While the general inflation is around 4.8 per cent, medical inflation has jumped 14 per cent in recent times, raising concern over access to proper healthcare for the economically weaker section of society, and senior citizens who are typically more vulnerable to health issues. So, a comprehensive health plan can protect you against medical emergencies financially.

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Here are seven things to consider before buying a health insurance plan:

Adequate Coverage:

Deciding the sum insured is the first step. The premium will vary accordingly. A higher sum insured means a higher premium. Decide the insured sum based on your health condition, age, lifestyle, the family’s medical history, medical costs, etc. To reduce cost, you may buy a basic health plan with a lower premium, and add a top-up plan with a higher coverage for a particular disease you believe you could be prone to. Also, opt for a comprehensive coverage for hospitalisation, pre-and post-medical expenses, daycare, ambulance charges, consultation, etc.

Floater Plans:

Floater plans are usually more affordable than individual policies. These plans cover several family members under a single policy. Each member can make an insurance claim, provided the expenses do not exceed the total insured amount provided under the policy.

Co-Payment Clause:

While choosing a health insurance policy, senior citizens should check the co-payment clause, the amount policyholder pay along with the insurance company for medical treatment. Choosing the co-payment option will reduce the policy’s premium. However, the hospitalisation or medical expenses will have to be borne by both policyholder and the insurer in a predetermined ratio.

Insurance For Lifetime:

Consider a plan which is renewable for a lifetime. On March 20, 2024, the Insurance Regulatory and Development Authority of India (IRDAI) scrapped its previous guidance to insurers not to decline people health policies for at least up to the age of 65, leaving it open for insurers to introduce suitable products for this age group and older. However, some insurers have already been offering lifetime insurance, which is renewable annually. Health insurance policies usually become more useful in old age. Hence, a lifetime cover makes sense. At the same time, buying a new policy could be difficult in old age due to the possible existing medical conditions, and higher premiums. So, thoroughly check the plan before deciding.
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Hospital Network:

Every insurance company has tie-ups with hospitals for cashless treatments. In non-network hospitals, policyholders can reimburse the expenses upon submitting the hospital bills. However, it could be a lengthy process, so it is better to buy a policy with a wide network of hospitals.

Pre-Existing Period:

Any prospective policyholder should look for a policy, where coverage of pre-existing disease starts early. In the March 20, 2024, gazette notification, IRDAI reduced the waiting period for pre-existing diseases (PED) from four to three years.

Claim Settlement Ratio:

The claim settlement ratio is the most important aspect to check while buying a policy. It tells about the number of claims settled against the total number of claims received. Look for a higher claim settlement ratio. Finally, while healthcare expenses are increasing, a health insurance policy can be a viable tool to meet medical emergencies.