10 Tips to Remember Before Opting For A Health Insurance

Health is the core of a healthy and peaceful life. So, are you keeping a check on your health? Do you have health insurance? If not, then you need to get one today. Here are 10 tips to remember before opting for health insurance.

Health insurance helps you to get desirable healthcare treatment without worrying about the extravagant treatment costs. Having a health insurance policy for yourself and your family is crucial because medical care or treatment is very costly, especially in private hospitals. The treatment expenses can empty your pocket by eating up all your earnings and savings of past years.

A good health insurance policy is the one which embraces all the treatment expenses such as consultation fees of doctors, medical tests and diagnosis expenses, ambulance charges, cost of treatment and medicines and recovery cost to a specific limit. Now, before exploring the tips to remember before choosing a health insurance policy, we should first get clear about what health insurance is.

What is Health Insurance?

Health insurance is an agreement under which the insurance provider company, against a regular payment of installments or premium, agrees to compensate the insured person for his medical expenses, in case the insured meets with an accident or falls ill, and needs to be hospitalized. Usually, insurance companies have contracts with major hospitals to render cashless treatment to the insured person. In cases where the insurance company has no contracts with the hospitals, they reimburse the hospitalization expenses to the insured. The government also encourages health insurance for the well-being of people by allowing it as a deduction from income tax under the Income Tax Act, 1961.

The need for Health Insurance

Usually, people purchase health insurance just to save tax. They fizzle out in understanding the fact behind getting an extensive health insurance policy. In our country, India, beyond 80% of financial catastrophe occur from medical urgencies, which can severely ruin an individual’s financial health. Along with requiring massive funds, a medical emergency also influences an individual’s capability to earn his daily bread. Hence, it is double-sided harm. It is a severe plight if you lose any of your dear ones just because you couldn’t manage to get the best treatment for him/her because of a lack of funds. Therefore, health insurance is a significant requirement nowadays.

Selecting the best health insurance plan is a crucial task for everyone. It safeguards you from adversities and gives a sense of satisfaction that you have a protective shield against adversities as the cost of medical care is hiking day by day, having health insurance beforehand is becoming inevitable. It’s better to pay small chunks as premium.

Nowadays, there are numerous insurance providers in the market, selling health insurance policies. Choosing one from those is a difficult task; however, there are few tips that you should remember while screening for the best plan that suits you.

10 Tips to Remember Before Opting For A Health Insurance

1. Opting for Individual or Family plan 

While choosing a health insurance plan, the first problem that you would face is whether to opt for a family floater plan or an individual plan. If you are single, you can end up selecting an individual plan, but if you’re married, family floater plans are a better option as they offer greats discounts. It gives you wholesome benefits. The plan you choose should be of enough amount that could cover soaring hospitalization costs. You can also purchase individual health plans along with the family floater plan.

2. Ascertain the cover required

It is daunting to find an accurate cover amount that befits everyone. As medical science has evolved treatments for the various disease which were not curable earlier, those treatments are inclusive of high costs. With increasing costs of medical treatment, an individual should opt for amplified coverage to ensure safety in the future. Accidents and mishaps are never predicted, so it is better to decide on the grounds of your affordability in terms of payment of monthly premium installments. The higher the plan you could opt for, the better protected you would be.

3. Medical tests

When you are purchasing a health plan, you may be asked to go through a series of medical tests. Generally, a medical test is compulsory, especially for senior citizens (people above 45 – 50 years of age), as they are at a higher risk of having health problems due to increasing age. It is also needed for a person buying a large sum insured beyond the average amount. If you are in the 30s and have good health status, then you are not required to go for an extensive medical test. People previously suffering from diseases or people with smoking habits are also required to have a medical test.

Tips to Remember Before Opting For A Health Insurance

4. Identify the insurer’s network of coverage for cashless claims

As it is earlier mentioned, claims are settled by two modes, first is cashless (in case of tie-ups), and the other one is through reimbursement (in case the insurer has no contracts with the hospitals). In the second case of claim settlement through reimbursement, you have to pay your treatment expenses from your own pocket and collect all the documents (bills or invoices) from the hospital and present it to the insurer to settle the claim. This process is usually time-consuming and requires a lot of running, here and there. Whereas, cashless facility is provided by the insurer in case of tie-ups.

5. Know the things that may not be covered

You must keep in mind that no health insurance covers all the diseases and adversities. Each health plan includes the conditions that are not covered by the policy. There are some diseases that are permanently excluded from a standard health insurance policy like AIDS, psychological disorder, gender-change surgery, dental treatment, sexually transmitted diseases (STD), cosmetic treatments, deliberate self-injury, and hospitalization due to war or nuclear perils.

6. Waiting period

There is a waiting period involved in the health policies; not all the diseases included in the coverage list of your health policy are covered just from the day you bought the policy. All standard health insurance policies have at least 30 to 90 days of waiting period from the date of initiation of the policy for any treatment.

Generally, accidents are covered from the first day of the policy. There are provisions of the waiting period for many medical conditions. Every health insurance policy comes with a list of diseases with a waiting period that ranges from two to four years. Diseases/operations such as ENT surgery, piles, hernia, cataract, kidney or gall bladder stone will be covered after specific years of the waiting period. You are required to go through the list, especially if you or someone in your family has a pre-existing disease.

7. Brace for future advancement of premium

In life insurance policies, generally, the premium remains the same during the entire policy tenure. Whereas, in health insurance, the premium increases with increasing age in most of the health policies. The method of increasing the premium varies from insurer to insurer. Some insurance providers increase the premium annually, and some do in every five years. You should enquire about the frequency of premium advancement from your insurance providers.

What to know before Opting For A Health Insurance

8. Provision for future enhancement of coverage

By the passage of time, the price of most goods and services is rising, which increases the cost of living. Your health insurance cover also magnifies with time to maintain the pace with hiking costs of medical treatment. Some health plans help you in dealing with the price rise to a great extent, as some health insurance policies come with inflation protection. It increases the sum assured by a definite percentage, as per the terms of the insurance policy. There are some plans which offer restoration advantage, which optimally doubles the cover limit.

9. Reveal all the material facts

At any point, in the claim settlement process, if the insurer finds out any concealed information, the claim may get rejected. It is highly advised that you disclose all material or relevant details and provide accurate information. It is most important and specifically required for people who have a habit of consuming tobacco or alcohol and smoking. These disclosures may increase your premium to a definite limit, but it is done to make sure you don’t face any trouble while settling down the claims.

10. Opt early for protection

Purchase a health insurance plan as soon as possible, and certainly before you turn 40. The foremost thing you should do after being well settled with a handsome salary is to buy health insurance. As you are likely to make no or very few claims in the early stages of life. You can avail of the no claim bonus and add up to the original cover of the policy every year. Since in the productive years of life you can earn more and save more for your future.

Recommended: Top 10 Health Insurance Plans For You In India

You must remember these tips before opting for health insurance. Amongst various health insurance policies available in the market, opt for the most suitable policy providing adequate medical cover with modest terms and conditions.

Sushma is a dynamic and knowledgeable personal finance expert and entrepreneur with a rich background in business and finance, holding a bachelor's degree in the field. Her passion for financial empowerment and a drive to teach others how to navigate the world of online money-making, create passive income streams, and achieve financial freedom sets her apart. With a focus on user-friendly apps and engaging games, she guides readers through the most profitable and enjoyable digital earning opportunities.


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