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Questions to Address When Buying Health Insurance
Nov 6, 2023

The Questions To Address When Buying A Health Insurance Policy

Imagine a situation where a medical emergency requires immediate hospitalisation, and the doctor recommends to undergoing the necessary medical procedure to avoid any risks. Sounds like a situation your family or your friends had to go through, right? The question you are faced with is: How do you pay for all this? Relying on savings is becoming a thing of yesterday. Purchasing health insurance in India is a crucial step towards safeguarding your well-being and financial stability. However, navigating the process of buying insurance can be daunting. In this article, we will address some common questions that individuals often have when buying health plans in India.

Questions Asked When Buying Health Insurance

Potential policy buyers tend to have multiple questions while they are contemplating buying health insurance. Here are some commonly asked questions which can expand your understanding:

"What are the different types of health insurance plans available in India?"

In India, health plans can be broadly classified into individual plans, family floater plans, and health insurance for senior citizens, and critical illness plans. Individual plans provide coverage for an individual, while family floater plans cover the entire family under a single policy. Senior citizen plans are offered to older adults to help them deal with health issues that may be aggravated with age.

"What factors should I consider when selecting a health insurance plan?"

Multiple factors should be considered which include the coverage amount, network of hospitals and doctors, coverage for pre-existing conditions, waiting periods for specific illnesses, and claim settlement history of the insurance company. Additionally, assess factors such as premium affordability, policy renewal terms, and the availability of add-on riders for enhanced coverage. Evaluating these factors will ensure that the plan you choose suits your healthcare needs.

"What is the role of a network hospital in health insurance?"

Network hospitals, also known as network providers, are healthcare facilities (such as hospitals) that have tie-up with insurance companies. One of the health insurance benefits of network hospitals is that you can avail of cashless hospitalisation. The medical expenses are settled directly between the network hospital and the insurance company. This may eliminate the need for you to pay upfront and file reimbursement claims. It is essential to check the list of network hospitals associated with your health plan to ensure easy access to quality healthcare services.*

"What is the significance of pre-existing condition coverage?"

A pre-existing condition is a health condition that existed before purchasing the health policy. Some health plans in India have waiting periods of one year for coverage of pre-existing conditions. This period may be longer or shorter depending on the policy and insurer you choose. During this waiting period, any medical expenses related to pre-existing conditions will not be covered by health insurance coverage. It is crucial to understand the waiting period clause and select a policy that offers adequate coverage for pre-existing conditions, especially if you have any such conditions.*

"What is the process of filing a health insurance claim?"

When filing a health insurance claim, you typically need to follow these steps:
  1. Notify your insurance provider about the hospitalisation or treatment within the stipulated time frame mentioned in the policy.
  2. Submit the required documents, such as the claim form, hospital bills, medical reports, prescriptions, and discharge summary to the insurance company.
  3. The insurance company evaluates the claim based on the policy terms and conditions including coverage limits and exclusions.
  4. If the claim is approved, the insurance company settles the claim either through cashless settlement with the hospital (in the case of network hospitals) or by reimbursing the expenses incurred.
Claims are subject to terms and conditions set forth under Health insurance policy.*

"What is a waiting period, and how does it affect my coverage?"

A waiting period is the duration during which specific illnesses or treatments are not covered by the health policy. It can vary depending on the insurance company and the type of illness or treatment. It is crucial to review the waiting period clause and understand the specific conditions or treatments that have waiting periods associated with them. This information will help you manage your healthcare expenses effectively.

Additional Tips To Make Your Purchase Easy

Apart from the questions answered above, you can take note of these tips as well to make your buying experience smoother:
  1. Thoroughly compare health insurance plans plans to filter out providers that do not meet your requirements. This can be done online using third-party aggregators.
  2. Go for online purchase over offline purchase as you do not have to pay for a commission or extra charges for your purchase online. ##
  3. Renew health insurance online since it can be done from anywhere and anytime and helps maintain a record online.


The above answers will help you understand how to look for the right policy and what things you should look for while selecting one. Use the health insurance premium calculator to see how much your ideal policy would cost as per your requirements.   *Standard T&C apply ##All savings are provided by the insurer as per the IRDAI-approved insurance plan. Standard T&C apply. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.

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