How to choose the right health insurance plan for your needs?

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Anuj Verma is in serious trouble. He recently lost his job due to Covid-19 as his company downsized the employee strength to cut expenses. Anuj only had corporate health insurance that covered him and his family. With the job gone, he wishes to buy a family health insurance plan but is confused about the process. If you are in a similar situation, this quick guide may help you choose the right insurance for your needs:

Jot down your needs

Know your needs first. Some of the questions that you must keep in mind while choosing a health insurance plan could be:

  • Whether you want a family or an individual health insurance plan?
  • How much coverage do you want?
  • What would be the amount of premium you can afford?
  • What kind of hospital network coverage do you wish for?
  • How much waiting period would be okay if there is a member with a pre-existing illness?


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Answering these questions will help you look for the most suitable health insurance plan.

Compare all the Health Insurance Plans

Compare the shortlisted plans on features such as cashless facility, room-rent, hospitalisation charges, pre, and post-hospitalisation facilities, illness and injuries covered, the network of hospitals, physical therapy, loyalty bonus, mental health care, unlimited restoration for unrelated illnesses, cumulative bonus booster, rewards for healthy lifestyle and more.

You must also keep in mind the claims settlement ratio and the time taken to settle a claim by the insurance providers. A higher claim ratio indicates less time taken by the insurance company to settle a claim. You can make use of insurance aggregator websites to compare several plans to find an optimal plan for yourself.

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Check the sub-limits and exclusions in Health Insurance

There are two major sub-limits that you should keep in mind – i) room-rent limit – Most health insurance policies come up with a limit on room rent that they can cover. For example, if the room rent limit is Rs 4,000 and you get admitted to a room charging Rs 6,000, then you will have to bear the remaining Rs 2,000 for each day that your hospitalised. Choose a policy without room-rent limit; ii) Disease-specific limits – Your health plan may not cover the treatment charges to its entirety. For example, cesarean delivery could be covered only up to Rs 50,000 even though the overall health cover could be of Rs 10 lakh. Enquire about such limits.

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Additional Benefits

Apart from the basic health insurance benefits, you may look for a plan that offers you additional benefits such as buyback riders, outpatient department (OPD) cover and top-up plans that offer you higher coverage. A buyback rider helps you reduce waiting periods on certain diseases. Similarly, you may opt for OPD cover on extra premium. Besides, top-up and super top-up plans help you get higher coverage at affordable rates.

Make sure that you understand all features of your health plan, which should surely meet your medical needs and of your family.

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