Crucial Factors in Comparison of Health Insurance Plans in India

THE HANS INDIA |   Sep 20,2017 , 04:03 PM IST

Crucial Factors in Comparison of Health Insurance Plans in India
Crucial Factors in Comparison of Health Insurance Plans in India

Many insurance companies offer numerous health insurance plans each makingbetter promises than the other. However, it's overbearing to understand that each policy has a different premium, covers different aspects, and are regulated by differentpolicy provisions. With the number of choices available, it will be foolish to settle for the first policy that comes your way. When you can get yourself a good deal for a worthy premium then why not do a bit of research and comparison.

There is no debating that selecting a health insurance plan can be difficult but if you look for the right factors you can get a plan suiting your requirements. So, let’s have a look at what factors/parameters to consider for filtering out theright health insurance plan for you.

Network Hospitals

The Cashless facility in a health insurance policy is a benefit that is only available at a network listed hospital of the insurance company. It is a benefit that provides a convenient way in case of medical requirements than getting the expenses refunded. It makes the treatment free of cost and removesthe hassle of waiting and going through the reimbursement procedure.

Check the network base of hospitals offered by an insurance company. If you have a preference for any particular hospital you can check if the insurance provider has that hospital listed in their network hospital list.

Room Rent Limit

This is one of the most important factors on which your claim settlement depends. Many insurance policies have per day hospital room rent charges fixed to 1% or 2% of the sum assured. If the room rent charged by the hospital is above this limit then your claim will be accepted proportionately.

Waiting period for pre-existing diseases

A pre-existing disease is a medical condition that existed before you got yourself the health insurance policy. You must read the prospectus and the terms of the policy and understand what is not covered under it. Normally a policy would exclude certain diseases from the first year of coverage and also impose a waiting period of 48 months for diseases which are pre-existing in the insured person.


Co-payment means sharing cost for medical expenses. This co-payment clause can be on claim or claim related to specific illnesses. If your policy is asking for co-payment let’s say of 15%, then you will have to pay 15% of the entitled claim amount from your pocket, along with the other non-entitled amount. Some insurance Companies have a co-payment clause after 65 years of age.

Pre and post hospitalization cover

Pre-hospitalization and Post-hospitalization are additional cover benefits which the insurance company offers to the policyholder. This benefit is provided to cover for expenses occurred for an illness or injury for a certain period before and after hospitalization.

Normally 30 days pre-hospitalization and 60 days post hospitalization expenses are covered under health insurance policies.

Day care treatment coverage

Due to technical development and enhancement in medical facilities, there are many treatments for which you may get discharged within less than 24 hours. Such kind of treatments comes under Day care treatment. Companies list down the day care treatment which they cover. It’s better to understand the detailed specifications to avoid any confusion during claim before going ahead with buying the health cover.

Lifelong renewability

Health cover is the most appropriate protection that ensures the health safety.

The service of lifelong renewal helps people enjoy the benefits throughout their lives. If you have a shelter of lifelong renewal you need not worry about huge medical expenses. Such plans are truly worth for your premium payment. They not only help curb the unexpectedmedical expenses but also provide a shield of health protection when you really need later in your life. Try to buy health cover that offers lifelong renewal. The best plan is the one that can provide insurance for lifetime at reasonable prices.


Alternate treatment coverage

If you believe in the powers of alternative medicine, it is a good idea to check which plans are offering alternative treatment coverage. Many companies today are offering non-allopathic in-patient treatments like Ayurvedic, Unani or Homeopathy with a condition of coverage. You can check the coverage for these treatments and depending upon your requirement,get the right coverage plan for yourself.


Exclusions are conditions or illnesses which are not covered by your insurance plan. Every insurance company’s plan has a list of items that the insurance company will cover and they also have a list of items they will not. It is absolutely important to review and actually understand the exclusions of an insurance plan before a purchase to avoid shock/disappointment during a claim.

Add on covers or riders

Add on covers or riders simply are additional benefits that can be packaged along with the base plan for an additional premium. They play an important role in giving youa wider coverage. You can opt for a maternity cover which will cover your expenses incurred during child birth procedures after a waiting period which could be two or more years depending on the insurer and plan. Room rent waiver rider will help you opt for a room with a higher sub limit. Hospital cash rider will provide for daily cash to cover medical expenses during your stay in the hospital. Each plan comes with a specific set of riders which you can avail depending upon your individual requirements.

Consider all the above factors in the comparison of health insurance plans in India and you will surely get a plan that will be worthy of your premium.

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