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5 Things to Keep in Mind While Buying Health Insurance in Mumbai

There are many things to make a note of before deciding on your health insurance policy. Take a look here and arm yourself with essential know-how

  • 18 Jul 2017
  • 6 min read
  • 146 views

Major factors to think about while buying health insurance in Mumbai

Health is a man’s only true wealth and without it, life becomes very difficult. This is especially true in a city like Mumbai, where life is so fast paced and there is also a major risk of accidents happening. It therefore becomes very important to choose the right health plan for you and your family, when you’re living in such a bustling metropolis. There are many good health insurance companies in Mumbai that you can rely on for securing your health. Here we tell you a bit more on how to go about it.

Major Factors to Consider

Choosing a health insurance plan is a big decision. The total cover amount (sum assured) and the premium are important factors to consider while deciding on your policy. The following are the other factors to consider:

·       Claim Settlement:

Insurance companies with high claim settlement ratios or a low claim pending ratio are better at handling health insurance quickly and efficiently. Choosing such a company, would be better for you, should you need to make a claim.

·       Co-payment:

Although the premium is an important factor, cheaper polices may not always offer you complete coverage, especially if it comes with a co-payment clause. Co-payment means that the policyholder will have to pay a pre-defined percentage of the claim while the insurance company will pay the rest. This is a common clause in group policies like employer-provided policies.

·       Day-care Procedures:

Day-care procedures are those that can be done without needing hospitalization (meaning within a day). Normally, to make a claim, at least 24 hours of hospitalization is required. Therefore, opting for a plan that covers maximum day-care procedures would be ideal.

·       Network Hospitals:

Insurance companies usually have a list of network hospitals at which their cashless facilities can be availed. This factor becomes especially important for those who travel a lot. The list will be different for different insurance companies. Explore the comprehensive list of hospitals in Mumbai covered by ICICI Lombard.

·       Pre/Post Hospitalisation:

Pre/Post hospitalisation expenses include those medical expenses incurred before and/or after hospitalisation. Follow up visits to the doctor, medication costs, follow-up investigations etc. are included under post hospitalisation expenses. However, this facility will cover only those expenses related to the ailment that you were being treated for.

Other Factors to Keep in Mind

Health insurance policies often include a no-claim bonus which can add to your overall sum assured if you make no claims in a year. Therefore, it is better to buy them early, when you are young and healthy. Additionally, since health insurance policies have a lifetime renewal, this can come in handy.

Another thing to keep in mind is that, even if you have a complete health insurance plan for your entire family, it is still better to have individual plans as well, especially for the older members of your family. This is because if the older ‘high risk’ members have frequent claims, it will leave other members of the family without any cover.

Finally, read the fine print carefully before choosing your health insurance policy, especially if you are buying it online. Consult an insurance agent/expert in case you need further clarifications.

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Tips to Select the Right Health Insurance in Mumbai

With multiple insurers and a wide range of policies available in Mumbai, selecting the right medical insurance policy can feel overwhelming. Keeping the following tips in mind can make the process simpler and more effective.

  • Compare multiple policies: Review different policies available in Mumbai to evaluate premiums, coverage, inclusions and exclusions before making a decision.
  • Check hospital network: Opt for an insurer with an extensive cashless hospital network across the city for easier access to quality healthcare.
  • Coverage for pre-existing conditions: Ensure the policy provides coverage for pre-existing conditions, particularly if you have lifestyle-related health issues.
  • Evaluate add-on covers: Consider riders such as maternity coverage, critical illness cover or wellness benefits that may suit your family’s needs.
  • Analyse claim settlement ratio: Choose an insurer with a higher claim settlement ratio, as it reflects trustworthiness and efficiency.
  • Look for long-term benefits: Opt for policies with lifetime renewability and consistent coverage, as healthcare costs continue to rise.
  • Focus on affordability and value: Select a plan that strikes a balance between affordable premiums and comprehensive benefits.
  • Check waiting periods: Pay attention to the waiting period for specific treatments or conditions to avoid unexpected delays in coverage.
  • Read the terms carefully: Review the policy wordings in detail to understand co-payment clauses, sub-limits and room rent restrictions.

Conclusion

Buying individual or family health insurance in Mumbai is a crucial step towards securing quality medical care in a city where healthcare costs continue to increase. By considering factors such as coverage, network hospitals, premiums and add-on benefits, you can choose a policy that suits both your needs and budget. A well-chosen policy ensures financial security during medical emergencies and peace of mind for your family.

While you explore different options, take a moment to fill out the form on this page to access guidance on choosing a suitable health insurance policy.

FAQs

  1. Why is it important to buy health insurance in Mumbai?

    Healthcare costs in Mumbai are relatively higher compared to smaller cities. A suitable medical insurance can help cover hospitalisation, treatments and other medical expenses, and significantly reduce financial stress.

  2. Can I include my family under a single health insurance policy?

    Yes, many insurers offer family floater plans that cover all family members under a single sum insured, making them cost-effective.

  3. Are cashless treatment options available in Mumbai hospitals?

    Most insurers have partnerships with several hospitals in Mumbai that offer cashless treatment. Still, it is advisable to check your policy wording.

  4. Is maternity cover available in health insurance plans in Mumbai?

    Maternity cover is not typically available with many health insurance policies. However, it usually comes as an add-on benefit.

  5. Can I port my existing health insurance plan to another insurer in Mumbai?

    Yes, portability is allowed under IRDAI regulations, enabling you to switch insurers without forfeiting your accumulated benefits, such as waiting periods.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It may contain outdated data and information regarding the topic featured in the article. It is advised to verify the currency and relevance of the data and information before taking any major steps. ICICI Lombard is not liable for any inaccuracies or consequences resulting from the use of this outdated information.

Buying health insurance in Mumbai involves assessing claim settlement ratio, co-payment terms, hospital network, daycare coverage, and pre/post-hospitalisation benefits to find a policy that offers financial protection and suitable coverage for your family’s healthcare needs.

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