Choosing the best health insurance plan is very important as it provides the necessary financial protection for your family’s health security. A suitable health insurance plan can be selected as follows.
1. Understanding your needs
First you need to decide what type of health insurance plan you want.
✅ Choose a plan for them:
- Individual Health Insurance – Only one
- Family Floater Insurance – For the whole family
- Senior Citizen Plan – For the elderly
- Corporate/Group Health Insurance – By company to employees
- Critical Illness Insurance like Cancer/Kidney
2. Choosing the right coverage
Know what is covered in the insurance policy.
Important points:
- Hospitalization Expenses
- OPD Expenses
- Pre-Hospitalization & Post-Hospitalization
- Emergency Ambulance Expenses
- Day care treatment (treatments completed within 24 hours)
- Maternity & Newborn Coverage (Delivery Expenses)
- Free Health Check-ups
- Cashless hospital facility
💡 Determination: As health services are expensive in big cities, it is advisable to take a policy with a coverage of at least ₹5 lakh.
3. Premium and Affordability
Every time choose a plan that gives better coverage than lower premium.
✅ Factors to Check:
- Premium vs Benefits – Want lower premium but need better coverage
- Deductibles – Check your affordability
- Co-Payment Option (Co-Payment Clause) – Will you have to share expenses?
4. Checking network hospitals
Check if the insurance company partners with the best hospitals in your area.
✅ List of Cashless Hospitals to Check:
- Is your favorite hospital available?
- Which medical centers are covered?
- Are there hospitals that can be used in emergencies?
5. Check Claim Settlement Ratio (CSR).
Does the insurance company settle claims easily and quickly?
✅ The higher the percentage, the better
- 90% – 95% CSR = Very good
- 80% – 90% CSR = enough
- If less than 80% = Doubt
💡 Tip: Check CSR on IRDAI (Insurance Regulatory and Development Authority of India) website.
6. Note the waiting period
Insurance does not provide immediate coverage for some health issues, so be aware of the waiting period.
✅ Important point:
- Pre-existing Disease (Existing Diseases) = 2-4 years waiting period
- Maternity benefits = waiting period of 2-3 years
💡 Tip: Choose policies with shorter waiting period.
7. Taking a plan with reinstatement benefit
It is better to choose plans where the coverage is activated again after full usage.
✅ Example:
- Is there a feature to get coverage again in the same year even if you take a ₹5 lakh policy and use it up?
8. To know about Top-Up & Super Top-Up Plans
Top-up plans can be taken if additional coverage is required.
✅ Who needs it?
- For those who already have health insurance
- For those who need more coverage
- For those who want a large amount of coverage at a low cost
9. Knowing Exclusions
It is important to know beforehand whether any treatments or diseases are not covered by the policy.
✅ Things not usually covered:
- Cosmetic Surgeries (Plastic Surgery)
- Fertility treatment
- Dental & Optical Treatment (except policies with strong coverage)
- Injuries caused by Acts of Terrorism
10. See Company Reviews & Customer Feedback
Read the user reviews of the policy and understand how the services of the insurance company are.
✅ Where to look?
- IRDAI Website
- Google & Customer Reviews
- Official website of insurance company
11. Thorough reading & consultation of policy document
All terms and conditions should be read and understood thoroughly before taking any policy. Further information can be sought from an insurance consultant or financial advisor if required.
🎯 Final Tips:
✅ A good plan: Should have at least ₹5-10 lakh coverage
✅ Choose a plan with good benefits rather than low premium
✅ Always check claim settlement ratio & hospital network
✅ Choose a policy with a shorter waiting period
✅ Get additional coverage by availing top-up plans
📌 A good health insurance policy can secure your future financially! Choose the right plan and stay healthy! 😊
