Key points to consider before buying health insurance

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The need to have a health insurance policy has grown drastically ever since the outbreak of the Covid-19 pandemic. The demand surged, and so did the number of people buying a health insurance policy who still need to fully understand what they want and whether the policy they chose will meet those requirements. 

With the increased options, you may need to burn a hole in your pocket to pick the right health insurance policy that checks all the boxes. From choosing the right insurance company to analysing the sum insured, there are multiple aspects you should consider before buying health insurance. Let’s explore some of the most prominent ones.

Top 10 points to consider before buying health insurance

Here’s a guide to help you pick the right health insurance policy:

  1. Choose the right insurance company

Choosing the right insurance company could make all the difference in buying health insurance. You must conduct thorough research on the insurance provider you have picked. Look for customer reviews for factors like ease of claim settlement and the claim settlement ratio, among other things. 

  1. Understand the inclusions & exclusions of the health insurance plan

Before buying health insurance, you must understand the scope of the policy, i.e., what the policy covers and the conditions against which you cannot make a claim. If you are unaware of what the policy covers, it can increase your out-of-pocket expenses if you get treatment for excluded illnesses. This can also increase the likelihood of claim rejections if you claim an excluded illness. 

  1. Choose adequate coverage and premium that fits your budget 
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Select a health insurance plan that offers comprehensive and high coverage. However, the higher and more extensive the coverage, the higher the premium amount. A health insurance plan with a lower premium can only be sufficient if it offers coverage at a premium you can afford. On the other hand, a lower premium can also mean limited coverage. Aditya Birla Insurance gives you the flexibility to choose a sum assured as per your needs and budget. Aditya Birla Insurance offers plans with a minimum sum assured starting from Rs. 2 lakh. 

Furthermore, if you go for a lower sum insured to reduce the premium amount, it might be insufficient to cover your medical expenses.

Thus, you should balance the coverage you choose and the premium you can afford. 

  1. Go through the network hospitals

Health insurance companies often tie up with network hospitals to offer cashless treatment. Select a health insurance policy provided by an insurer that has a tie-up with many network hospitals. For example, the health insurance plans offered by Aditya Birla Insurance have a tie-up with 8000+ network hospitals across India to ensure that you get cashless treatment in a hassle-free manner. 

Furthermore, check whether these network hospitals have cashless hospitalisation facilities. It offers you convenience since you are not required to pay the hospital bill. 

  1. Check the waiting period clause 

The waiting period is when you cannot file a claim after buying the policy. The waiting period varies from policy to policy and provider to provider. However, it’s usually 2 to 4 years. 

Most health insurance policies don’t cover pre-existing conditions unless the waiting period is complete. It’s one of the most crucial aspects to consider before you buy a health insurance policy.

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Thus, you should select a health insurance plan with a lower waiting period. 

  1. Understand the pre & post-hospitalisation coverage

You must buy a health insurance plan that covers pre- and post-hospitalisation expenses. Many policies will demand a lower premium but trim pre-and/or post-hospitalisation costs. Expenses incurred on doctor visits, medical tests, treatments, medicines, ambulance charges, etc., before or after hospitalisation can also snowball into a huge amount that can pinch your pocket. 

Therefore, ensure that your plan covers pre and post-hospitalisation charges.

  1. Explore the ‘add-ons’ in the plan 

You can purchase additional benefits with the health insurance policy to expand the coverage. You can personalise your health insurance policy by selecting adequate add-ons per your needs. For example, getting a maternity add-on might be a great idea if you plan to expand your family. Similarly, the room-rent waiver add-on ensures that you get to choose a room type of your choice in a hospital without worrying about the rent. 

However, you should keep in mind that add-ons increase the number of premiums. 

  1. Go through the claim process

Carefully review the claim process of the health insurance company. Do thorough research, read customer reviews online, and select a health insurance company known for a smooth claim settlement process. 

An insurer’s claim settlement ratio effectively explains the insurance company’s efficiency in settling the claims. The claim settlement ratio is the total claims settled against the total claims received. 

For instance, Aditya Birla Insurance offers health insurance plans that have a claim settlement ratio of 94%. Thus, selecting a health insurance company with a higher claim settlement ratio can benefit you. 

  1. Co-payment clause 
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Under the co-payment or co-insurance clause, you must pay a certain amount against the claim while the insurer pays the remaining portion. Select a health insurance plan only after checking whether there are additional clauses for co-payment, sub-limits, or deductibles since these would lower the amount of the sum assured at the time of claim.

  1. Check if there is a room rent limitation

Opt for a health insurance plan that covers private and semi-private rooms. Furthermore, higher room-rent limits can help you save money. 


Health insurance is one of the most crucial aspects of financial planning. It not only helps you save money on medical expenses but also ensures financial security in times of medical emergencies. Thus, you must spend considerable time reviewing and comparing different potential health insurance policies before picking the one that meets your requirements.


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