Factors to Know Before Switching Health Insurance Policy

The rising medical costs in India have created a dent in many peoples’ savings. Even more for those who have suffered the brunt of COVID-19’s harrowing experience.

With expenses related to treatment, medicines, & surgeries, going upward, people have started investing in comprehensive health insurance policies. But not everyone with insurance seems to be satisfied with their existing health insurance policy coverage and their insurer, in general.

If you too purchased health insurance a few years back, but the current policy terms and customer service seems to be highly unsatisfactory, you can consider switching your policy to a better insurer.

Many people have taken advantage of accessing health insurance portability for better policy terms. You can do it too if your insurer isn’t providing you good support, causing trouble during claim settlement, or if falsely charging higher premiums for a policy with fewer benefits. The only way out of this is opting for health insurance portability.

Porting of insurance will only be possible during your policy renewal period of the year. However, to ensure you switch to the right insurer and policy, you have to consider these factors shared below:

Check the Waiting Period

Health insurance policies usually have a waiting period categorized under three timelines. The first waiting period is 30 days for new policies. The second waiting period is of up to two years for diseases for whom benefits cannot be claimed before the said period is over. And the last waiting period is of up to four years, wherein pre-existing diseases like cancer, Type 2 Diabetes, etc., can be covered.

If your current health insurance policy has a waiting period of three years for a particular illness, and you have already completed two years, check if the insurer you’re trying to port to will give you the accrued benefits and require you to complete only the remaining, i.e., one year as the waiting period.  

Look for the Sum Insured to be Increased

With changing time, your policy’s current sum insured might not be enough to cover your new medical needs. In such cases, you might want to shift to a better insurance company that offers similar policies with better coverage terms. While placing a health insurance portability request, you can ask the new insurer to increase your sum insured amount.

But the decision to accept this request will lie with the new insurance company’s underwriter. If you don’t want to come under the new insurance company’s scrutiny for raising the sum insured request, don’t ask for a steep increase. The amount you wish to increase should look reasonable and justifiable to the new insurer.

Compare the Premium with Existing Policy

Many people prefer to switch policies because they find a similar or better insurance policy at a lower or rather affordable premium amount. If you want to switch your current health insurance policy for the same reason, look for an insurance company that offers similar policies at a reasonable premium amount. If you wish to enhance the coverage of your health insurance while porting, the new insurer will levy a high premium.

To get a relatively clear idea of how much the new insurer can charge as the premium for enhanced health insurance coverage, you can use an online medical insurance premium calculator. To get near accurate premium estimates, provide the necessary details correctly in the online premium calculator. You can also add/remove riders or benefits to get a clear picture of premiums.


Enquire about the Reimbursement Process

One of the biggest or most crucial things that any insured person would want from an insurance company is hassle-free and quick reimbursement. If you’ve had a terrible experience while filing a claim request and following up for reimbursement, you should look for porting to a better insurance company known for its faster and hassle-free claim settlement and reimbursement processes.

It will ensure you never face a bad encounter with the insurer at a time you need their cooperation the most. You can try reaching out to other people on Insurance-related Facebook groups, subreddits, forums, or other online communities inviting unbiased opinions of their current insurers. The collected data can help you pick the right insurer from the lot. 

Check the List of Network Hospitals

Every insurance company has a list of partner hospitals that the insured can visit to avail of cashless treatment. Visiting any hospital out of their network will result in zero reimbursements for the treatment expenses incurred by the insured. If your existing insurer doesn’t have any specialty hospitals or really good hospitals on the list, you should consider switching to a better insurer.

An important thing to consider while porting is inspecting the list of partner hospitals you’ll get access to after completing the porting process. The list is generally available on most insurance company’s website. If you cannot find it online, consider contacting their customer support via email, phone, or a direct visit to their office.

Double-check the Inclusions & Exclusions

When porting to a new insurance company, the last thing you would want to do is assume the policy offers certain benefits. There are always exceptions for certain offerings, so make sure you don’t fall in the exception category. To avoid porting to an equally average or bad insurance company, go through the inclusions and exclusions listed on policy papers.

Before you start reading the policy papers, a good step will be to acquaint yourself with some commonly used insurance terminologies like co-payment, sum insured, waiting period, claim settlement, critical illness, cumulative bonus, etc. It will help you better understand the inclusions and exclusions, allowing you to make an informed porting decision. 

Analyze Policies with Better Co-payment Clause

For the uninitiated, co-payment refers to the percentage of claim amount one has to pay once the claim gets approved. The co-payment clause and premium are directly linked to each other, so you should not ignore the co-payment clause while porting to a new insurance company.

The higher the co-payment percentage, the lower will be the premium, and vice-versa. If you want to lower the premium and are comfortable with paying a higher percentage during claim settlement, you can also ask the new insurer to add a higher co-payment clause in your policy.   

Know the Room Rent Limits

A misconception some people have while taking a health insurance policy is that the insurance will cover full room rents, irrespective of the amount charged by the hospital. Every insurance company has put a cap on the amount they’ll reimburse for room rent, so always check the limits before finalizing any new insurance company.

The room rent limits vary from one insurance company to another, so never assume or guess the limits while porting. Read the permissible room rent limit available on the fine print of policy paper or limits updated on the insurer’s website. For the safe side, always look for an insurer that provides generous room rent limits.

Other Factors to Consider

Besides the factors mentioned above, check if your medical history will affect your health insurance portability decision. Not all insurance companies and policies might cover certain diseases, and even if they do, the premiums might be skyrocketing.

Health insurance policies consider a person’s age while deciding the coverage and premium, so people with 40 years of age or above should be extra attentive while finalizing an insurance company they wish to port to.

If you have finally decided to switch to a new insurance provider, always remember that you are only allowed to port a similar type of policy and to a similar type of insurance company. This means, if you’ve taken a health insurance policy from a health insurance company, you cannot port to a general insurance company. Also, your current health insurance policy can be slightly modified to accommodate your current health requirements, but the coverage cannot be entirely changed.

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