Medical emergencies come unannounced and bring with them a long-list of expenses which owing to lack of adequate planning often leads to financial distress for the patient & their family. Having a comprehensive Health Insurance helps in managing such situations and one must foresee the future cost of their healthcare needs before deciding on the quantum of coverage.


With so many product options in the market, selecting the right cover could be a daunting task. However being apprised of certain key requisites when buying a Health Insurance might make the process a lot simpler – here are five imperatives that one must consider before settling for a plan.


1. Waiting period-

Every health insurance policy has a waiting period, especially for specified list of illness & pre-existing diseases. This basically means that the insured would have to wait for a certain period of time before they can claim for these. This waiting period can range from 1-4 years, depending on the policy & insurer.

Since most major illnesses occur at a progressed age it advisable to get health insured at a young age so that one can avail complete policy benefits when required.


2. Comprehensiveness of Coverage- 

Health Insurance plans go beyond covering expenses incurred at the time of hospitalization and even cover other miscellaneous medical expenses such as – pharmacy bills, diagnostic tests & doctor consultations; incurred 30 days before and 60 days post hospitalization.


Furthermore, apart from allopathic treatments there are plans available in the market that offer coverage for non-allopathic treatments such as Ayurveda, Unani, Homeopathy & Siddha. Some insurance products offer you the options of availing treatment overseas and even recharging one’s sum insured amount should the same be exhausted during the policy year.


Another important thing to consider is cashless hospitalisation. Health insurers have a network of hospitals at which they provide cashless treatment. This facility makes one free from the stress of arranging funds at the time of an emergency and even eases the discharge process. It is advisable to opt for an insurance plan that has quality empanelled hospitals within your proximity.


3. Claims procedure-

Your insurance plan should make things easy for you, and should not add on to the stress for you or your family at the time of emergency. The claims process should be simple and quick. Opt for an insurer which is well-reputed for its quick claims settlements for e.g. cashless claim approval TAT could be a good measure of claim settlement efficiency. There are insurers who handle the claim settlement process in-house which has certain obvious merits.


4. Applicable Sub-limits-

Sub-limits are monetary caps that insurers place on the insurance cover amount. Basically it means that the insurance company will limit its liability, which is the amount to be paid for a medical service, in certain cases by placing sub-limits over specific medical charges. In this case, the insurer will only pay a certain sum for a medical expense and the rest will have to be borne by the individual.


When buying a health insurance policy, compare the sub-limits that different insurers have included in their plans. The less number of sub-limits in a plan, the better it is. However, have a good understanding about the sub-limits which you can afford to have.


5. Discounts or Value added services-

For many, one of the key factors for selecting a health insurance plan is its affordability. Insurers address this by offering a discount to those who choose to stay with them for longer & select policy tenure of greater than year. These discounts could range anywhere between 7.5% – 10% for a 2 or 3 year policy term. Furthermore, insurers reward customers for maintaining good health such as increase in cumulative coverage in case of a claim-free year, in addition to offering value added services that include discount coupons for pharmacy related expenses or health check-ups.