HealthPlanning to Buy a Mediclaim Policy? Here’s a Checklist


Planning to Buy a Mediclaim Policy? Here’s a Checklist

An ideal mediclaim policy would provide you and your loved ones with maximum coverage in the face of a medical emergency. There are several options of health insurance policies available in the market, and it might be overwhelming to assess and choose from all these plans. Many people end up choosing a plan without understanding their own needs or comparing policies offered by different insurers. It is important to compare health insurance policies to ensure you pick the best.

Reasons to Get a Medical Policy

  • Increasing medical costs

Healthcare is becoming more and more expensive by the day. Therefore, no surprise that many people end up digging into their savings in the event of a medical crisis.  But, robust health insurance can help you in such situations.

  • Increased inflation

Inflation is unavoidable. Even though savings have appealing interest rates in banks, they may not be sufficient to meet all medical needs. Medical insurance can assist you in meeting your anticipated medical expenses. Mediclaim covers a diverse range of charges and helps you fight the consequences of inflation—from equipment costs to the costs of treatment, medications, and diagnostics.

  • Lifestyle change

There are several reasons for having health insurance coverage. The massive lifestyle change has rendered us more vulnerable to a variety of health issues. Daily commutes, stressful work schedules, poor eating habits, food quality, and increasing pollution levels have all raised the likelihood of developing health issues.

  • Pre and post-hospitalisation expenditures are covered

It is worth noting that medical insurance not only covers hospitalisation charges but also pays the fees for outpatient care and diagnostic testing before and beyond the actual treatment.

  • Tax benefits

Though not limited to young individuals, a tax rebate can be claimed on money spent on health insurance premium payments. Every year, a maximum of Rs. 25,000 can be claimed as part of Section 80D exemptions against premium charges.

  • To cover up for inadequate insurance coverage

Examine your existing health insurance to assess the coverage it offers. If your current health insurance does not cover possible risks such as sicknesses and diseases that are passed through families, it may prove insufficient in a time of crisis. Furthermore, as medical treatments develop, having a larger sum secured may ensure that your every medical need is financially satisfied.

How to Compare Health Insurance Policies?

It might be difficult to decide which mediclaim policy you should buy. When deciding on health insurance for your family and yourself consider your options and compare them for the following:

1. Premiums

What will your monthly insurance cost be? Premium is the cost of your insurance coverage. Typically, monthly premium payments must be made; if you don’t, your coverage might be cancelled. Remember, there are more expenses related to buying and utilising insurance. Deductibles and cost-sharing will also be your responsibility.

2. Medicine coverage

Does your insurance cover your usual prescriptions? A formulary or the list of medications covered by the plan is given to each policyholder. Patients may not be insured for medication if it is not listed on the formulary, and obtaining coverage may involve a drawn-out process. Tiers help in categorising covered drugs and establishing potential co-pay and co-insurance amounts. Make a note of your existing medications and compare them to the policy to ensure that they are covered and that you are aware of any potential out-of-pocket expenses.

3. Suitable coverage

Select a health plan that offers advantages such as pre and post-hospitalisation, childcare costs, and coverage for diseases you may be prone to based on your family’s medical history etc. Health insurance protects you against a broad range of health-related issues. When purchasing a medical policy for your family, be sure that each family member is catered to. To choose a policy that meets your needs, think about your needs, and research plans based on benefits and pricing.

4. Network medical facilities

Always take into account the network hospitals included in the policy’s terms before purchasing health insurance. A group of hospitals known as “network hospitals” accept payments from your existing health plan. Always choose a plan with the most network hospitals available in your area. If not, your medical policy would be meaningless in times of need.

5. Pre-existing condition waiting period

Each health insurance company establishes its own rules regarding pre-existing ailments. Any claim stemming from a pre-existing condition is considered only after the waiting period is completed. Most medical policies include a waiting period of two to four years. So, if you have a pre-existing condition, always opt for a policy with a short waiting time.

6. High ratio of claim settlements

The claim settlement ratio compares the number of claims resolved by the insurer to the total number of claims filed. The greater the claim settlement ratio, the more trustworthy an insurer is.  As a result, always select insurance with a high claim settlement ratio.


Last but not least, select the best policy and compare  health insurance outlines of each plan side by side. Health insurance plans that do not, on the whole, outperform other plans should be eliminated. Make sure the mediclaim policy you select provides you and your family with access to excellent healthcare in any part of the country and covers essential medical expenses in your time of need.

Disclaimer – The above information is for illustrative purposes only. For more details, please refer to policy wordings and prospectus before concluding the sales.

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