Things to know before buying Health Insurance in India

Medical inflation is at an all-time high! It has caused healthcare expenses to shoot through the roof! In such times, not having the appropriate and adequate medical insurance for oneself and one’s family can be a major financial drawback.

This is because medical adversities come unannounced and have a dampening effect on one’s spirits, not to mention the financial instability that they cause. This is where having medical insurance in India can be so helpful! It will act as your protective shield against overbearing medical expenses and give you access to quality healthcare.

Many of us mistake health Insurance in India as a tax-saving tool, which is an extremely flawed point of view. The primary purpose of Health Insurance is to financially safeguard you against unforeseen medical exigencies. 

However, today there are numerous insurance companies in India providing a multitude of benefits such as high cover, less premium, maternity benefits, OPD cover, quick claim settlement, etc. Moreover, insurance companies are now offering health insurance policies tailored specifically for individuals, families, senior citizens, critical illnesses, and employees working in an organization, and so on. With so many alternatives to choose from, how does one choose the right health insurance in India? Well, here are some tips you can use:


To Begin With, Your Employer's Insurance is Not Enough! Here's Why:

Many jobs come along with an added benefit of health insurance plans by the employer. Since such a prerequisite is already built into the contract and bear thin chances of rejection, employees hardly analyze or compare these plans and their benefits.

Health insurance plans provided by the employer are usually master policies designed for covering all the employees within an organization. While these employer health insurance policies are definitely useful, they do not always suffice.

A number of people covered – The employer health insurance policies are generally group insurance policies, and only cover the individuals working in an organization. These may or may not necessarily cover the dependents (spouse, parents, children, etc.) of the employees.

Co-pay clauses – The whole idea behind purchasing medical insurance in India is to gain maximum possible coverage against health-related expenses. This, however, is not the case with company health insurance. They are tailored to cover only a certain part of the total medical expenditure incurred by you; you yourself will have to take care of the remaining.

Employment status – Company health insurances cover an individual only till the time they are a part of the company. The moment their employment is terminated (for whatever reason that is), their health insurance coverage shall also cease to exist.

Post-retirement coverage – One of the biggest disadvantages of a company's health insurance policy is that it does not provide post-retirement coverage, which is what anyone needs the most. Medical complications and the related financial burden increase with age, and so do the premium rates of health insurance plans.

Room rent limit – Company health insurances also include a room rent limit clause, as per which only a part (somewhere around half the total amount) of the room rent is covered under the policy. The clause only includes the charge of room occupancy and excludes the extra charges for everything else within (doctor or nurse care etc.).

Overall effective cover – Another drawback of company medical insurance in India is that the coverage these provide is not much. Given that all terms and conditions are fulfilled, the total financial coverage is generally around Rs. 1.5 lakhs to Rs. 2 lakhs, which may not be adequate in times of a serious medical issue or long-term hospitalization.

Apart from the above, another thing to note about employer health insurance policies is that these are offered to the employees within any organization as a part of their perks. Such health insurance is not considered as their right and can be changed or revoked anytime the employer wishes to, without involving any legal ramifications. Hence, it is always smart to have a primary health insurance policy (private policy) to back oneself up and treat employer-provided insurance plans as a secondary cover.


The Right Time to Buy Health Insurance:

Okay, so we've ascertained that your employer's plan is not enough and that you need a policy of your own. But when is the right time to buy a plan? Some individuals assume that if they are young and healthy, they do not need a plan immediately. However, on the contrary, the best time to buy health insurance in India is when you are young, here's why:

Lower rejection rate – People with a medical history of chronic diseases are either rejected or have to pay high premiums in India. Since young people with sound health care at a lower risk, they are less likely to face inconvenience on the said grounds.

Low premium rates – Since younger people have lesser health risks associated with them, therefore, health insurance companies in India provide them with lower premium rates as compared to older people.

Waiting period – Medical insurance in India comes with a waiting period during which you cannot make claims even if there is an emergency. Purchasing a health insurance policy at an early age not only allows insurance holders to pass the waiting period without any concerns but also saves them from longer waiting periods and exclusions, which they would otherwise have to bear during the later stages of their lives.

Coverages – The top health insurance companies in India provide wide-ranging coverage, right from daycare facilities to maternity benefits. However, at old age, health complications increase and the cost of health cover steeps higher.

Financial Planning – Besides higher coverage, health insurance plans at a young age also boost financial planning. With an adequate medical cover by your side, you receive the freedom to make long-term investments.

Duration – Buying health insurance in India at a younger age lets you benefit from the policy coverage for a longer duration, without worrying about the ceiling on the upper age.

