Things to know before buying a health insurance policy 

Health insurance has become indispensable, given the rising medical inflation, especially in times of the pandemic. What’s more, long work hours lead to a sedentary lifestyle, unhealthy food habits are also triggering the rise in lifestyle diseases. However, if you have a health insurance policy you can keep your family guarded against such unforeseen eventualities. But buying a health insurance policy may not be enough as you also need to know some of the key things to cut out surprises later at the time of making a claim. So, here are 4 things to zero in on the right health plan suited best for you and your family. 

Room rent: While buying a policy the first question to ask is whether there are any sub-limits in your insurance policy. This is important as it caps your room rent expenses. For example: if a policy has a room rent limit of 1 per cent of the sum insured say Rs 1 lakh, then you will be paid only Rs 1000 as room rent.  It is always better to go for a policy without any sub-limits as the cap on room rent also determines other charges such as doctor’s fees. 

Co-payment: One of the common reasons for a low premium on health insurance policies is the co-payment feature. Under the co-payment feature, a policyholder has to bear some portion of the hospital bill at the time of discharge. The feature is mostly seen while underwriting policies for senior citizens, as they are more likely to require medical services and treatment frequently.  

Why opt for a co-payment insurance plan? If you have a problem in paying the premium then you can opt for the co-payment option to reduce the premium, as something is always better than nothing. The co-payment percentage is typically a minimum of 10-20 per cent from the insurer. Therefore, before buying the policy do ask if there is a co-payment option to avoid surprises at a later stage. 

Waiting period: It is important to look at the waiting period before buying a policy. Under the waiting period if there is any pre-existing condition then it will take time for coverage under the insurance policy. The waiting period is generally from 1 to 4 years.  

So, if you have bought a health policy and have a pre-existing illness, which if unfortunately worsens then the health policy will hardly be of any use if the waiting period for the existing illnesses is high. Hence, it is good to opt for the lower waiting period while buying a health policy, especially for your parents. 

Consumables: The consumables such as syringes, gloves, masks, thermometers, among others are non-payable and have to be borne by the policyholder. Typically, consumables constitute around 5-10 percent of a hospital bill. With a view to standardising the claims procedure, the insurance regulator has listed 199 items as standard exclusions where consumables are not payable.