Are you comparing health insurance plans for yourself and your family members in order to get the best one? First up, there is nothing that can be objectively classified as the best plan. The best health insurance plan for you and your family is one that depends on your specific needs and requirements. It is important to remember here that what works best for you may not be suitable for someone else, so it is best to do your research before opting for a specific plan.

Health insurance policies are usually of two kinds, i.e. those that pay for the costs incurred post hospitalization and those which pay out a fixed amount upon diagnosis of any illness without taking hospitalization into account. Fixed benefit health insurance plans offer a guaranteed payout upon the diagnosis of any critical illness covered by the policy. You do not require medical bills for making a payout claim for the same.

In contrast, other types of health insurance allows the insured to avail of cashless treatment at network hospitals upon hospitalization and treatment for an illness. In this case, hospital expenses will be verified by the insurer before the money is directly paid to the hospital. The person insured may also seek treatment at a network hospital although expenses will be reimbursed later on by the insurance company post verification.

What to keep in mind while comparing health insurance plans

While comparing health insurance plans, you should keep a few things in mind. These include the following:

• Claims Process: You should be able to get your dues with a fast claims process which does not require much paperwork or substantiation with bills and other medical documents/proof.
• Waiting Period: In case there are any pre-existing illnesses, insurance companies specify various waiting periods for the same. Any claims linked to these illnesses will be processed only after the completion of such waiting periods.
• Coverage: You should always opt for ample coverage. The emphasis should not be on the cost of premiums alone. For example, treatment for serious illnesses like cancer may necessitate costs between ₹ 4 to 20 lakhs and hence, your insurance plan should offer coverage for the entire amount.
• Network Hospitals: Health insurance policies which have reimbursement-based frameworks, come with faster claim settlement at network hospitals and this is often cashless as well. However, if you choose a fixed benefit health insurance plan instead, there is no requirement to look for a network hospital since you will be paid out the fixed amount based on the diagnosis report of an illness irrespective of actual proof of hospitalization. There are no limitations in other regard as well like room rent, sub-limits and so on.
• Post/Pre-Hospitalization Benefits: Reimbursement health insurance policies may have varying regulations regarding pre and post hospitalization coverage. Fixed benefit health insurance plans do not come with any limitations since the settlement of claims is based on the diagnosis of an illness and not on the actual hospitalization.

Salient features of health insurance plans

Fixed benefit health insurance plans come with several features that you should know about. These include the following:

• Assured Benefits - Lump sum payout of guaranteed benefit upon first diagnosis of illness covered in the policy without medical bills. This makes sure that you get payout instantly without having to worry about treatment costs. You can then focus on the treatment and subsequent recovery from your illness.
• Flexibility - There are no limitations regarding the type of hospital room and pricing of the same, or regarding any waiting periods, pre-existing diseases, co-payment terms and so on. Since you get the payout instantly, you can focus on your health without having to worry about the costs and all the other factors linked to hospitalization.
• Tax Benefits - Tax benefits are provided under Section 80D for health insurance premiums paid under these policies. You can thus get additional savings with your health insurance plan which ensures that the family budget is not negatively affected or depleted³
• Additional Coverage - These health insurance plans also help in taking care of non-medical costs like transportation or household necessities in addition to post-treatment costs like regular doctor visits, medicines and so on. This secures you financially and emotionally as you may be unable to work/earn during this period yet have your basic costs taken care of by these plans.