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Buying health insurance for the first time? Know what to look for!

Updated on: 08 February,2024 02:17 PM IST  |  MUMBAI
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Here are some recommendations that will help you choose the best health insurance policy for your family.

Buying health insurance for the first time? Know what to look for!

We all wish to have a health insurance plan that would provide optimum coverage to our loved ones in times of medical need. However, with so many different health insurance plans available in the market, it can be difficult to make an informed decision. Going through so many policies, their features, exclusions, and limits might be overwhelming. And, to escape the hassle, many people purchase a health plan without knowing whether or not it is appropriate for them. Here are some recommendations that will help you choose the best health insurance policy for your family.


Choose one which provides a wide range of coverage: Choose a health plan that provides coverage for a wide range of medical issues & covers pre and post-hospitalisation coverage, ambulance charges, critical illness coverage, maternity benefits, cashless treatment, daily hospital cash benefits, in-patient hospitalisation, and so on. If you are purchasing medical insurance for your family, ensure that the coverage fits the needs of each individual in the family who must be insured.


Review the policy features and exclusions before signing the policy. We often overlook hidden factors such as sub-limits and waiting period in health insurance. As a result, make sure you read through the policy wording for all terms and conditions. This ensures that you and your family are not inconvenienced during the claim process.


Look for flexibility when adding new family members: When selecting a family health plan, ensure that you can quickly add a new family member. If the senior-most family member dies or is no longer eligible for coverage, the remaining family members can continue to use the plan without losing any of its advantages.

Check the Waiting Period Clause: Health insurance policies cover pre-existing conditions, maternity expenses, and certain treatments such as hernias, varicose veins, and so on after a set waiting period in health insurance, which ranges from 2 to 4 years & varies per plan. For example, maternity expenses are often reimbursed after two to four years from the date of insurance acquisition. Check the time period after which pre-existing conditions will be covered under your family health plan, and select a plan with a short waiting period in health insurance.

Check the Co-Payment Clause: It is the percentage of the money you will have to spend out of pocket, and the insurance company covers the remaining hospitalisation costs. For example, if you have a policy with a 10% Co-pay provision, this means that for a claim of Rs. 1 lakh, you would have to pay Rs. 10,000 out of pocket while the insurance company will pay Rs. 90,000. You can also search for a policy that does not have a co-payment provision.

Select a Plan with Lifetime Renewability: Lifetime renewability is also an important aspect to consider that many of us tend to forget. Check the number of years your insurance is valid and whether it offers restricted lifetime renewability. Why? Because you will need a health plan the most in your later years of life. So, choose a family health plan that may be renewed for a lifetime. This allows you to remain with the same plan in the years to come without having to purchase another policy after reaching the age limit. For example, your health insurance policy allows you to renew for up to 45 years. Once you reach the age limit, you will need to purchase a new one, which will cost significantly more. And if you purchase a plan with lifetime renewal, you can easily renew it in the future.

Room Rental Limit: The type of plan you choose determines whether you will be assigned a private hospital room, a semi-private room, or a shared room. If you need to avoid paying extra out of your own cash, choose a policy with a greater room-rent limit.

Prefer family health insurance plans over individual plans: For those without a family to support, individual plans are a good option. To get the best features at a lower cost, go for a family health plan if you are purchasing a health insurance plans with your family in mind.

Don't forget to compare quotes Online: To make sure you purchase a health insurance plan that meets your needs, you can compare health insurance policies online. You can even "request a quote" online that entails entering your information on the website to obtain an approximate cost for your policy's premium. To make a choice, get the best quotes and compare them.

Check the network hospital coverage: Once you've narrowed down your list of potential health plans, find out if the hospitals and physicians you've chosen are part of their hospital network. Choose an insurance company that has a large global network of hospitals wherever possible.

Should have a high ratio of claim settlement: The ratio of claims settled by the health insurance company to all claims received is known as the claim settlement ratio. Pick an insurance company with a high ratio of claims settled.

Check whether it comes with Cashless Facility's availability or not: When a medical emergency arises, having a health insurance policy with a large network of hospitals can turn out to be a godsend. By receiving care at the closest network hospital, one can make use of a cashless facility without worrying about the cost.

The most important point-Always Look for Disease-Wise Sub-limits.

You must have read about the 10 lakhs cover at an annual premium of just ₹6,000. Then, one day, your worst nightmares materialise. You are forced into the operating room due to a slipped disc. You need intensive care. The total cost is high. ₹4,36,000, totaling all expenses. But the insurer informs you they can only cover ₹2,00,000, even though you have a 10 lakh cover. They eventually inform you that your coverage includes sub-limits based on diseases. That is to say, there is a maximum cap of total coverage that is required for particular diseases.

Cardiovascular disorders, for example, only receive ₹2,500,000, ₹2,75,000 for knee replacements and so on.

At last, you comprehend how the organisation is able to provide you with ₹10 Lakh coverage at such a minimal charge. In most cases, they probably never pay the entire cover amount. Avoid becoming a victim of this tactic. Be sure you are always aware that there are no limitations based on diseases, as you never know what might strike you. It is generally advisable to carefully compare the top health insurance plans on the market before selecting one with no such restrictions.

So, we are saying,

When purchasing health insurance for your family, use the aforementioned points to maximise your coverage benefits. You will be able to make an informed decision in such a way. Furthermore, you wouldn't have to sprint from pillar to post during the claim process.

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