How to choose the Best Health Insurance plan | How to decide which medicare plan is best

Before knowing "How to choose the best health insurance", I would like to start this article with a story. Suppose you want to start a business. That is why you set up a manufacturing factory by investing your hard-earned money and after some time, your factory is set up, and you start manufacturing and selling products, and you start earning profits. But one day, there is a fire in your factory, and you did not install a fire extinguisher. Your years of hard work and huge investment are gone in a few seconds. Now you must be thinking, how is this story related to the topic of health insurance? Well, it is very much related. The problem is that when it comes to money management, everyone is looking for investment ideas. Everyone is looking for multibagger stocks. It is like creating an asset, just like the factory and earning money. But many people make the mistake of not taking health insurance. It is just like not installing a fire extinguisher. Just one mistake could wipe out your entire lifetime of earnings. Friends, risk management is a very important aspect of financial planning. It is not just about investing money in stocks and mutual funds. But it is ensuring that you don't end up losing your lifetime of savings. And that's where health insurance and term insurance comes into the picture. In fact, health insurance is the first and foremost thing that you need to take in your life. even before you start investing money. Over the years, I have seen many cases where people lose their lifetime savings just because they did not have a medical plan. Recently one of my relatives was admitted to the hospital due to COVID. He had a severe breathing issue and was admitted to the ICU ward. in the next 15 days, the total bill was Rs 3.5 lakh, and guess what he did not have the health insurance. Unfortunately, he did not have that much liquidity. Hence, he ended up selling his investments. For a middle-class person in India Rs, 3.5 lakh is a huge amount. It takes years to save that much money and it was wiped out in just 15 days. In fact, every year, millions of people in India end up selling their assets like property, gold, land, etc. to pay for medical expenses. Recently, I conducted a survey in my city on how many people covered themselves and their families with health insurance, and I got almost 19,000 votes, of which, only 49% of people covered their entire families with insurance, while the remaining 57% have not covered their family with health insurance. These are startling figures. In fact, out of 57%, only 7% have a medical plan for themselves, and the remaining 50% do not have a health plan. I have a message for all those who have not taken out health insurance. Don't make this financial mistake.

How to choose the best health insurance
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Take health insurance right away. Many people think that we are young, so we don't need to take health insurance, we will take it later. But my dear friends, the right time to take health insurance is when you are young and disease-free. If tomorrow let's say you become diabetic, then you will have to shell out a lot of money for insurance. On top of that, you won't be covered for the treatment of diseases related to diabetes for a long time. Hence, do not ignore health insurance and take it when you are young and disease-free. But before you take out health insurance, Now there are 13% of people in the survey responded that they want to take health insurance but have doubts. So in this video, I've tried to solve the most common questions around health insurance. Many people have asked about the best medical insurance, so I have entered them as well. Then there is a common question that should a person already covered by an employer take separate health insurance. So I've tried to answer that as well. Then there are some other common questions that I've tried to answer to the best of my knowledge. Alright, let's get started. 

  

What are the key points to keep in mind while taking health insurance?

There is basically a checklist that you need to keep in mind. 

  • Ensure that the medical plan covers the entire cost of treatment and you don't need to pay anything from your pocket. For example, if you take a medical plan, where there is a co-payment clause that is needed to pay, let's say 20% of the medical expense, and if there is a medical bill of let's say, 2 lakh, then you would end up paying rupees 40,000 from your own pocket. So make sure that your medical plan covers the entire treatment cost.

  • Ensure that there is no hospital room rent capping that you can take room up to rupees let's say 2000 or 3000, or take double sharing. Ideally, you should have the choice to select any type of room in the hospital.

  • Ensure that there is a minimum or zero waiting period for the pre-existing disease. For example, if you or your family member have diabetes, then you should take a health plan that has a minimum waiting period for diabetes.

  • Ensure that the health insurance covers all sorts of diseases, including critical diseases, and there is no capping on the treatment cost.

  • Ensure that there is an option of an increase in sum assured every year in case of no claim. For example, if you take health insurance of rupees 5 lakh and you do not make a claim, your sum assured should increase by let's say 20%, and next year, your cover should be at least 6 lakh and likewise.

  • Ensure that your entire family's covered, do not just take a health plan for yourself, ensure that your parents, wife, and kids are covered. you can consider taking a family floater rather than an individual health plan.

