Will Your Health Plan Save You?

Will Your Health Plan Save You?

Health insurance, or any other sort of insurance for that matter, is something that people only think about twice in their lives: when they get it, and when they need it. It is just not part of our everyday discussion. One thing is true though, 63% of people wish they had put in more thought into the sort of health plan that they went in for. Will your health plan save you when those bills start racking up and the odds seem stacked up against you?

Insurance is something you get, hoping you never need. Our world is unpredictable, and while we hope for the best, nobody will fault you for expecting the worse. The only way to know if your health plan will save you is by asking the right questions at the very beginning, that is when you actually decide on a health plan-after all, you are surely not going to think about it again until you need it.

You have to take an active approach. Don’t let a salesman dictate your needs to you. Instead, take the driver’s seat: ask the right questions and make a choice that you feel will best suit the lifestyle that you live. Taking a passive approach may be setting yourself up for denied claims and rejections in the future. Here are a few tips that can help you down the right path.

  1. Avoid Committing Moral Hazard

Be honest when disclosing the facts about your health. Resist any urge to hold anything back. Doing so will constitute a moral hazard, is considered fraudulent by insurers and will create a fertile ground for the rejection of claims. While there are plans that do not require medical disclosure, they often offer very little. Go for the comprehensive plans, and try to be as honest as possible.

  1. Be Wary about Group or Company Plans

Just because you are included in the company plan does not make it enough. Take a closer look at the provisions, and often you will find limitations. For example, is support for your family members included? Up to what amount does this company plan offer coverage? Another drawback of these plans is the fact that they only cover you for as long as you are a part of the group. Even if you are included in such a plan, it is always wise to look for another plan that will cover your specific needs.

  1. Don’t Go for the Plan with the Lowest Premium

This is not an admonition to break the bank in getting health insurance, but often in life you get what you pay for. Don’t go cheap because you secretly think you are paying for something you feel you will never need. Nobody knows tomorrow. Make a careful check of all that you need, and then choose the health plan which you can afford that most closely satisfies. Low premium health plans, more often than not, come without many important features and coverage.

  1. Look Out for Factors that Affect Premiums

There are two obvious factors that affect the premium you pay for any health plan: Age and Health Condition. Others exist, however. One of these is the Co-Pay option. Co-Pay is common in plans for people who are over 60 years of age, and is an option that stipulates that you carry some of the financial burden if and when disaster strikes. Another factor is the Sub-Limit which puts a coverage cap on expenses such as lodging. Both factors produce lower premiums, but are best avoided. It is better to pay the higher premiums and guarantee proper care should you ever need it, especially if you are among the aging.

  1. Go for a High No-Claim Bonus

Insurers offer bonus percentage pay-outs for the following cycle of years if you have not claimed in the past. Some offer 5%, while some offer 10%. Go for the higher. An incremental bonus of less than 5% will generally not be enough to meet the rising costs of healthcare. Given that these bonuses increase over time you can see the wisdom with going for 10%

  1. Go for Plans that Have Few Diseases that Require a Waiting Period

Several plans come with waiting periods for certain diseases. Because disease and misfortune don’t care about what plan you are on, you will have to pay out of your pocket during this period even though you have health coverage. The sort of health plan you want is the type that does not have too many diseases falling under this category, or, better yet, no diseases under this category. No need paying premiums then still paying your own bills.

  1. Don’t Budge on Having Low Pre-existing Exclusion

Why is this important? Most plans come with a clause that stipulates a waiting period for pre-existing conditions during which the insured cannot make a claim for a pre-existing condition. This is to prevent insured from making a claim immediately after making a premium payment. The maximum length for this period is four years. It is better to go for a plan that has a shorter waiting period as opposed to a longer one.

  1. Keep an Eye on the Disease-Wise Capping

Some plans have caps on the amount that will be paid out for them. In these cases, one cannot lay claim on the total amount. Take the time to educate yourself about such features-read the fine print-so that you can choose a plan that is hassle free.

  1. Claim Settlement Ratio, and Rejection Ratio

The best predictor of the future is the past. Before signing anything, look out for the insurer’s reputation for settling claims, pending claims, and also rejected claims, so that you have a clear picture of what you are signing up for. All the precaution in the world will be off no use if you are dealing with an insurer who has a history of going back on their word time and time again.

Because the future is hidden from us, there is no such thing as a perfect health plan. But this does not mean that one cannot try. Put some effort into choosing your health plan. The above points are important pointers down the road to assurance during the odd moments when you wonder if your health plan will save you.


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