Tailor Your Health Insurance: The Smart Way To Get The Right Coverage

Health insurance is not a one-size-fits-all product. You can customize your health insurance policy according to your needs. However, you need to balance coverage, features, and affordability smartly.

How To Customise Your Insurance Plan 

Before choosing a customized insurance plan, understand your personal health profile by getting a basic health check-up to spot any existing or potential health issues like diabetes, high blood pressure, high cholesterol, etc.

“Consider your age, family medical history, lifestyle habits, and job risks to understand what kind of coverage you might need. Ensure to be completely transparent about your medical history while buying a policy, as hiding or misrepresenting information can lead to claim problems later. This helps you select the right coverage, benefits, and add-ons that suit your needs,” says Sarita Joshi, head of health and life insurance, Probus.

There are many health risk assessment tools available commercially. “Some of the insurance companies are also offering such services as part of their health insurance product. For example, ICICI Lombard offers health vitals via face scan. This feature is available in their app. Based on assessment, appropriate insurance products and sum insured can be chosen,” says Hari Radhakrishnan, expert, Insurance Brokers Association of India (IBAI).

For a personalised policy, make sure your sum insured is adequate to cover serious medical expenses. Look for coverage that includes hospitalisation, ICU charges, room rent, and day-care procedures, and it is equally important to check if your preferred hospitals are in the insurer’s network for cashless treatment. Be aware of waiting periods, exclusion,s and sub-limits. “Avoid unnecessary riders as they inflate the premiums, stick to only riders like critical illness or maternity cover if they are relevant to you, and prioritise lifelong renewability,” says Joshi.

Do A Cost-Benefit Analysis 

“The choice of health insurance involves cost-benefit analysis. There is no need to opt for feature-dense products that are of little practical use but can significantly increase costs,” says Radhakrishnan.

For instance, there are plans with unlimited hospitalisation reimbursement and unlimited sum insured recharges, but these can become quite expensive as one ages. The plan opted for should be sustainable in the long run. One may have less disposable income to afford such plans after retirement.

“Balancing coverage and premium is about being realistic and strategic. Select a plan with a premium you can afford and a sum insured that realistically covers medical costs. Skip unnecessary add-ons and consider a top-up plan carefully if you need more coverage,” says Joshi.

Co-pays or deductibles can lower premiums if you’re healthy or comfortable paying a portion of expenses when a claim arises. Review your policy every year to make sure it still meets your changing health needs or budget.