Finance buying guide

How to choose health insurance

Health insurance should protect you from large, unexpected medical bills. Policies differ mainly in the fine print: waiting periods, exclusions, sub-limits, co-payments and how claims are settled. Read the policy wording and the key features document, disclose your health history honestly, and know the regulator's complaint route.

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Weighted criteria

What matters when choosing health insurance

Weights add up to 100 and reflect how much each factor usually decides satisfaction. Change them to fit you in the scorecard.

  1. Cover amount & scope

    25%

    The sum insured, and what is covered: hospitalisation, day-care, pre- and post-hospital costs, maternity and outpatient care where relevant.

    How to check: Compare the policy wording, not just the brochure, for the treatments your family is likely to need.

  2. Waiting periods & exclusions

    20%

    How long before pre-existing conditions and specific treatments are covered, and what is never covered.

    How to check: Find the waiting periods and permanent exclusions in the policy wording.

  3. Sub-limits & co-pay

    20%

    Caps on room rent, specific procedures, and the share of each bill you pay yourself.

    How to check: Look for room rent caps, disease-wise limits, deductibles and co-payment percentages.

  4. Claims process & network

    15%

    Cashless treatment at network hospitals near you, and how reimbursement claims work.

    How to check: Check the network list for hospitals you would use and read the claims procedure.

  5. Premium & renewal

    10%

    Current premium, how it changes with age, and renewal terms.

    How to check: Ask how premiums change by age band and whether no-claim benefits apply.

  6. Portability & complaints

    10%

    Ability to switch insurers while keeping credit for waiting periods served, and complaint routes.

    How to check: In India, ask about portability rules under IRDAI; note the insurer's grievance process.

Avoid

Red flags

  • Agents who discourage you from disclosing health conditions.
  • Low premiums driven by heavy sub-limits or co-pay you were not told about.
  • No access to the full policy wording before buying.
  • Pressure to buy a bundled policy you did not ask for.

Before you pay

Checklist

  1. Estimate the cover your household needs.
  2. Read the policy wording and key features document.
  3. Check waiting periods, exclusions and sub-limits.
  4. Check network hospitals near you.
  5. Disclose your health history fully and honestly.
  6. Use the free-look period to review the policy after it arrives.

Ask the seller

Questions to ask

  • What are the waiting periods for pre-existing conditions?
  • Is there a room rent limit or co-payment?
  • Which hospitals near me offer cashless treatment?
  • How long is the free-look period, and how do I use it?

After you buy

Warranty & returns

Insurance has no warranty; your rights come from the policy contract and the insurance regulator's rules, including a free-look period in many markets.

  • In India, complain to the insurer's grievance officer first; if unresolved, use IRDAI's complaint channels or the Insurance Ombudsman.
  • In the US, HealthCare.gov explains marketplace plans and enrolment periods.
  • In the UK, unresolved complaints about insurers can go to the Financial Ombudsman Service.

Track the return window and warranty end date

Common mistakes

Myths vs facts

Myth Employer cover is always enough.

Fact It can end when you change jobs and may have limits. Check whether you need your own policy too.

Myth Not disclosing a condition saves money.

Fact Non-disclosure can lead to claims being rejected or the policy being cancelled.

Where this comes from

Official sources

Criteria and weights are AltFTool's editorial judgement, not a statement by these bodies. This guide is general consumer information, not professional advice.

FAQ

Health Insurance: common questions

How much cover do I need?

It depends on medical costs where you live, your family size and existing cover. Read official guidance and compare policies with a clear head.

What is a free-look period?

A window after you receive the policy when you can cancel and get a refund, minus certain deductions. The length is set by the regulator and stated in the policy.

Can I switch insurers?

In India, IRDAI rules allow portability, letting you keep credit for waiting periods served, subject to the new insurer's underwriting.

Free tools

Use these with this guide

Weighted scorecard

Review pattern checker

Complaint letter writer

Warranty & returns tracker

True cost calculator

Also handy: insurance cover calculator, insurance policy comparator

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