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5 Things You Must Consider When Choosing Health Insurance

Choosing a health insurance policy can be a daunting task. Providers have different levels of coverage in their policies, meaning that you will have to take your time to research the best cover for your needs.

To help you in that regard, the following are five of the most important things to consider when looking for your ideal health insurance policy.

1.  Your Health and Family History

This is a relatively simple process, as it only involves identifying any pre-existing conditions that you might have. However, it becomes complex if you are looking for a plan to cover the entire family, as it means that you will have to take note of all conditions that your partner and children might be predisposed to.

Insurance plans that provide comprehensive coverage to the entire family’s needs are not only rare but also quite expensive. In such cases, you might want to consider obtaining a separate health cover for the kids.

Assessing your health, as well as your family history, allows you to narrow down your options. When it comes to family history, investigate whether there are any hereditary conditions or genetic disorders running in your family, which includes your grandparents, aunts, uncles, parents, and siblings.

2. Evaluating the Different Types of Coverages

When it comes to private health insurance, you will find that there is no one-size-fits-all policy or product. As such, you will have to look for one that covers most of your needs. Nonetheless, private health insurance policies fall in either one of four tires, depending on the amount of coverage they offer. The four tiers are Gold, Silver, Bronze, and Basic.

As you can imagine, Gold and Silver offer coverage that is more comprehensive. While they might be expensive, they give you peace of mind knowing that you will be covered in most situations. Nonetheless, you might find that the services that you think you will mostly rely on are covered by Bronze or Basic. Therefore, check the lower tiers as well since they might just have what you need.

3. What is Not Covered

Read the fine print carefully, as most healthcare policies tend to have exclusions and restrictions. By reading the fine print, you will get to know the extent of the policy’s coverage. Restrictions refer to the services that are covered partially.

On the other hand, exclusions refer to those services that are not covered by the plan in any way, shape, or form. Restrictions and exclusions vary between policies from different providers, which is why it is crucial that you evaluate a plan carefully before choosing it.

4. When and How Much to Claim

If it is your first time taking out a private health insurance plan or are upgrading from a lower tier to one that is more comprehensive, you will be subject to a waiting period. Waiting periods are measures put in place to prevent people from claiming their policies immediately after obtaining them and then canceling before they get to pay any premiums.

Additionally, consider the annual limit that a particular policy subjects you to, as it will determine the maximum amount you can claim on each service.

5. Agreement Between Your Health Fund Provider and Hospitals

You obviously want your health policy to be functional in hospitals of your preference. Therefore, ensure that you check if your health fund is accepted in those hospitals.

If they have an agreement with your hospital of preference, you will not have any out-of-pocket expenses. However, if you are admitted to a hospital that has no agreement with your health fund, you might have to meet a significant amount of the costs out-of-pocket.


A health insurance policy ensures that you and your loved ones are covered beyond what Medicare does for you. Different people require different policies, which is why you must do your homework first before putting money in a cover that does not meet your needs.