Tax benefits – Since premiums for health insurance are eligible for tax deductions, buying health insurance plan at a young age also let's enjoy tax benefits for a longer duration of time. With that said, ‘tax benefits’ should never be a deciding factor when buying medical insurance in India.

Bonus – Young insurance buyers are more likely to renew their policies at the end of every term to benefit from the “No Claim Bonus”, in the absence of any claims throughout the policy year. The bonus thus accumulated will result in insurance coverage at a lower premium amount, which will be of advantage later on.


Factors That Affect Health Insurance Premiums:

Premiums are an important factor to consider when buying health insurance in India. We all want a plan that offers comprehensive coverage but at an affordable premium amount. But, have you ever wondered what affects the cost of your health insurance plan? Well, let's find out!

Medical history of the family – Often, individuals with a family history of medical conditions (heart disease, cancer, etc.) that put them at a higher risk, have to bear a higher rate of premium.

Pre-existing health issues – People with pre-existing health disorders also have to pay higher premiums, in case health insurers do not cover them under their existing health insurance plans.

Age – Older people have a number of identified and unidentified health problems and are liable to visit the doctor more often. Hence, insurance companies in India charge higher premiums for them.

Profession – People in professions that put their health or safety at risk (construction sites, industries involving radiation, chemicals, etc.) end up paying higher premiums.

Body Mass Index – Higher BMI often leads to health issues such as joint problems, heart disorders, etc., which is why people with high BMI end up paying more premiums.

Lifestyle – Smokers, alcoholics, and tobacco addicts pay higher premiums or may even be rejected from being covered under a health insurance policy since their chances of suffering from chronic ailments including cancer are higher.

No previous insurance – People with no previous coverage under any medical insurance, may have to pay higher premiums under the assumption that they will make frequent trips to doctors and hospitals.


Dos & Don’ts to Keep in Mind When Buying Health Insurance in India.

Health emergencies come without prior notice and can be quite financially testing. At times, these might even put people in debt, and also affect their future earning ability. This is why it is important that you do not just purchase a health insurance plan for the sake of it. Instead, buy the one that fits your major needs perfectly. Apart from saving taxes, a health insurance policy is what will actually be your savior in case of a medical crisis.

When buying health insurance in India, there are a few do's and don'ts that one must follow to enjoy a smooth purchase process and hassle-free user experience in the future. We have highlighted some of these guidelines to ensure you get full-proof protection without any unwanted hiccups during and after buying the plan.

Do’s -

When buying medical insurance in India, it is important that you inspect all the details very carefully, including

  • Terms relating to co-payment, wherein you as the policyholder will have to contribute some amount to the claim.
  • The clause regarding the coverage of pre-existing diseases.
  • The waiting period after which coverage for some diseases shall begin.
  • Maximum age limit for the entry and renewal of the policy.
  • Conditions regulating the renewal of the policy.

·         Disclose details regarding any pre-existing disease or medical condition to your insurer.

·         Be prepared with all the documents including medical reports.

·         Inquire about the place where the medical tests are to be done and who shall be covering the cost.

·         Pay premiums only when you have ensured that your insurance proposal has been accepted.

·         Once accepted, make sure to pay your premiums and get the policy renewal in time.

Don’ts -

·         Do not hold back facts related to your health conditions when purchasing a health insurance policy as it could land you in a mess during claim settlement.

·         Do not keep any gap in your policy renewals that could adversely affect your cover.


Why Choose IFFCO-Tokio for Your Health Insurance Plan:

We are one of the top health insurance companies in India. We provide you with several customizable plan options to ensure that you get coverage that suits your exact needs. Our health insurance plans offer comprehensive protection for you and your family at affordable premiums. Here are some reasons why you should choose IFFCO-Tokio for your health insurance needs.

5000+ cashless hospital - We have a wide network of cashless hospitals spread across the country. This ensures that getting quick, convenient, and cashless claims are easier for you.

Claim settlement ratio of 92.65% - When it comes to claims settlement, we are one of the top health insurance companies in India. We have settled a total of 8.61 lakh claims in FY2019.

20 years of experience - We have over 20 years of experience in the insurance industry. This expertise enables us to provide medical insurance in India that’s perfect for your needs.

20,000 branches & agents across the country - We have touchpoints all across the country. This ensures that expert guidance and assistance is always just a few minutes away!

Award-winning protection - IFFCO Tokio won Digital Insurer of the Year, 2019 by Insurance Asia News Awards for Excellence.

While your health insurance policy may not generate returns, it will definitely save you from major unwanted healthcare expenditures. Hence, if you haven’t bought yourself some health insurance, it’s time you get a move on. 

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