One of the more interesting things I realised while living in the USA was the amount of importance attached by people there to their medical / health insurance – and the contrast with how little people think about it in India.
Healthcare is, of course, completely privatised and obscenely expensive in USA, which means that having insurance has become a necessity – so much so, that the quality of the health insurance offered by a prospective employer is at least as important as the pay package for a typical American job-seeker.
India may not be as expensive a market for healthcare as USA is, but the difference in quality between government-provided and private-sector medical care can be quite stark, especially for serious ailments. In such a scenario, it is not surprising that almost every other day we hear a sad story about a person who suffered dire consequences as his or her family could not scrape together the money to pay the hospital for his treatment, or at least not in a timely manner. More rare, but just as heart-breaking, are the stories of families brought to financial ruin due to the cost of an expensive treatment.
So we must accept that health insurance, even in India, is as big a priority as anywhere else. But which policy should one choose? After all, at last count, there are 22 companies offering Health Insurance in India.
We recommend checking on the below points before finalising the policy you buy, and which company you buy it from (and surprise surprise, the amount of premium is not #1)
Not all Health insurance policies are created equal. Some cover accidents, some do not. Some cover non-essential but medically-advisable surgery, others do not. Some exclude terminal illnesses like cancer, others do not. Look through the fine-print very carefully before signing on the dotted line.
Unlike most of the other points here, this will NOT be in the fine print of the policy itself. The settlement ratio refers to the amount paid out by the company against the claims made. This is very important as being covered is no use if the company you are covered by has a track record of not paying out on claims made to it. Some companies have a history of rejecting claims for frivolous reasons, so it is very important that you narrow your options down to those that have among the highest settlement ratios.
An interesting fact that most people do not realise is that the type of room you opt for in a hospital has a cascading effect on all the charges you pay over there. But your eligibility for insurance coverage is defined in your policy – if the room you opt for is of a higher standard than your policy says, you will have to shell out the difference not just of the room rent, but everything else. So ensure you go for a policy as per your requirements here as well.
Riders are like an ‘add-on’ coverage that adds to the benefits available on your policy (for an increase in premium). See if the policy you are looking at offers such riders, for example, additional payments for attendants who may be required after the patient is discharged, adding coverage for maternity hospitalisation and so on. If you are recently married, or wish to cover your parents, you may want to explore these riders.
Explore the relative costs and benefits of opting for a family-coverage policy. Sometimes that can be more cost-effective than opting for separate policies for each individual family member. But here, again, it is important to look at who exactly is covered. Some policies cover only spouse and children, others do include parents, and the age of each insured person make a big difference as well.
Once you have narrowed down a good Insurance firm, only then should you start looking at the premium. Obviously, nobody wants to overpay, so if you have narrowed down multiple options based on all the five criteria given above, pick the one with the lowest premium!