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Checkpoints to Remember Before Buying a Mediclaim Policy

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August 28, 2018
A medical emergency may cause a great deal of emotional, physical, and financial stress. Financial advisors, therefore, recommend purchasing a health cover as it offers a safety net against such medical contingencies. In an event of hospitalization, the insurance provider meets all medical expenses, including room rent, nursing fees, doctors charges, and cost of medicine, among others. You may, therefore, have peace of mind knowing that your medical expenses will be taken care of, and focus on receiving quality treatment at the hospital of your choice.

It is imperative to make a well-informed decision while purchasing a mediclaim policy. For this purpose, you may go through the following five checkpoints.

1. Type of health plan

There are two major types of health insurance policies, namely individual plans and family floater plans. Individual plans, as the name suggests, provides health coverage for a single individual. While deciding the premium rate for such a policy, insurers consider individual parameters such as age, choice of profession, existing medical conditions, and family medical history, among others.

Family floater plans, on the other hand, offers health insurance to various family members under a single plan. In such a type of policy, the sum insured may be utilized by any member.

2. Renewability clause

With age, an individuals health generally begins to deteriorate. Therefore, there is a greater need to be covered at a later stage of life. For this purpose, it is imperative to choose a policy that offers renewability until lifetime. Doing so will provide financial security against medical bills during your old age.

3. Sub-limit

This is an important factor to take into consideration while purchasing a mediclaim policy. Sub-limit refers to the monetary cap placed by the insurer on your insurance claim. This can be in respect to aspects such as doctors fees, room rent, cost of medicine, and cost of surgery, among others.

For example, assume that your policy is worth INR 5 lakh with room rent sub-limit of 1% of the sum assured per day. This means that the insurer is willing to pay a maximum of INR 5,000 per day for room rent. In case the room rent charges for a single day exceeds this amount, you will have to make out-of-pocket expenses towards the same.

4. Co-payment

Co-payment refers to the sharing of the expenses in a pre-mentioned proportion. For example, if your policy has a co-payment clause of 20% and the hospitalization expenses amount to INR 2 lakh, then you will need to pay INR 40,000, and the rest will be borne by the insurer.

5. Exclusions

Some mediclaim policies come with a list of conditions and ailments that are beyond the scope of coverage. This means that your insurance claim will be rejected in case you make a claim towards diseases in the exclusion list. Therefore, you may, read the prospectus carefully before signing on the dotted line.

A mediclaim policy offers the ability to receive medical care without straining your finances. You may keep the aforementioned factors in mind before buying such an insurance plan.

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Francis Rodrigues Francis Rodrigues

Francis Rodrigues has a decade long experience in the insurance sector, and as SVP, E-Commerce and Digital Marketing, HDFC Life, manages the online sales channel, as well as digital and performance marketing. He has had hands-on experience in setting up sales channels and functional teams from scratch over a career spanning 2 decades.

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Vishal Subharwal Vishal Subharwal

Vishal Subharwal heads the Strategy, Marketing, E-Commerce, Digital Business & Sustainability initiatives at HDFC Life. He is responsible for crafting and ensuring successful implementation of the overall organisation strategy.

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