  • Check the restoration benefit. For example, if you've taken a health plan of rupees 5 lakh and you ended up with a medical bill of let's say 4.75 lakh then you will only be left with obese 25,000 for that year. Hence, there should be a raised tuition benefit so that next time your wife has a medical expense of let's say obese 2 lakh then you don't need to pay rupees 1.75 lakh from your pocket.

  • Ensure that the health insurance covers the top hospitals in your city and provides a cashless facility so that you don't need to pay anything upfront.

  • Do not just shortlist health insurance based on a low annual premium, you need to ensure that you get proper health coverage and do not end up paying from your own pocket.

  • Always declared the pre-existing diseases, if any. In many cases, people tend to hide the medical problems, or sometimes simply ignore declaring the pre-medical conditions. Dear friends, it is one of the biggest reasons for the rejection of health insurance claims. So make sure that you always declare the medical condition before taking the health plan. But it also doesn't mean that you declare unnecessary information as well. For example, if you face a medical condition 10 years ago, and there is no relation to that disease today, then don't declare it. Otherwise, the health insurer would ask for the documentation of that medical condition and it would be a pain to get that information.

 


Which is the best health insurance?

Well, there's nothing called best health insurance. Let me help you understand with an example. Let's say you choose Max Bupa as it has a very good claim settlement ratio, low premium, and good services. But what if you live in Tier 2 or Tier 3 city and Max Bupa does not cover hospitals in your city its list of impaneled hospitals. In that case, you need to select a medical plan that covers hospitals in your city. Let's see another case. Let's say you take Bajaj Alliance insurance based on various factors like good services, low annual premium, high claim settlement ratio, etc. But let's say you are diabetic and Bajaj health insurance has a waiting period of 3 to 6 months. Should you take this health insurance? No, you should take insurance that covers pre-existing diseases and has no waiting period. It means you are covered from day one, you might need to pay the higher premium for that. But it would still be better than waiting for you to get covered for pre-existing disease in case one. For example, you have HDFC optima energy.


Should salaried people take separate health insurance?

Yes, salaried people who are already covered by their employer should also take separate health insurance. There are many reasons for this.....

  • The first reason is that in most cases, the health insurance from the employer is not enough, the health care cost is rising rapidly.

  • Second, employers negotiate a lot with health insurance companies as they take group insurance in bulk. As a result, there are a lot of features that are missing from the policy. for example, in many cases, the health insurance from the employer doesn't even cover 100% of expenses, it would cover 75% or 80% of the cost. your health insurance from the employer might not cover various critical illnesses. It may not have the best hospital in its network, and there may be other reasons.

  • Third, and the biggest reason is when you leave your job, your policy will not continue further. Now let's say if there is a gap in joining another company, then you won't be covered with health insurance during that period. So basically, health insurance from employers is good for ordinary health coverage. If you really want to plan for proper health insurance, you should take a customized insurance plan as per your requirements separately.


How much amount of medical insurance and term plan should take one? 

Well, it really depends from person to person and family to family. For example, if you are young, and have a wife and a kid without any medical issues, then you can consider taking a medical plan of somewhere around 3 to 5 lakh. This is the minimum you should take as the healthcare cost is rising at a very fast rate. If you are a parent with a medical condition, then you should consider taking a higher plan of let's around 7-10 lakh. The term plan would again vary, I would suggest taking a term plan somewhere around 1 to 2 crores.


Can a heart patient or a diabetic patient also be insured?

Yes, a heart patient or diabetic patient can also be insured. There are multiple plans that are specific to diseases. For example, you can take the Star Cardiac Health plan for heart issues. But like I said before, we can't analyze one health insurance for everyone. The health plan would vary from person to person. Traditionally, health insurance was purchased via an agent, but now you can take health insurance online. However, like I said before, you should know what details to provide and what details to skip, as it can have a significant impact on your policy approval, or rejection, as well as claim approval and rejection. And that's where I would recommend taking help from an expert. I am not sure, how many of you know or do not know that there is an app named Finshots which provides interesting analysis related to business and economy in few minutes. These guys have also launched the health insurance platform called ditto. This is the website where you can get all the details for health insurance. Moreover, you can speak with them personally to get the best health insurance for yourself and your family. They have a hotline number where you can book a slot and schedule the call. You can also watch them for more details regarding health insurance. So in this article, we discuss the most common question around health insurance. I hope you will find the article useful.


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