days before hospitalization and 120-180 days after discharge. This ensures complete financial protection around a medical event.
6. Network Hospitals & Cashless Facility
Prefer insurers that have a wide network of empaneled hospitals where you can avail of cashless treatment. This saves you from paying out-of-pocket during emergencies and ensures a smoother experience. Also, verify that good hospitals in your city are part of the insurer’s network.
Final Words
Choosing the right health insurance plan is an investment in your peace of mind and future health security. Take your time to compare policies, understand the terms, and don’t hesitate to seek expert advice before committing.
💡 Tip: Use IRDAI’s Health Insurance Comparison Tool or trusted insurance marketplaces like Policybazaar or Coverfox to simplify your decision-making process.
Disclaimer: This article is for informational purposes only. Please consult a licensed insurance advisor or financial planner before making any insurance-related decisions.