Like it or not, sooner or later someone in the family will face medical expenses. It is anybody’s guess how much that can amount to. But it is up to you to decide today if you want to pay it out of your pocket, or if you want your Medical Insurance to cover the expenses.

Don’t let an illness erode away your savings.

Again, this is an insurance, an expense, that will not, and should not grow your money. It is only a guard against a future, much bigger expense. Of course, we hope that all our medical insurance premium amounts go waste.

At a young age, you can rely on the insurance provided by your employer, but read the fine lines of the cover limit, inclusions, exclusions, etc.

What all should you look for in the medical insurance you choose?

  • Family Floater plans are a good idea. Per person premiums are lower, and coverage is generally higher. Although, the main con of family plans is that there is not much you can do if 2 members of the same family fall sick in one year. This is because the total amount due by the insurance company remains fixed.
  • An important thing to take care of is, the maximum age up to which the policy can be renewed. Probably, as you grow older, medical expenses will increase, making it necessary to stay covered in your old-age, specially post retirement.
  • As with any kind of insurance, choose a company with a high claim settlement ratio.
  • The sub-limits of per day room charges can really pull money out of your pocket. This need to be illustrated with an example. Let’s say that your per day room charges are capped at Rs6,000/-, but owing to the lack of availability, or for any other reason, you go for a room that costs Rs10,000/- per day. In this case, you will be entitled to claim only 60% of your TOTAL expenses. Not just of the room rent. If the doctor’s fee is Rs50,000/- for the duration of your stay, you will end up getting only Rs30,000/- from that too. This is irrespective of the total cover of your policy. Go for a policy which allows high per day room charges. Ideally, one with a private room eligibility or one with no room rent capping.
  • Make sure that the company has network hospitals around the country, especially in your city. Do note that this list can change frequently.
  • Pre- and post-hospitalization charges should be covered
  • Approvals should not take more than 1 hour.
  • Make sure the cover is large enough to cover you till old age
  • Organ Donor costs should be covered without limits
  • Day care treatments should be included
  • Multiple restoration of sum insured
  • No-claim bonus should increase your cover
  • Non-consumables should be included
  • Included annual health check-up, OPD charges, and alternate treatments like Naturopathy, Ayurved etc. might attract you. If you plan to use any such service, go for its cover.

Consider add-on factors like

  • accident cover, which will give you a fixed amount depending on the kind of injury you sustain and
  • critical illness cover, which entitles you to a fixed, often big amount on diagnosis of a critical illness. You don’t need to furnish any bills in this case.
  • If you are in that stage of life, consider getting Maternity cover.
  • AYUSH benefits

Mind the exclusions. Look for limits, co-pay options, loadings and deductibles which can force you to pay a certain percentage of every claim.

Be more cautious about what the insurance provider is excluding from the policy, than about what they are including.

I would always prefer cashless claims, as it reduces the effort of paying, and then asking the insurer to reimburse. In case of non-cashless claims, you also need to ensure more liquidity at all times to pay upfront.

Don’t forget to claim deduction under Section 80D while filing your Income Tax Return.

Check out a more detailed list of things you must do before you start investing.

There are plenty of websites and agents from where you can buy Medical Insurance. Just go to Google and search.

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