Here's 5 Factors that Affect Health Insurance Coverage

With the rising health threats and the exponentially rising healthcare costs, health insurance has become one of the most important investment decisions that every individual needs to make. Experts suggest that even before one starts working on their financial goals, they should buy health insurance. However, before you set to purchase a health insurance cover, it is crucial to be well-aware of the factors that determine the extent and cost of your health insurance cover.

If you go through the plans of the different health insurance providers, you would realise that almost all the plans offer a specific sum insured that holds valid only under certain conditions. Depending on the kind of the health plan - an individual plan or a family floater plan - the coverage amount is decided. The higher the extent of coverage and risk, the higher the premium amount.Further, the coverage amount, benefits and the cost of the health insurance plan that the insurance provider sets across different plans depends on the following factors:

While designing a health insurance plan, the insurance providers create a target set of buyers on the basis of age. For example, a basic individual health insurance policy offers coverage that is more suitable for a young individual, who is at the nascent phase of his/her career, does not have any dependents and whose family is already insured. A person with dependants and family would need higher coverage and extensive range of benefits.

Coverage amount of a health insurance plan varies across the two genders. For instance, health plans that are exclusively designed for women covering health crises such as breast cancer and cervical cancer have higher coverage and premium value. If such medical conditions or maternity benefits are part of a family floater plan, the coverage amount increases.

The extent of coverage of health insurance highly depends on the existing medical conditions. People with existing medical conditions would need higher coverage as they are at a higher risk of falling prey to grave medical crisis. Accordingly, the coverage amount is set higher to keep them covered.

For many ailments, most health plans have the condition that the coverage will be disbursed after a certain gap (as specified in the policy documents) between the date of the issue of the policy and the date of the claim. This time gap is known as the waiting period, which may vary from days to months or years for different ailments. Such policies provide coverage only if the claim is made after the completion of the waiting period.Hence, before buying a health insurance plan, it is imperative that you understand how the above-mentioned factors are affecting your policy. This will help you to make an informed decision while procuring health insurance.

The information contained herein is generic in nature and is meant for educational purposes only. Nothing here is to be construed as an investment or financial or taxation advice nor to be considered as an invitation or solicitation or advertisement for any financial product. Readers are advised to exercise discretion and should seek independent professional advice prior to making any investment decision in relation to any financial product. Aditya Birla Capital Group is not liable for any decision arising out of the use of this information.