What are the things to look for before buying a health insurance cover? (Health insurance)

Before buying a health insurance cover, it is important to look at several key features to make sure the policy fits your needs and offers good value. Here's what to look for:

✅ 1. Coverage and Benefits

• What is covered? (Hospital stays, surgeries, doctor visits, maternity, mental health, etc.)

• Does it cover day care procedures?

• Does it include outpatient care? (Not just hospitalization)

• Does it cover pre-existing conditions?

• Are preventive services (check-ups, vaccines) included?

✅ 2. Premium Amount

• This is the monthly or yearly fee you pay for the insurance.

• Compare different plans to see which one offers the best balance between cost and coverage.

✅ 3. Deductibles and Co-payments

• Deductible: How much you must pay out-of-pocket before insurance starts covering costs.

• Co-payment (co-pay): The fixed amount you pay when you receive services. 

• Choose a plan with deductibles and co-pays which you can afford.

✅ 4. Network of Hospitals and Doctors

• Make sure the insurance plan includes:

• Hospitals or clinics near you

• Specialists you may need.

• Some plans only cover costs if you use their network providers.

✅ 5. Exclusions and Limitations

• Read the fine print to know what is not covered.

• Common exclusions include:

• Cosmetic surgery

• Certain dental or vision services

• Some chronic conditions or experimental treatments

✅ 6. Waiting Periods

• Many plans have a waiting period before certain benefits begin (e.g., maternity or pre-existing conditions).

• Know how long you will have to wait before you can use the full benefits.

✅ 7. Claim Process

• Choose a plan with a simple, fast, and transparent claim process.

• Check if they offer cashless claims or reimbursement only.

• Ask how long it usually takes to get claims approved.

✅ 8. Maximum Sum Insured

• This is the maximum amount the insurance will pay for your medical expenses in a year.

• Choose a sum insured that covers possible large expenses like surgeries or emergencies, which covers modern treatments.

✅ 9. Renewability

• Make sure the plan offers lifetime renewability, so you are covered as you get older.

✅ 10. Additional Benefits or Riders

Look for optional add-ons (also called “riders”) like:

• Maternity cover

• Dental or eye care

• Accidental disability cover

• Critical illness cover

✅ 11. Customer Service & Reviews

• Read reviews and ask around about:

• How easy it is to contact them.

• How helpful and responsive they are.

• Claims settlement ratio of the Insurer.

✅ 12. Regulatory Approval

• Make sure the insurance provider is licensed and regulated by your country’s insurance authority.