ATK

New Delhi [India], December 24: Buying a health insurance policy is never an easy decision to make. To begin with, the insurance market has many big players offering lucrative plans, and the plethora of options can be overwhelming. Secondly, a policyholder needs to strike a balance between the scope of coverage and the premium charged. As you know, the policy premium will increase if you add more benefits, while opting for a cheaper plan may leave you underinsured amid the rising costs of healthcare. Making a well-informed decision is crucial. So, let's discuss in detail whether you really need a high-value health insurance policy.

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1. Why is a high-value health plan needed?

Medical science is progressing rapidly, leveraging artificial intelligence and machine learning to improve diagnosis and the accuracy of surgical procedures. However, all this advancement comes at a cost. Healthcare services are expensive, and in the absence of medical insurance, you may end up depleting your savings. Merely buying a policy isn't enough; you must ensure that the coverage is adequate. While you may feel that your age and health status don't warrant such a plan, the reality is that fatal accidents and critical illnesses do not discriminate based on class, colour, gender, or age. Hence, you should never underestimate the importance of having a high-value plan.

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2. Advantages of high-value health insurance

Some key advantages of high-value medical insurance plans include:

* Comprehensive coverage

High-value health plans offer extensive coverage for a wide range of services, including hospitalisation, preventive care, prescription medicines, surgeries, mental health services, and specialist consultations. Such plans allow policyholders to access quality treatments without substantial out-of-pocket expenses.

* Less out-of-pocket expenses

Although high-value plans have higher premiums, they often come with lower deductibles, co-payments, and co-insurance. This reduces your out-of-pocket expenses significantly, making them particularly beneficial for those with chronic health conditions who require regular medical attention.

* A wider network of healthcare providers

Policyholders have the flexibility to choose from a broader network of specialists, doctors, and hospitals. This makes it easier to receive treatment at preferred healthcare facilities, which is often a feature of high-value health plans.

* Additional benefits

High-value plans offer extra benefits that are usually not covered by standard health plans, such as wellness programmes, alternative therapies, and dental care.

3. Disadvantages of high-value health insurance

High-value health insurance plans come with some drawbacks, such as:

* Higher premiums

The premiums for such plans are higher compared to standard health policies due to the comprehensive coverage and additional benefits. If you are considering high-value plans, you must assess whether the higher premiums fit within your budget and whether you genuinely need these extensive benefits.

* Expensive for healthy individuals

If you are healthy with minimal healthcare needs, a high-value health plan could cost you more than necessary. The extensive benefits may not be utilised, so it is important to evaluate your healthcare needs before opting for a premium plan.

4. Factors to consider while buying a high-value health insurance plan

Here are some factors to consider before choosing a high-value health plan:

* Inclusions and exclusions of the plan

The scope of coverage is determined not only by what is covered but also by what is excluded. Take a careful look at both the inclusions and exclusions. Many people whose claims are rejected are unaware of the plan's exclusions. For instance, you might go for treatment and then discover that a particular illness isn't covered. Reach out to the insurance company if you need clarity. To be on the safe side, ensure that daycare procedures and AYUSH treatments are part of the plan.

* The waiting period

The shorter the waiting period, the better. Since you cannot make a claim during this period, it is essential for individuals with pre-existing conditions that the waiting period is as short as possible, as there is always a risk that their condition may worsen.

* Policy premium and sum insured

The sum insured is the maximum amount you can receive for treatment. If you increase the sum insured, the premium will also rise. Make sure the premium is within your budget and provides you with the coverage you require.

* Limitations and clauses

A good plan will have fewer limitations, such as room rent limits and co-payment clauses, as these conditions can increase your financial liability.

* Availability of add-on covers

The plan should offer you add-ons to enhance your coverage at a reasonable price. These could include critical illness cover or maternity benefits.

* Discounts and other benefits

The policy should offer a No Claim Bonus for every claim-free policy year or at least one preventive health check-up as part of the plan.

* Reputation of the insurer

It's crucial to choose an insurer with a good market reputation for hassle-free claims, a high claim settlement ratio, and a broad network of hospitals.

5. Conclusion

The price of the premium doesn't guarantee its value. So, you should opt for a high-value plan that meets your needs rather than simply choosing the most expensive option. Conduct thorough research on the policy's benefits, exclusions, and other terms and conditions. Additionally, selecting the right insurance provider is equally important. Buying health insurance plans for family while you are young and healthy will allow you to secure cheaper deals and easily complete the waiting period, making it easier to benefit from your medical insurance when needed.

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