With so many Insurance companies, so many health insurance policies with different names, complex features and hidden clauses, it becomes an arduous task for  a layman to choose a policy and be confident about it. You are confused about things when it comes to health insurance and not clear about will you deal with various things in Health Insurance and delaying your decision of taking a health policy. (This article also got published  in Dainik Bhaskar)
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We are simply programmed to try to buy policy at lower premium with high sum assured.  But, acquiring health insurance is to understanding the benefits and terms are more important than the cost you are paying. By paying lower premium with partial core features could result in a disaster. Getting known the features of Health insurance requires deeper insights into the overall insurance coverage over and above price comparison. Either you need to get yourself into comparing the features in detail, or take help of an unbiased health insurance advisor or financial planner.Here are the most important things, you must known when you buy health insurance product.

Co-Pay Clause in Health Insurance Polices

Under this clause, the insured is also required to bear a certain percentage, say 10% or 20% of expenses incurred on illness/disease while hospitalized, either conditionally or under certain conditions. Most of the companies levy this clause once the policyholder enters the Senior citizen category that is after the age of 60. But some companies are come with the same clause at the entry of the policy till long life renewal. Some other companies, preferably PSUs, charge this co-pay clause if the policyholder is taking treatment in out of network hospitals.

Look for Limits

Look for treatment wise limits in the products. Treatment wise limits basically cap the amount you can claim for a particular surgery under the policy, room rent limit etc. Such limits would cap your claim, even n when you have a large sum insured under the policy. You need to weigh this in, before you sign up.

Check Loading clause in Health Insurance

Loading, in terms of Medi-claim Insurance means the Insurer (Company) will charge more amount than the regular premium from the policy holder after a claim has been made. Generally, the insurance company is of the view, that once a policyholder has made a claim due to any illness or some major illness, he might make the claim again in future (if not near then in the distant future), so just to be prepared to face those recurring claims, the company tries to safeguard itself, by procuring a larger premium by way of Loading.

Look for Lifelong Renewals

Look for Lifetime products. Rule out all products, which do not cover your family members for a reasonable lifetime. A product, which ceases renewal, while you are still alive and when you need it more than any time before, is a BAD product. Shift through all products and find out the lifelong renewal age.

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Suresh Kumar Narula

SEBI Investment Advisor, Founder & Principal Financial Planner at Prudent Financial Planners
Suresh K Narula is founder and Principal Financial Planner at Prudent Financial Planners. He has earned the professional CERITIFIED FINANCIAL PLANNER and got registered with SEBI as Investment Advisor. He writes on personal and financial planning articles and got published in Dainik Bhaskar, Business Bhaskar and The Financial Planner's Guild, India. He is also a member of Financial Planner's Guild India ( An association of practicing SEBI registered Investment advisers) to create awareness about Financial Planning in general public, promote professional excellence and ensure high quality practice standards. Suresh received his an M.com from Himachal Pardesh University and an MFC from Punjab University, Chandigarh. He can be reached at info@prudentfp.in
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