13 Points to Remember Before Buying Health Insurance

Choosing the correct health insurance plan is an important decision for all of us. Not only is health a true wealth, it gives a sense of security and peace of mind for both you and your family. 

It always assures us of the best chance to get well, just in case something goes wrong. Here are 13 points to consider before buying health insurance.

  1. Buy health insurance early

The earlier you buy, the better for you because as you grow older you are likely to become less insurable. Some of the benefits that I see while buying health insurance at an early age are as follows:

  • No medical checkups.
  • Lower chances of rejection for buying a health insurance plan.
  • Coverage for all diseases.
  • Hassle-free policy renewal.

  1. Sum assured

In simple terms, the sum assured is the maximum amount you get as coverage in a policy year. It’s the basis of all your claims. 

Before you select your sum assured, consider the rising costs of hospitalization and treatment. 

It’s better to go for a higher cover, but at the same time, it shouldn’t be so high that you have to go out of your way to pay the premium.

  1. Co-pay and sub-limits

Insurance companies have introduced co-pay and sub-limits to prevent hospitals from billing them unreasonable room rents. In co-pay policies, you have to pay part of the expenses, regardless of the sum insured. 

For instance, if there’s a 10% co-pay in a policy, the insurer will pay 90% of the expenses while you have to bear the balance. Besides, many treatments are capped by insurers to reduce hospital claims. 

The system is called sub-limits. Choose a policy with fewer sub-limits. Many insurance companies have no capping on the room rent. Ideally, select a plan which has no co-payment or sub-limits.

  1. Critical illness

Most comprehensive healthcare policies cover critical illness. It’s not required to go for another policy. It’s better to opt for a comprehensive plan and then top up insurance which doesn’t cost much. These two would be enough for most of the issues.

  1. Family Floater

It’s always better to invest in a single plan which takes care of your family members including you, such as the Family Floater instead of taking the separate plans for each of the family members as the premium for multiple policies will be higher than the premium for a single policy. 

Also, In Family Floater the full coverage, if required, can be utilized by a single member of the family.

  1. Restore benefit

This feature will allow you to reinstate the basic sum assured, in case you have already exhausted the sum assured and the multiplier benefit within the policy year. 

But market experts say that the benefit is unavailable on the same illness where the limit has been already exhausted.

  1. No claims bonus

Insurance companies generally provide a no claims bonus to a customer if there are no claims against the policy in the preceding year. 

Before buying a plan, check out the quantum of no claims bonus, which often ranges from 5% to as high as 100% of the Basic Sum Insured. 

A high no claims bonus can cover you against medical inflation and you won’t have to increase your coverage every year.

  1. Pre-existing, waiting period and exclusions

Pre-existing diseases are the ones you have at the time of buying the policy and most insurers have a waiting period for such ailments. 

If you have one, your insurance company may not give you a cover against it while subscribing to the healthcare policy. 

The pre-existing disease, depending upon the insurer, usually gets covered after at least a couple of years. Many insurers take four years in this regard. It’s also important to check the list of exclusions. 

For instance, if you have diabetes at the time of taking the policy, kidney ailments may be excluded from the list if it’s caused due to diabetes. Don’t hide any pre-existing health issues when you buy a policy. It may greatly reduce your claims in case of hospitalization.

  1. Annual free check-up

Many insurance companies provide a free health check-up to the subscriber. But it always comes at a price that is embedded in the premium. You may go for it only if you are keen to avail of the facility every year. 

It’s also important to check whether a healthcare policy, which is renewed every year, covers you for the entire life because life expectancy is increasing, courtesy; improvement in medical technology. 

While the majority of the popular policies give whole life coverage, there are a few that cover only till 75-80 years.

  1. Maternity and daycare

Many recent policies now extend cover against day-care procedures in hospitals that don’t require an overnight stay. 

Before buying such a policy, check out the number of procedures covered in the plan that doesn’t require overnight hospitalization. Besides, if you are planning a baby, ensure that the policy covers maternity expenses. 

Most insurance companies don’t consider maternity as a medical emergency and if you have no plans for a baby, you shouldn’t look for it because the price is embedded in the premium.

  1. Top-up plans

Rising medical costs call for large covers. However, not all can afford high premiums. This is where a top-up plan comes useful. 

In a standard plan, your insurer pays up to the sum assured. But top-up plans don’t pay until your bill breaches a particular limit.

  1. Air ambulance

This feature covers the expense for Air Ambulance transportation for emergency life-threatening health conditions which require immediate ambulance transportation to hospitals in India & abroad. 

Many insurances cover air ambulance up to 10% of the sum assured while some offer up to 5 lacs with a maximum of 2.5 lakh per hospitalization.

  1. Global coverage

Cover your medical expenses related to inpatient & daycare hospitalization incurred outside India, provided that the diagnosis is made in India. Few companies offer global cover for critical illness only whereas few offers for any planned medications.


It’s quite important to select the right coverage or else you will increase your premium. Remember a 4 inches pizza with more toppings will not help a family of 4. You need an 8 inches pizza either with more topping or less. 

Now that you are aware of things that you need to keep in mind while buying health insurance, why wait? Call our success planners to get quotes from top insurers. You can easily compare plans and buy.








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