Discover common health insurance mistakes people make to ensure you make smarter choices and don’t overpay or undercover your medical needs.
In today’s world of rapidly rising costs and inflation, everything is becoming steadily expensive. Unfortunately, the medical sector isn’t immune to this. Even though life is unpredictable and emergencies can crop up without warning, the best you can do is prepare. Selecting the right health insurance policy is a simple way to ensure your health and financial well-being in a medical emergency. However, choosing the right health insurance policy might seem daunting, especially when the policy documents are riddled with complex jargon that requires you to read between the lines. Falling for the wrong policy can increase medical expenses or lead to inadequate coverage. The good news is all this can be easily overcome.
Remember the old saying, “Health is wealth”. Well, this is something you must keep in mind while choosing health insurance. In this article, you will be introduced to common mistakes most people make when choosing health insurance.
Mistakes to Avoid
Avoid the following mistakes when finding a health insurance policy without overpaying or under-covering your medical needs.
Mistake #1: Considering Only the Premium to Be Paid
Don’t make the mistake of looking at the premiums to be paid and choosing the one with the lowest premium, thinking it’s a good deal. While a low premium might be an attractive consideration, it comes with limitations such as a limited hospital network, high deductibles, sub-limits, or exclusions for common procedures.
Instead, look for a plan that balances premium and coverage. Consider options like super top-up plans and deductibles to manage costs without compromising coverage. Also, check for long-term affordability and benefits like restoration of sum insured and annual health check-ups.
Ensure the coverage offered keeps up with inflation. In case of an emergency, finding yourself underinsured can be a source of financial stress. Ideally, the policy should be reviewed annually to ensure it is adequate.
Mistake #2: Not Paying Attention to the Network Hospitals
Cashless treatment at a nearby hospital is extremely helpful in case of a medical emergency. So, don’t forget to go through the network of hospitals covered by your insurer and cashless facilities. If not, you might have to pay upfront and wait for prolonged periods for reimbursement.
IRDAI mandates faster claim approvals for cashless treatments at network hospitals, often within an hour. Take the time needed to ensure your chosen insurer has tie-ups with quality hospitals within reach that accept cashless claims.
Mistake #3: Ignoring the Fine Print
Take the time needed to carefully go through the fine print. Don’t assume all health conditions are automatically covered. Carefully read through the policy document to understand the coverage and limits offered by the policy, including no claim bonus and cumulative bonus, as well as sub-limits.
Pay attention to co-payment clauses, room rent limits, and exclusions like cosmetic procedures or self-inflicted injuries. Don’t hesitate to obtain the needed clarifications about policy essentials such as claim limits, exclusions, waiting periods, and documentation.
Mistake #4: Concealing Medical History
Concealing your past or current medical history is a grave mistake. Non-disclosure can result in the rejection of the claim, too. Policies might also have waiting periods and pre-existing disease clauses.
IRDAI guidelines mandate a waiting period of up to 3 years for pre-existing conditions, and a 5-year moratorium period after which claims cannot be denied for non-disclosure unless fraud is proven. Always disclose chronic illnesses, surgeries, and ongoing treatments honestly.
Mistake #5: Overlooking Family Coverage
Health insurance is not a one-time decision. With age, healthcare requirements change. For instance, a single health insurance plan might not be enough once you have a family.
Family floater plans are economical for young families but may fall short if multiple members need treatment in the same year. In such cases, a mix of individual and floater plans is recommended.
Also, note that children covered under floater plans may need separate policies once they reach a certain age (usually 18–25 years).
Key takeaways
- Never choose a health insurance policy purely based on its premium; instead, look for one that offers adequate benefits and coverage.
- Always read through the fine print to understand the waiting periods, exclusions, and co-payment clauses.
- Don’t forget to check the insurer’s hospital network to ensure your convenience and access to cashless treatment.
- Look for a policy that takes care of not only your individual needs but also your family’s, with flexibility for future changes.
Health insurance is a safety net and a tax-saving tool that must not be ignored in today’s world of rising healthcare costs. Choose a policy that caters to your and your family’s healthcare needs and reduces financial stress during medical emergencies. Before choosing a healthcare policy, don’t hesitate to reach out to a professional or insurance advisor to make the best decision. After all, it’s your protection and peace of mind that matter at the end of the day.
