Health insurance companies provide insurance policies thatcover the entire or a part of the medical expenses of a policyholder when he becomes ill, injured or is hospitalized otherwise. The cover is sometimes expanded to include long-term nursing or custodial care requirements or insurance covering disability.
Factors to Consider While Selecting Health Insurance Companies
The role of health insurance companies is critical in areas where the cost of hospitalization is high. However, with countless options available, you must consider the following factors while making a decision:
- AM Best rating:AM Best rates insurance companies based on the insurance company's ability to pay claims. While an A++ rating is the highest, F5 is the lowest. Companies in between the B and F5 range are considered "vulnerable" and there is a high probability of these companies not being able to pay the claims, especially when a large number is submitted at once. Avoid insurance companies that have an AM Best rating lower than A.
- Coinsurance: The coinsurance clause requires you to pay a percentage of the medical claim up to a specific figure. It is usually expressed as 80/20 coinsurance. This means that after you have paid the deductibles, the insurance company will pay 80% of the claim and you will pay 20%. This continues until the claim reaches a predetermined amount after which the insurance company pays the entire claim.
- Deductibles: The deductible is the amount you need to pay before your insurance company pays anything. An insurance company may ask for either an annual or a per occurrence deductible. In annual deductibles, the insurance company starts to pay after your claims over the year reach the deductible amount. With per occurrence deductible, you have to pay the amount with each claim. Opt for an insurance company that requires deductibles to be paid annually.
- Exclusions: Check what is not covered in the policy offered by the companies. While preexisting conditions may not be covered by certain providers for a specific period, self inflicted injuries and those inflicted during a criminal act will not be covered. Check whether the medical insurance company is providing an accident, sports (if you play sports), maternity problems (if you are a female) and dental coverage.
- Support services: Consider the kind of advice and support offered by private medical companies. You want to receive quick and comprehensive answers to your queries. You would also need guidance from the company. While some providers have an enquiry hotline, others might also be offering a service to arrange medical treatment on your behalf.
Ensure that you understand the policy offered by various health insurance companies before opting for the one that best suits your needs.