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Health insurance price or health insurance premium is the amount you pay to the insurance company to buy the policy. Different policies will have different premiums. The premium will depend upon a variety of factors.
Some factors are in your control while there are some factors where you cannot do anything. For example, you can choose to select an add-on, go for a top-up plan, or increase room rent but you cannot change your age or your pre-existing disease. Here’s a list of factors that you need to consider while calculating the health insurance premium.
The final payable premium will depend upon the kind of plan you choose. Health insurance is broader than car insurance. While car insurance has just two plans in the form of Third-party and Comprehensive, a health insurance plan offers Individual Policy, Critical Illness, Policy, Accident Cover, Maternity Cover, Family Floater plan etc. Thus, while using the calculator, you will have to select a plan and then proceed.
This term means that you are willing to contribute a fixed amount/percentage when it comes to the claim amount. This is an optional feature. It might not be available across all policies. As per the co-pay clause, you enter into an agreement that states that you will co-pay the hospital bill along with the insurer. As the insurer’s risk-bearing capacity is reduced, they charge less premium. Thus, the higher the co-pay amount, the lower the payable premium. However, it also means that the higher the co-pay amount, the lower the claim receivable.
Add-ons are small covers. They offer specific insurance coverage and you have to pay an additional premium to buy them. Therefore, the higher the add-ons, the higher the final health insurance premium. Therefore, you need to analyze your health and risk factors and choose only suitable add-ons. Otherwise, unsuitable add-ons will just spike up the premium.
If you are healthy, the chances of a claim are less than compared to if you have certain medical conditions or if you are prone to them. Thus, your current health condition will also play a role in determining the final premium. However, when it comes to calculating the premium, you might have to share basic information related to pre-existing diseases and lifestyle-related choices such as whether you smoke or drink, etc.
Your age plays a big factor when it comes to calculating the premium. For example, an Individual Health Plan purchased by a 25-year-old person will be less costly as compared to that purchased by a 52-year-old person. The simple logic for this is that as the body ages, the chances of health complications increase. Thus, insurers take on a higher risk by insuring an elderly person and therefore charge more for such a service.
The health insurance premium will also depend upon the company from whom you are buying the policy. For example, digital-first insurers might offer lower premiums as they save on operational cost. Thus, it is possible that you can get the desired coverage and the services for a lower rate from an online insurer. Thus, it is suggested to compare plans before buying them.
The above-mentioned section highlighted the factors that have an impact on the premium. This section will tell you how to tweak those factors in your favor so that you reduce the payable premium. Not all factors can be tampered with but some can. Here’s how you can reduce your health insurance premium.
As stated above, the policyholder’s age is a key determinant when it comes to the health insurance premium. The idea here is to buy a health policy at a young age and then keep renewing it. Buying a policy early on will help you to obtain it at a low cost. This is because the cost of insuring a young person’s health is less as compared to an older person.
For example, the cost of health insurance will be less if you buy it in your twenties as compared to buying it in your fifties. This applies not just for individuals but also if you want to buy a policy for someone else. For example, if you want to insure your parents, make it a point to buy a policy for them before they turn 60. Premiums for senior citizens are on the higher side.
At the outset, a co-pay clause might sound counter-productive. After all, you would want the insurance company to manage as much load as possible when it comes to settling hospital bills, right? But opting for Co-pay can work in your advantage as well.
Opting for it will result in a lower premium. However, if you are planning to go for this option, think it through. Work backwards. Think of it as how much of a financial hit can you handle in case of a health emergency? Once you have an approximate amount, think of the Co-pay percentage accordingly. If you are finding it difficult to make all the calculations, simply contact the insurer and they will assist you.
Top-up plans usually come into the picture when the bill is over and above a certain limit. Thus, if you feel you can manage to settle the hospital bill if it is up to a certain amount but cannot do so if the bill goes overboard, you can skip the individual plan and opt for a Top-up plan instead. However, go for this option if you have some sort of back up in the form of Family Floater Plan or an Employee-offered insurance policy.
Do not go overboard when it comes to including add-ons in your policy. Yes, they enhance the coverage but do not forget that they increase the premium as well. Select only those add-ons that will help you make the most of the premium attributed to them.
Skipping middlemen and opting to buy directly from online insurers can help you to purchase a wide-ranging health plan at a relatively low cost. Such companies usually have a streamlined insurance buying and claiming process.
