How To Choose The Best Mediclaim Policy For A Family In India: Guide

Nowadays, each person needs health insurance coverage to cope with the alarming inflation of medical treatments. With innumerable types of health plans available in the market, selecting the most befitting one can prove to be a tough challenge. In this article, we will highlight some of the major considerable factors when choosing the best mediclaim policy India.

With medical inflation close to 14% on a year-on-year basis, it is very important to opt for high coverage for your health so that you do not have high out-of-pocket expenses. Data says that high medical expenses push 55 million Indians below the poverty line every year as there is no insurance coverage.

Significant factors to consider while choosing the best mediclaim policy for family in India

1. Seek the right coverage:
   
   Ideally, seek a health plan that covers pre-and-post-hospitalization, ambulance charges, cashless treatment, maternity benefits, critical illness cover, daily hospital cash facility, in-patient hospitalisation, along with an extensive range of ailments.
   
   While purchasing a family plan, ensure that the plan suits each member incorporated in the plan. It is best to make a comparative study among various plans to understand the picture well. After choosing a plan, go through the policy document well enough to understand every clause.
2. Check the waiting period clause:
   
   Generally, most of the standard mediclaim and health insurance plans for pre-existing ailments, maternity benefits, and certain particular treatment costs like hernia, varicose veins, etc., depending on the choice of the plan and the insurance provider, the waiting period can range between 2 and 4 years. Pre-existing ailments can have a waiting period of up to 4 years.
   
   This implies that during this period, no claim can be raised for treating the specified ailments. Several insurance providers even offer a lower waiting period. Therefore, imperatively ensure the waiting period clause for every ailment before purchasing best mediclaim policy for family.
3. Ensuring the flexibility of adding new family members into the plan:
   
   While purchasing or investing in the best mediclaim policy for family, you must ensure the process of incorporating new family members into the purview of the concerned plan. The process should be simple, quick, and hassle-free.
   
   In case any senior family member is no longer eligible to enjoy the insurance coverage or passes away during the policy tenure, the other family members incorporated in the plan can enjoy the plan coverage without compromising any of its benefits.
4. Select a plan with a lifetime renewability option:
   
   This is one of the most highlighted factors that need to be considered before purchasing the best mediclaim policy for family. It is essential to check the policy tenure and whether the concerned plan offers limited renewability or lifetime renewability option. This is essential as mediclaim policies are more important in the older ages.
   
   Therefore, it is best to choose a mediclaim plan with a lifetime renewability option. This factor ensures that the concerned family enjoys identical coverage in future years, even after crossing the required age limit. Moreover, it also saves the time and hassle of buying another new plan.
5. Check out the co-payment clause:
   
   Co-payment clause of a health plan refers to the percentage that the policyholders need to pay from his/her pocket with mutual agreement. The remaining cost of hospitalisation is duly taken care of by the concerned insurance company.
   
   If the policyholder agrees with a 10% co-payment clause, then during a claim settlement worth INR 1 lakh, he/she needs to pay INR 10000 out of his/her pocket. You are also free to choose a plan without a co-payment clause too.
6. Room rent sub-limit:
   
   During any medical contingency, the insured person is eligible for a private, semi-private, or shared room, depending on the type of the plan. The experts always insist on selecting a plan with a higher room rent limit or no limit at all. This avoids spending out-of-the-pocket expenses in this context if you choose the best mediclaim policy for family.

Conclusion

Under the current circumstances, maintaining a health insurance plan or a mediclaim is more of a necessity than a choice. While selecting the best mediclaim policy for family in India, ensure to exercise the above-mentioned factors for better stratification.

FAQs

1. How do I settle any health insurance or mediclaim claims?

During hospitalisation, first, contact the TPA or through any in-house claim processing unit/department present in the hospital.

2. Am I eligible for any tax benefits that I can avail of any health insurance plan?

Yes, the premium paid for any health insurance plan is eligible for tax deduction under Section 80D of the IT Act, 1961.

3. What is meant by the co-payment clause in the health insurance plan?

This is a mutual agreement between the insurance provider and the policyholder to share a certain percentage of the total hospitalisation bill. The remaining expenses are taken care of by the concerned insurance provider.