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selecting the right health insurance

The most important points to consider before selecting the right health insurance

by Holistic | Filed Under: Insurance

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Life’s uncertainties can disturb the rhythm and throw us off our balance. While we can’t predict the future, insurance planning can help us stay on the shore even during the times of tide. Health care is one of the important aspects that need to be covered through insurance. Health insurance covers the risk against sudden expenditure towards unseen medical expenditure. With surging medical costs and unhealthy lifestyles, a right health insurance policy is a boon.

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How to choose the right health insurance plan?

With many organizations entering the insurance forte, deciding the best health insurance plan requires careful analysis. Apart from measuring the affordability from the premium payment perspective, there are other factors that help you arrive at an informed decision.

Claim payment mode

A claim is made on the occurrence of the event for which the insurance is obtained.

  • Cash less facility – A cash less scheme is one where treatment can be undergone in network hospitals, without paying the hospital during the treatment or stay. The insurance company settles the bills directly on behalf of the insured. To avail this benefit, the procedures and regulations laid down in the policy need to be adhered to
  • Reimbursement facility – A reimbursement policy requires the insured to pay the dues to medical institution upfront, and then reimburse these costs from insurer after filing a claim
  • IRDA, India has made it mandatory to provide both cashless and reimbursement options for all health insurers. If the treatment is pursued outside the network hospitals, the reimbursement option can be availed
  • Since the cash less mediclaim policies spare you from the stress of gathering cash during emergencies; it is preferred to ‘cash in’ on a ‘cashless policy’

Coverage and Network hospitals

A hospital or medical institution which has an agreement with the insurance company or TPA (Third Party Administrator) to provide cash less treatment, is a ‘network hospital’. Appraise yourself with the below information before deciding on the insurance plan:

  • Proximity of the network hospital from your place of residence or work. Opt for a provider who has more network hospitals in geographical locations where you are likely to need medical care.
  • Ensure that the facilities and repute of the hospitals in the network are worthy.

Policy exclusions

Exclusions are medical conditions that are not covered by the mediclaim policy. Exclusions are of 2 types – Permanent exclusions and temporary exclusions. Ensure that you check the policy document for the following:

  • Coverage of pre-existing illness – Some specific illness like cataract or knee replacement surgery would be covered only after a period after 2 years. Majority of the policies have such temporary exclusions, hence awareness about such essential information is desirable
  • Fixed exclusions based on the policy – Few ailments are excluded from the purview of the policy, and no claim can be made even after the waiting period. Some of these permanent exclusions are – Dental treatment except arising out of accidents, Naturopathy, alternative medicine/treatments including acupressure and magneto-therapy etc

Waiting period

Waiting period is the initial time frame immediately after effecting the policy, when claims are not entertained. Points to consider regarding the waiting period are:

  • Initial waiting period timeline and insurer’s liability to process claim. Some insurance policies admit accident claims during the waiting period
  • Policy renewal and waiting time. Ascertain if the waiting period is only a one time affair or if it gets repeated during every policy renewal
  • The time limit after which pre-existing illness gets covered. Though the average norm for pre-existing illness coverage is 3 years, it varies from policy to policy

Coverage/Co-payment limits

The sub limits define the maximum liability of the insurance company under various expense categories like room rent, doctors’ fees etc. It requires you to foot the medical expenses even if the bill amount is lesser than the insured value. Clarification of the below points with the insurance company can be of help:

  • List of various services where the insurance company does not pay the full amount
  • The percentage of cost sharing of these services between the insurer and insured
  • Co-payment – Applicable on both cashless and reimbursement schemes, co-payment requires the insured individual to pay a portion of the total medical cost. For instance, in a policy where the co-payment is set at 20%, and the medical expend is 100,000, the insurance company reimburses only 80,000

Insurance is an integral part of any prudent individual’s financial planning. With the privatization of the insurance regime in India, there have been more options to the customer to choose the policy that would best fit his changing needs.

With splurging medical costs across the globe, a medical policy can help you stay more relaxed for finances during emergencies and also entitle you to impressive tax benefits. With some planning and careful analysis of the policy guidelines, you would soon realize that selecting a health insurance plan is not as daunting a task you thought it was!