Consider different types of health insurance covers and then plan your portfolio. For example, if your family members are already covered in some plan or the other, you might not need a Family Floater Plan. Instead, you can focus on an Individual Plan and save on the premium that you would have paid for a floater plan.
A lot of people find filing a health insurance claim troublesome. They feel it is a big task to get the claim settled. This is where online insurers are changing their perception. They are utilizing technology to bring in simplicity, transparency, and speed.
You can file claims via the offline mode, the insurer’s representative, or the online mode using the insurer’s website or the mobile app. The tech-driven process is usually more convenient. Also, you have to decide whether you want a Cashless Claim process or a reimbursement claim process.
In the Cashless Process, you do not have to pay a major part of the hospital bill upfront. The insurer and the hospital settle it between themselves. In the Reimbursement Process, you have to clear the hospital bill, stack the receipts, apply for a claim and then get it reimbursed from the insurer.
Here’s an overview of a claim process.
Step 1: Visit a hospital that is a part of the insurer’s network for Cashless Claims and share your Health Card or state your policy number/details. If you are not opting for Cashless Claims, then visit any hospital of your liking and let the insurer know of it directly or via a Third-party Administrator.
Step 2: You will come across a Third-party Administrator at the hospital who is a link between the insurance company and the insurer. Comply with the TPA with respect to furnishing documents and sharing information.
Step 3: Go through the treatment. In a Cashless Process, you will have to pay for the Deductibles or any other extra costs and the rest will be taken care of by the TPA on behalf of the insurer. In case of a Reimbursement Claim, pay the entire bill and ensure to keep detailed receipts and bills from the hospital and apply for a claim.
Step 4: The Cashless Process shall be completed once you pay the residual bill while the Reimbursement Process shall be completed when you receive the settlement amount from the insurer in your bank account.
Note that for prearranged hospital visits, please discuss the due process with the insurer.
Just as several factors are taken into consideration in car insurance, health insurance also considers some factors to determine the premium for a policy. The premium is the amount taken by the insurance company to insure the policyholder. It is based on how risky it is to insure a particular person’s health. Therefore, the person’s age, lifestyle, and health are looked at along with other factors such as residential area, type of policy, etc. to determine the premium. The premium calculation works on the combination of the above-mentioned factors.
Health insurance premium varies from one person to the other. The same policy might cost more for person A as compared to person B as their age and health conditions vary. You can use a health insurance premium calculator to know how much it will cost you to buy a policy.
Since you know the sum insured you are looking for, simply enter it in the online calculator along with other details while calculating the health insurance premium.
Yes, you can calculate the medical insurance premium for your parents online. Ensure to specify the parents’ age and health conditions in the calculator and you will be able to find out the approximate payable premium to buy a policy for them.
Yes, you can compare health insurance premiums online. Some aggregator websites can help you to do so. However, make sure that they cover all insurers. Another way to go about making the comparison is to shortlist around three to five insurers and then visit their website individually and calculate the premium. Once you have the premium amount from all five insurers, you can compare the cost easily. Ensure to keep factors such as the coverage and sum insured constant across insurers while comparing plans.
Usually, health insurance companies do not charge for premium calculations. Such a service is offered free of cost. However, you might have to enter personal data such as age, contact information, etc. to be able to calculate the premium.
Yes, the premium can be on the higher side in case of pre-existing diseases because insurers perceive such profiles as risky.
Yes, family history of the policy seeker plays a vital role in determining the premium in certain cases. A history of illness in the family increases the candidate’s risk profile as far as insurance is concerned. Thus, the insurer asks for more premium to insure such a risk.
Yes, GST charges are applicable when it comes to the health insurance premium. Therefore, while comparing plans or planning your health insurance portfolio, do consider the GST charges.
Yes, you are eligible for tax benefits on health insurance as per the applicable tax benefit slabs for the assessment year. There are different slabs for tax benefits when it comes to the premium paid for self, family, and the elderly.
Disclaimer: *Except for exclusions like maternity benefits, undisclosed diseases, etc. Please check policy wordings for more details. |
The plans, services, features, processes, and other details mentioned on this page are subject to availability and changes. Please check the applicable policy wordings before making any insurance-related decisions. Feel free to reach out to us at [email protected] for any queries. |