Choosing the right health insurance: A step-by-step approach with your agent

Health insurance is necessary for financial planning and ensuring access to quality healthcare. However, with the wide variety of options for insurance providers and numerous plans offered by each of them, choosing the right plan might feel like a daunting task, whether it is the feeling of missing out due to a lack of industry knowledge or due to the jargon and complexities involved with a particular policy. 

This is why numerous ways exist to prevent this confusion and have someone help you get the best plan based on your needs. This blog will explore one such method for choosing the right health insurance plan– with the assistance of an agent. 

Who is a health insurance agent?

A health insurance agent is a trained professional responsible for advising prospective customers and selling policies to them. They are licensed by the regulatory authority for insurance in India, the IRDAI, following training and a prescribed examination. 

Types of insurance agents

• Exclusive insurance agents: An exclusive or captive agent represents a single insurance provider and sells policies exclusively from them.

   

• Independent insurance agents: On the other hand, an independent agent has a more extensive portfolio of policies from various insurance providers with whom they are affiliated. 

What are the types of health insurance policies?

There are typically eight types of policies under health insurance, which can be opted for based on your specific needs.

• Individual policies

This is a personal plan providing coverage for only a single person.

• Family floater policies

A family floater offers coverage for spouses, children, and even parents.

• Senior citizen policies

Senior citizen policies are designed to consider senior citizens' needs, including those with pre-existing diseases, etc.

• Maternity policies

These are specially designed to cover medical expenses related to maternity and childbirth.

• Group policies

These policies offer a consolidated plan for all individuals in a single group. Although this policy is typically provided to corporations and companies, other groups, such as associations, can also opt for it.

• Critical illness policies

These policies offer coverage for medical conditions that can have a more severe impact on the policyholder’s health, like cancer and heart attack.

• Top-up and super top-up

These are not standalone policies but add to an existing policy to make it more comprehensive and enhance protection.

What are some factors to consider when choosing a policy?

• Current health condition

Assess any existing medical conditions to understand the particular coverages to opt for. 

• Family considerations

Understand the healthcare needs of your loved ones and dependents.

• Medical history

Evaluate your medical history and assess previous medical conditions and any genetic predisposition to certain critical illnesses.

• Preferred healthcare providers

Check if the insurance provider is affiliated with your preferred healthcare providers. This can make the claims and reimbursement process a lot simpler.

• Coverage

Understand the inclusions and exclusions to see if any non-negotiables in the policy need to be considered.

• Budget

Assess your finances and figure out if the premium for the policies fits your budget and out-of-pocket expenses. Although there exist policies that can offer coverage for up to Rs 1 Crore and cover most medical ailments, if it doesn't fit your budget, it doesn’t match your needs.

• Deductibles and co-pay

A deductible is the amount a policyholder must pay before filing a health insurance claim. A co-pay is the percentage of every medical expense you must pay. Evaluate these before choosing a particular policy.

• Customer service and reputation

Always evaluate the reliability of an insurance provider before purchasing a policy from them. Consider factors such as claim settlement ratio, customer reviews, testimonials, etc.

What are the steps to choose the right health insurance?

1. List all of your needs and requirements to the agent.
2. Once they show you a few policies, read the policy documents, evaluate the coverages, and assess them based on your needs determined in the previous section. 
3. Other than the coverages, consider the total costs of the premium, deductibles, co-pays, etc, and compare that with your budget. 
4. Once all these are considered, complete the formalities and purchase the policy.

Conclusion

Today, with the rising cost of healthcare and growing health concerns, opting for the right health insurance can alleviate anxiety and allow you to live your lives to the fullest with peace of mind. As you enter 2024, take the right step forward and secure your health with the best policy for your needs with the help of trained experts in the form of health insurance agents.