Compare Health Insurance

Sum insured

This is the maximum amount that the insurer will cover you for. Health insurance premium and the sum insured (SI) are directly related. Thus, a policy with a low premium might offer lower SI. Make sure you have adequate SI to ensure substantial financial assistance in the time of need.

Coverage

Coverage goes beyond the sum insured. Its scope is much wider. It pertains to the inclusions and exclusions of the policy. Check if the policy offers pre- and post-hospitalisation coverage, COVID-19 coverage, day-care treatment, etc. as well.

Network hospitals

Pick an insurer that has a long list of network hospitals, including prominent medical facilities. These are hospitals with whom the insurer has a tie-up to facilitate cashless claims (direct claim settlement between the insurer and the hospital for the amount covered). Do a quick check to ensure top hospitals in your vicinity are a part of the insurer’s network.

Waiting period

Insurance policies don’t cover you against all illnesses from day one. In some cases, you need to wait a particular period (days/months/years) to be eligible to raise a claim against an illness. This period is known as the waiting period. Usually, this period is applicable for diseases that you are already diagnosed with before buying health insurance (pre-existing diseases). Check the waiting period of the policy to avoid claim rejection.

Sub-limits

The policy might have sub-limits on certain coverages. Simply put, if a policy has a 50% sub-limit on Ayurvedic procedures, then irrespective of your claim amount being under the sum insured limit, the settlement amount will be for 50% of the cost of the ayurvedic procedure. For example, if the procedure with a 50% sub-limit costs Rs. 1,00,000, the claim will be settled for Rs. 50,000. Look out for policies with no/manageable sub-limits.

Co-pay

If a policy has a co-pay clause, it means that you have to contribute towards claim settlement. For example, if the claim settlement amount is Rs. 5,00,000 and the co-pay clause is for 20%, then you need to pay Rs. 1,00,000 (20% of 5,00,000). Note that the example does not consider deductibles and other charges for simplification of the concept. A co-pay clause reduces the policy premium as the burden of claim settlement is shared between you and the insurer.

Room rent limit

This is a critical point of comparison that has an effect on the premium charged, coverage offered, and the claim settlement amount. The room rent limit is a cap on the amount spent on the hospital room. This limit can either be mentioned as an amount (for example, Rs. 10,000 per day) or as a percentage of the sum insured (for example, 1% of Rs. 10,00,000). Note that the proportionate deduction clause is applicable in the case of room rent.

Add-ons

Sometimes, insurers might package add-ons as a part of the Comprehensive Health Insurance Policy. This can increase the premium. On the other hand, keeping the Comprehensive Plan to a bare minimum will reduce the premium comparatively. Also, all insurers might not offer all add-ons. Some might even have different names for add-ons that serve the same purpose.

Long-term policies

Considering health insurance needs to be renewed periodically, it would save you time, money (lower premium) and effort if you buy a policy that covers you for more than a year. Check if insurers offer long-term coverage or provide lifetime renewability options for the policy chosen by you.

Digital setup

Choosing an insurer with a digital setup is the need of the hour. Digital insurers make life easy for policyholders while buying, renewing, and claiming health insurance. Insurance-related processes are streamlined thanks to a responsive website and most likely a handy mobile application.