1. Hospital Room Rent Eligibility
2. Co Payment and Sub Limits for diseases (if any)
3. Waiting Period for Pre Existing Disease
4. Waiting period for few specific diseases like Cataract, Hernia etc
5. Cover Amount and Premium charged as compared to other players with same features
6. Pre Hospitalisation and Post Hospitalisation Coverage
7. Free Preventive Health Checkup Facility
8. Coverage for Critical Illness – Basis:- family history, option for top ups
9. Restoration Benefits – Whether with or without extra premium
10. Ambulance charges – whether covered
11. Eye Care, Dental Care, AIDS/HIV and Suicide Attempts – Generally are not covered
12. Alternate Treatments – Whether Allowed like Ayurveda?
13. Daily Hospital Cash Benefit, Organ Donor Expenses, convalescence benefit (i.e. time spent recovering from an illness or medical treatment) – Generally covered by way of Add on Cover
14. Outpatient Benefits like Consultancy Fee, Pharmacy Fee – Generally covered upto Rs. 5000 p.a. as add on cover
15. Maternity Benefit – Normal, C Section coverage, pre and post natal coverage, new born baby vaccination coverage, waiting period (Generally waiting period of 3-4 years, high premium and coverage upto Rs. 30,000 to Rs. 40000/- only)
16. Network Hospitals and Claim Process including timelines (Cashless as well as reimbursement)
The above ratios are available on IRDAI website (Annual Report). Also if you are not happy with the services or Policy of any company, IRDAI has mandatorily given option of free look up period for cancellation within 15 days of taking policy as well as Portability option is available near to renewal time of policy. Policy can be ported to another company without losing waiting period/NCB benefits , provided prior to 45 days of the date of renewal, a written request is sent to existing insurance company.
You can claim tax deductions under Section 80(D):
Hope this article will help you in choosing best Health Insurance policy keeping several factors in mind.
Author of this article can be reached at [email protected]
(Republished with Amendments)