What factors should I consider while selecting a health insurance in India

What factors should I consider while selecting a health insurance in India.

What factors should I consider while selecting a health

insurance in India?


As there are a lot of firms selling health insurance policies in India, selecting one can really become a daunting task. Apart from a lot of plans to choose from, intimidating jargon’s which otherwise are called as policy wordings add to the confusion.

While buying health insurance is a tough choice, there are a few factors you should consider when zeroing down on a plan. Below are the to consider before purchasing health insurance.

Type of Plan

It is imperative to decide on which kind of insurance plan you are looking for. Is it for your own individual self, your family or your parents. There are individual and family floater plans which are offered by almost every insurer selling health plans. It is important to decide on the planning basis your family structure, current health status, any existing diseases, etc. If you have a nuclear family where you and your spouse are in an age bracket of up to 40 years, then getting your family including kids can be covered under a single umbrella plan. In case, you have some medical illnesses or at an advanced age, then it is suggested to go for an individual plan and get your family insured under the different health plan.

Cashless claim facility

Cashless Claim is a direct settlement of the bill between the hospital and the insurance company. Though most health plans have a cashless settlement of a claim, the same should be checked before you commit to the plan.

Additional Benefits

While checking the policy, it makes sense to opt for certain necessary riders as additional benefits at an additional cost so as to increase the scope of coverage and increase the benefits of the comprehensive coverage.

 Claim Process

The simpler the claims process and the faster the settlement of the claims, better it is for the insured. Therefore, these two are major factors when it comes to the selection of a policy. Good customer support is an additional advantage one should look for.

 Waiting Period

Most insurers have a waiting period for pre-existing diseases. The period can range from two to five years and differs from one insurer to another. You need to keep that number in mind while buying a health plan. A good way is to buy a health insurance plan in your youth, there is a statistically less chance of you filing a claim and you can clear the waiting period with ease.

  • Initial Waiting Period:  Where in the post taking a policy there is a waiting period clause ranging from 30 to 90 days (as per different insurers).  Any claim against your health insurance policy will not be admissible except for the hospitalization expenses due to an unforeseen accident. Such waiting period refrains the person from taking undue advantage of their health insurance as people might take the health insurance immediately post being diagnosed with any illness or disease.
  • Pre-existing Conditions: There are waiting periods ranging from 2 years to 4 years in the health plans regarding the medical condition which you had before taking the plan.
  • Maternity Benefit: The waiting period to get childbirth-related expenses covered ranges from 9 months to 48 months.

 Add-On Covers

Don’t miss out on these value-added covers such as critical illness, accidental death etc. These covers give you a lump-sum amount in the event of a claim. Thus, it is advisable to go for a critical illness cover, if you there has been a history of such diseases in your family. These will provide a much-needed cushion in times of distress.

 Network hospitals

It is advisable to check the network of hospitals which are covered by the insurance company. It should be considered as an important factor, and you must check the list of hospitals if in case they are among the ones you already visit. Also, in case you travel often, you must definitely check for the hospitals to have your insurance travel with you as well. Cashless facilities, as might be needed, are available in network hospitals only.


You must decide if or not you need co-payment. In co-payment, the policyholder is supposed to pay a fixed amount which has been pre-defined and the remaining shall be settled by the insurance company. The percentage of co-pay is generally 10-25%. However, if you opt for this option, your premium will be rather lower.

For example, if you choose 20% co-pay in your plan then your Mediclaim premium can be lowered by up to 20%. It must be kept in mind that the hospitalization cost in case of serious illness is high, and accordingly, the co-payment amount will also be high.

The health insurance is the first priority of financial planning.

The inflation of hospital sector is about 20% The claims can more than one time in the policy year or no also.

So the factors are.

  1. You should consider the comparing it online with a maximum number of companies.
  2. The quote of the premises for your family size to be compared online.
  3. Companies background.
  4. Is the claim process is cashless?
  5. Number of network hospital in India to check
  6. Policy wording is to be understood.like the exclusions of 24 months, pre-existing diseases waiting period.
  7. In-house claim settlement or outsourced to TPA third party assistant.
  8. Free health check-up for everyone for every year.
  9. No claim bonus.
  10. Automatic restore of the sum assured with terms and conditions.
  11. Renewal tillage?
  12. A number of Daycare procedure.
  13. Room rent, ICU rent.


Choosing the right health insurance for you and your family is a serious business and in order to avoid any financial crisis during the times of emergency, it is always advisable to choose the health insurance wisely.

Though people often buy health insurances with the aim of saving tax, it should be kept in mind that in times of medical emergency, it is this insurance that will be your savior.

Insurance and Investment are two separate but very important parts of one’s financial portfolio.

People often go into debts when a health emergency falls upon them. It does not only leave them in debts but also rips the future ability to earn. With the increasing healthcare costs, it is feasible to have the right kind of health insurances with a decent health coverage.

Your health advisor will help you figure out the right mediclaim policy for you and your family.

Whatever the case may be, while you buy a health insurance or are offered one, it is highly essential to be educated enough about various company policies and consider various factors.

If your Health insurance plan is suitable and apt, it will cover your major health and medical needs (if in case the need arises) and will get you rid off any sort of health-related concerns in terms of finance. Therefore, choose your plan wisely and smartly!

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