Agar aap health insurance lene ja rahe hain to ye 10 important baatein zaroor jaan lijiye. Ye guide batata hai health insurance lete waqt kin baton ka dhyan rakhein taaki aapka claim reject na ho aur maximum benefit mile.
💡 Introduction
Aaj ke time me health insurance lena luxury nahi, zarurat ban chuka hai.
Rising medical costs, hospital bills aur emergencies ne sabko yeh samjha diya hai ki bina insurance ke ek treatment bhi financially heavy pad sakta hai.
Lekin zyada log galti yahi karte hain — policy lene se pehle terms aur cover samjhe bina sign kar dete hain. Aur jab claim karne ka time aata hai, tab realize hota hai ki kuch conditions cover hi nahi thi.
Isliye aaj hum detail me baat karenge — health insurance lete waqt kin baton ka dhyan rakhein, taaki aapka plan sahi ho aur future me kabhi regret na ho.
🔹 1. Apni Zarurat Aur Family Size Samjhein
Sabse pehle ye samajhna zaroori hai ki aapko kis type ka insurance chahiye — individual ya family floater.
Agar aap married hain ya dependents hain (parents, spouse, children), to family floater plan better hai.
Example:
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Single person → Individual plan (₹5–10 lakh cover)
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Family of 4 → Family floater (₹10–15 lakh cover)
👉 Health insurance lete waqt kin baton ka dhyan rakhein me sabse pehla point hai — apni need ko sahi identify karna.
🔹 2. Sum Insured (Coverage Amount) Sahi Choose Karein
Hospitalization cost har saal badh rahi hai. Metro cities me ek major surgery ₹3–5 lakh tak aa sakti hai.
Aapka sum insured utna hona chahiye ki pure family ke liye enough ho.
💡 Tip:
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Metro cities → Minimum ₹10 lakh
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Tier-2 cities → ₹5–7 lakh sufficient
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Large family → ₹15–20 lakh cover better
👉 health insurance lete waqt kin baton ka dhyan rakhein — sabse zaruri hai adequate coverage amount lena.
🔹 3. Waiting Period Samjhiye
Har health insurance policy me ek waiting period hota hai — jisme aap kuch diseases ke liye claim nahi kar sakte.
Normally ye 2–4 years tak hota hai for pre-existing diseases (jaise diabetes, BP).
✅ Solution:
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Short waiting period wali policy choose karein.
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Agar aapko pehle se disease hai, to declaration zaroor karein.
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Renewal consistently karte rahein taaki waiting period khatam ho jaye.
👉 Health insurance lete waqt kin baton ka dhyan rakhein — waiting period ko ignore mat karein, warna claim delay ho sakta hai.
🔹 4. Network Hospitals Ki List Dekhein
Cashless treatment ke liye ye sabse important point hai.
Aap jis insurance company se policy le rahe hain, uske network hospitals ki list check karein.
✅ Tips:
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Apke area me at least 3–5 reputed hospitals included ho.
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Emergency me nearby hospital cashless facility accept kare.
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Tie-up hospitals ke reviews check karein.
📍 Agar network hospital list kam hai, to cashless treatment mushkil ho sakta hai.
🔹 5. Claim Settlement Ratio Check Karein
Claim settlement ratio batata hai ki company ne kitne claim approve kiye total claims ke comparison me.
High ratio = trusted insurer.
💡 Example:
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95%+ = Excellent (LIC, Star Health, Care Health)
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85–90% = Average
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Below 80% = Avoid karein
👉 Health insurance lete waqt kin baton ka dhyan rakhein me claim settlement ratio ek major factor hai.
🔹 6. Pre & Post Hospitalization Cover Dekhein
Achi policy wahi hoti hai jo hospitalization se pehle aur baad ke expenses cover kare.
Kai log sirf hospitalization pe focus karte hain, jabki diagnostic test, medicines aur follow-ups bhi costly hote hain.
✅ Dekhne Wali Baatein:
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Pre-hospitalization: 30–60 days cover
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Post-hospitalization: 60–90 days cover
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Day-care treatments included hon
👉 Health insurance lete waqt kin baton ka dhyan rakhein — pre aur post hospitalization cover zaroor dekhein.
🔹 7. Room Rent Limit Samjhein
Kai policies me room rent cap hota hai — jaise ₹5000 per day.
Agar aap zyada expensive room choose karte hain to proportionate deduction lagta hai, jisse claim kam milta hai.
✅ Tip:
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No room rent capping wali policy choose karein.
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Room type flexibility (single/private ward) better option hai.
🔹 8. Co-Payment Clause Check Karein
Co-payment ka matlab hai — claim ke time aapko kuch percentage khud pay karna padta hai.
Example: 10% co-payment par ₹1 lakh claim me ₹10,000 aapko dena padega.
✅ Suggestion:
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Kam co-payment ya zero co-payment wali policy lein.
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Senior citizens ke plans me co-payment common hota hai, use samajh ke hi sign karein.
👉 health insurance lete waqt kin baton ka dhyan rakhein — co-payment clause par extra focus rakhein.
🔹 9. Sub-Limits Aur Exclusions Padhein
Kai policies me disease-specific limit hoti hai, jaise cataract ₹40,000 tak hi cover.
Aise sub-limits aur exclusions ko ignore karne se claim disappointment hoti hai.
✅ Solution:
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Sub-limit aur exclusions section dhyan se padhein.
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“No sub-limit” policies thoda costly hoti hain but worth it.
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Cosmetic surgeries, dental, maternity cover check karein.
🔹 10. Claim Process Aur Customer Service Check Karein
Emergency me fast response wali company hi kaam aati hai.
Claim process complicated hone par delay ya rejection hota hai.
✅ Tips:
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Online claim submission option dekhein.
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24×7 helpline number available ho.
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IRDAI registered company se hi policy lein.
👉 Health insurance lete waqt kin baton ka dhyan rakhein — smooth claim process aur reliable customer support par focus karein.
💬 Bonus Tips – Smart Buying Checklist
✅ Compare 3–4 companies before buying
✅ Online policy lene se premium kam hota hai
✅ Rider add-ons dekhein (critical illness, maternity, OPD)
✅ Annual medical check-up benefit include ho
✅ Lifetime renewability wali policy prefer karein
🧩 Conclusion
Health insurance ek long-term financial safety plan hai.
Lekin sahi plan tabhi milta hai jab aap aware ho ki health insurance lete waqt kin baton ka dhyan rakhein.
Agar aap in 10 points ka dhyan rakhenge — coverage, network hospital, waiting period, claim ratio, aur exclusions — to aap ek perfect policy choose kar lenge jo har emergency me aapka saathi banegi.
“Insurance lena smart decision hai, lekin sahi policy lena intelligent decision hai.”
❓FAQ – Health Insurance Lete Waqt Kin Baton Ka Dhyan Rakhein
Q1. Health insurance lete waqt sabse pehle kya check karna chahiye?
Ans: Sum insured aur network hospitals list — ye dono sabse important hote hain.
Q2. Kya pre-existing disease batani zaroori hai?
Ans: Haan, agar aap kuch hide karte hain to future me claim reject ho sakta hai.
Q3. Waiting period kya hota hai?
Ans: Ye wo period hai jisme pre-existing disease ke liye claim accept nahi hota, usually 2–4 saal.
Q4. Cashless claim kaise hota hai?
Ans: Network hospital me admission ke time company ko inform karke direct bill payment insurance se ho jata hai.
Q5. Health insurance online lena safe hai kya?
Ans: Bilkul safe hai, bas IRDAI-approved company se lena chahiye.
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