To take the right critical illness insurance, health insurance, life insurance and other investments, preparing a fundamentally strong, fool proof financial plan is required. If you would like to create such a financial plan, then I would firmly vouch for you to take advantage of

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Previous article: Factors to Consider Before Selecting a Location for the Property
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Jey S
24. September, 2021.
I have been using Holistic Investment Planners for the last three years. Mr. Srinivasavaradhan answered all my questions and doubts very patiently during the first free consultation. I was able to clearly define my short-, medium- and long-term goals once I signed up for the comprehensive plan and got their investment plan suggestion to achieve my goals. They are very polite and highly professional whenever I contact them for any queries or make investments. They never pressurize you to invest on their recommended financial products. I would have been lost money by investing directly without their help since I do not have time and knowledge about different financial products. Risk planning is also done as part of financial planning. Truly, they are holistic planners when it comes to your financial planning. They help you to define your life goals, understand your financial resources and establish a plan to invest towards reaching those goals. They do review your plan as you progress to make sure that you are on correct path to achieve those goals. Kudos to the team and keep up the good work!!! I am happy that I found holistic investment planners for my financial planning and management.
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aksaswadkar
24. September, 2021.
I was about to retire and really not understanding how to invest money to have financial freedom and fulfilling my goals. Was desperately searching on internet way out and fortunately came across Holistic Investment Planners. I read number of articles on their website and realized that this is the agency which I want and engaged their services for my retirement planning. It is an excellent experience to be associated with Holistic. Right from day one our interaction was fantastic and they gave me such a wonderful plan that I had never imagined. I am fortunate enough to be in the client list of Holistic. I have recommended Holistic to my friends as well.
Lionel Faber
Lionel Faber
16. September, 2021.
I've been availing their services for the past year. They are highly knowledgeable in the field and are very patient with all doubts and queries. Personalized financial planning is provided keeping your short term, medium term and long term goals in mind. They do not pressurize you to purchase schemes of their choice. They provide their input and suggestions and leave the decision up to you which shows their honesty and high principle.
Sridhar
Sridhar
8. September, 2021.
Financial planning brings peace in life. Holistic Investment have supported in arriving financial plan based on future goals. My investments are regular since then. They are professionals in their business, will recommend others.
Nitesh Agrawal
Nitesh Agrawal
6. September, 2021.
I have been using Holistic Investment Planners from last one year. The journey has been fantastic. Being a finance person myself I always thought we can look after and plan own finances also. However, due to lack of time and deciplain the things are not always as desired. After joining with Holistic Investment for the first time Icame to know the Financial goals and quantified them. Some dreams were unrealistic based on the earnings and savings so had a reality check. Also got the information and deciplain of investing on regular and more rewarding securities. I definetly suggest to use Holistic Investment Planners. They are professionals, available and hear youor full story before presenting plans. They are flexile in the sense if there are some urgent deviations required, they help to plan the same. For all professionals/individuals I would suggest using professional help of Holistic Investment Planners for best results in long term investment and financial goals achivements. Last advise will be to start early in your life. It really pays well to start in the beginning itself else the dreams needs to adjust :)
Swetha Vasanth
Swetha Vasanth
6. September, 2021.
This is my first year service with the Holistic Team and I would say that they are very much helpful in creating a financial plan and follow ups during the year. I would definitely suggest them if anyone who is willing to proceed with their savings professionally.
Joseph Mathias
Joseph Mathias
6. September, 2021.
I came to know about Holistic Investment Planners online while searching for different investment ideas. Once I contacted them the journey was very smooth. Mr. Ramalingam explained all the aspects of Financial planning in detail and it opened my mind. I realized how important it is to have a Financial planning. Mr. Rajan suggested all the requirements as per my goals and made a Investment plan keeping in mind of my goals. I started my Investment journey with them. I wish I had done it some years back then it would have been in a different level. Review meetings were held every six month to check the implementation of the plan and check the results as per the requirements and to check if any changes required. Overall it was a good experience with Holistic Investment team and would like to continue in the years to come.
Srinvas Kannan
Srinvas Kannan
30. July, 2021.
I came across Holistic investment planners almost 5-6 years back, but I did not have the trust since I had met a few of them who did not sound promising. Then I started investing through a financial advisor of my friend. After 4 years of investing the returns were very low. I was disappointed and started looking for financial advisors when I came across Holistic investment. I had a detailed discussion about my goals and the way they would approach achieving my goal before deciding to switch my investments to them. After a thorough analysis of my then existing portfolios, they suggested new ones and we zeroed-in on 6 schemes/funds where our investment would be split. I am glad I made the decision of switching over and taking Holistic planner's advise, my returns are handsome and I only wish I could have taken their help/advise 5 years back itself. Neverthless, I would like to recommend their services for investment and financial advise if someone is serious about their investments.
Shivaram Andiappan Selvaraj
Shivaram Andiappan Selvaraj
3. July, 2021.
I got a free first time consultation. I got my doubts resolved. They also gave additional advises for investment planning which was also useful.
Nellai B
Nellai B
26. June, 2021.
I have been associated with them for the past three years. They are very professional and polite in answering all our questions. I have complete trust in their suggestions. I strongly recommend for anyone. I am looking forward to have strong and successful association with them.
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