Health Insurance Checklist

This is a list of important policy features and it should give you an idea about what to expect from a decent health insurance policy

Must have Features

Don’t split the Bill

Insurers might nudge you to consider a co-payment clause, in which case, you’ll be forced to foot a part of the bill each time you make a claim. Could be 10%. Could be 20%. Could even be 30% of the bill. So opting to co-pay might not be the best option, unless you have no choice.

Don’t split the Bill

Restrictions on room & room rent

Some insurers won’t let you pick a room you like. Instead, they’ll have a limit on room rent. And in the event, you breach this limit, they’ll make you pay extra for every little service rendered in the room and not just the rent. At the end of it all, you’ll end up paying a good portion of the bill. So opt for a policy that doesn’t have too many restrictions on this front.

Restrictions on room & room rent

Check for Disease Wise Sub-limits

It’s what happens when the insurer offers you a massive cover (say 10 lakhs) for a modest fee, only to include restrictions on how much of this cover will be available for each disease. So, in effect, you’ll likely end up having only a part of the 10 lakhs available in most cases.

Check for Disease Wise Sub-limits

Opt for pre and post-hospitalization care

Nobody falls sick right off the bat. You’ll likely have to go through a host of diagnostic tests before you’re hospitalized. Once you’re discharged you’ll have to worry about medication. And these costs can add up. So it’s always best to pick a policy that covers pre & post-hospitalization care.

Opt for pre and post-hospitalization care

Seek a Low Waiting Period

If you have pre-existing diseases (including diabetes, blood pressure or thyroid-related illnesses), then it’s likely you’ll have to wait a fixed period before your insurer starts covering claims arising out of these complications. Typically anywhere between 2 to 4 years. So it’s always best to pick a policy where you don’t have to wait a lot.

Opt for pre and post-hospitalization care

Coverage for daycare treatments

Chemotherapy, dialysis, a quick appendectomy. All of these procedures might last less than 24 hours. And even if you’re hospitalized to avail treatment, some insurers might not cover these claims, because they don’t do “daycare treatments”.

Coverage for daycare treatments

Ask for restoration benefit

You buy a policy for the family. You are hospitalized. You make a claim. Your cover runs out. And then a few days later, someone else in the family falls sick. But you’ve already used up the cover. The only thing that can help you is a restoration benefit i.e. if your insurer restores your cover each time you make a claim. If not every time, maybe at least once? It’s possible. You need only ask.

Ask for restoration benefit

Good to have Features

Bonus in case you don’t make a claim

What if the insurer offers you extra cover every year you go without making a claim? Wouldn’t that be nice? Well, guess what? Some insurance policies do offer a lot of bonus cover. So maybe it makes sense to check if your policy extends these benefits too.

Check for Disease Wise Sub-limits

Free health checkups every year

Some insurance policies pay for your health checkups each year. So if you are looking to make sure you’re always in tip-top shape, these health checkups might come in handy.

Free health checkups every year

Cover for Alternative treatments

If you’re into alternative medicine — Think Ayurveda, Yunani, Siddha etc, then you might want to check if your insurer covers these treatment options as well.

Cover for Alternative treatments
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