Monday, March 31, 2008

5 Vital Tips on Health Insurance

1. Define your requirements of health coverage

Define what you want to cover yourself against – is it just critical illness, or injuries resulting from an accident, hospitalization expenses or OPD expenses as well. There are different kind of policies available depending on your requirement and your budget.

2. Decide which members of your family need to be part of the health insurance policy – you might find splitting policies to be beneficial.

When buying for a family check multiple options. Sometimes its beneficial from a cost perspective for the oldest member of the family to have a separate policy. Usually all insurance companies offer policies for coverage of you or spouse; and up to three children under one policy. Some policies also give coverage for dependent parents in the same policy.

3. Decide the total amount of health coverage needed.

The total amount of coverage needs to be determined by the number of people that you want the policy to cover, your estimate of the health care costs and the existing coverage that you might have from other sources like employee provided group insurance.

4. Read through the list of exclusions of the health insurance policy – both permanent and first year.

Exclusions define the ailments and the conditions under which the health insurance coverage will not be valid. For example a common permanent exclusion is cosmetic surgery. Such surgery is discretionary and usually not life threatening and performed at the insistence of the patient. A common first year exclusion is cataract; cataract surgery is covered from the second year onwards. This is to avoid moral hazard.

5. Check the network coverage of the Third Party Administrator (TPA) being employed by the health insurance company.

Ensure that the hospitals near your residence which might be used in case of an emergency as well as the hospital where you seek regular or specialist treatment is part of the TPA (Third Party Administrator) network.
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