Mr. and Mrs Sharma, are a family of three and plan to have another child. It is crucial to plan so that the newborn comes in healthy and the mother is cared for. However, there is an average waiting period of three to four years before which they may be unable to avail of maternity benefits. An average of 3.6 crore repudiated claims were made, amounting to 10,937.18 crore in FY2023-2024 as per the annual report of the Insurance Regulatory and Development Authority of India (IRDAI).
Choosing a customised health insurance for family plan according to future needs leads to proactively protecting finances and navigating challenges without facing any hardship. Therefore, to protect the family's finances in a medical emergency, obtaining health insurance coverage in time is crucial.
Let us explore the step-by-step guide to customising the health insurance plan.
Why Customisation MattersA strategy that fits everyone invariably has many gaps in coverage or incurring heavy costs for unnecessary features. Customising medical insurance policy ensures:
- Sufficient coverage for every family member.
- Optimised premiums.
Customised health insurance policies are becoming essential in today’s dynamic healthcare landscape. A recent study highlighted that over 70% of urban households in India face significant out-of-pocket medical expenses, underlining the inadequacy of generic insurance plans. Tailored policies address this gap by factoring in individual needs such as pre-existing conditions, lifestyle choices, and specific age-related risks.
Step-by-Step Guide to Customising Your Family Health Insurance Plan
Here’s a step-by-step guide to customising your family's health Insurance plan:
1. Assess Your Family’s Healthcare NeedsIt is essential to evaluate the medical history and the necessary health requirements of the family members. The following table explains the key considerations for different family members:
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Family Member
Key Considerations
Children
Vaccinations, paediatric care
Adults
General check-ups, dental care
Seniors
Chronic conditions, higher coverage
2. Choose an Appropriate Sum Insured
The sum insured can be computed based on certain variables such as:
- Total family members.
- Age and health risks.
- Cost of healthcare in your city.
For example, in a metro city, a family of four might need coverage between ₹10 lakh and ₹15 lakh to meet escalating medical costs. The sum insured should be increased annually due to many factors such as inflation, technological advancement usage, etc.
3. Opt for the Right Add-Ons
These integrating functions enrich your plans without having to change service providers; simple availed options could consist of the following:
- Critical Illness Cover that shields one from contact with major illnesses such as cancer.
- Maternity Benefits that take care of delivery expenses with associated neonatal care.
- Room Rent Waiver, which removes caps on charges levied on hospital rooms.
Ensure your insurance company is affiliated with the best hospitals nearby. Cashless treatments come as a boon during emergencies. You can also use the insurer’s mobile app to identify and verify the nearest network of hospitals available.
5. Understand Policy Terms and ConditionsThe most important aspects to check are as follows:
- Waiting Period: Pre-existing conditions and maternity benefits are concerned.
- Co-Payment Clause: The percentage of expense you will bear.
- Exclusions: Treatments or conditions not covered.
Choosing reliable health insurance for your family ensures you can customise your policy to cover these aspects effectively.
6. Compare Policies OnlineUse the internet resources to:
- Evaluate premium prices.
- Survey customer feedback.
- Identify the claim settlement ratios.
In line with your family's development and medical needs, revisiting the policy achieves relevance over time. Coverage and add-ons or premiums can be changed within the policy as required.
Benefits of Customised Family Health Insurance
A customised policy gives optimal value and coverage for your family’s health needs.
- A fully personalised plan that covers your family completely.
- Affordable premiums.
- Complete peace of mind
Conclusion
Personalising health insurance for family is crucial to living a protected and secure life. Following the steps above, you can make sure that your policy is right for family coverage, keep it informed, and plan to secure the family's future. The right planning and timely-made choices ensure that you stay ahead in providing protection to your family and navigating through emergencies.
