While we are aware that the cost of the policy is determined by factors like age, health and gender, we often tend to overlook location.So, what are the most significant changes that you ought to look out for, if you relocate to a new city?
1. Change in premium rate
The most important aspect that is likely to be impacted is the premium paid for the health cover.For some insurers, health insurance cover is determined on the basis of the zone in which each city falls.
Cities have been classified into three zones at present (Zone 1, 2 and 3) and while different insurers have their own specific way of classifying cities into each zone, Mumbai and Delhi fall under Zone 1, most Tier-I cities fall under Zone 2 and the rest of India falls under Zone 3.
However, not all metro cities are classified as Zone 1. For example, in the case of Max Bupa, Delhi is considered to be a Zone 2 city, but for Star Health, it is a Zone 1 city.
If a person moves from a Tier-I city to a Tier II or Tier III city, most insurers provide a policy at a discounted price.
While the policy needn’t be changed, policyholders could enjoy the benefit of a refund as there would be an endorsement provided.
Depending on the policy, the individual needn’t necessarily change it as treatment can be availed on the same policy anywhere.
The cost of hospitalisation is lower in smaller cities, as currently, there are more cases of infectious ailments, as opposed to a general tendency of larger cities having to tend to lifestyle diseases.
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2. Restrictions in coverage for advanced medical treatment
In the case of a policyholder moving from a lower zone and avails of advanced treatment, some insurers restrict the coverage of the policy.
The level of restriction tends to vary from policy to policy. Under such circumstances, a policyholder can avail of a co-payment clause, wherein a fixed percentage of the consultation fee, medical expenses and hospitalisation would have to be borne by them.
Depending on the health insurance plan in question, this contribution by the policyholder can range from anything between 10-20%.
If policyholders would rather not co-pay every time they require advanced treatment, they can instead opt to pay a higher premium. Generally, migration is allowed at the renewal stage of the policy.
3. Access to medical facilities and network of hospitals
Another factor that comes into play is your choice of hospitals, depending on the network of hospitals provided to you by your health insurance plan.
Network hospitals provide cashless facilities, and you would also be able to make use of those facilities that you tend to often visit, at greater ease.
Remember to take a look and find out whether your preferred hospital features in the list or not. You might have to opt for a policy with a different insurer just in case your preferred hospital is not in the list.
The hassle of having to change your health insurance policy is negated if you opt for an All-India coverage.
However, given that the premium paid for such coverage is higher, policyholders can instead, select a zone-based cover, after considering factors such as age, duration of stay in the new city and health condition.
If advanced treatment is required or the policyholder is a senior citizen, a pan-India cover would be better as it applies to all cities across the country, irrespective of the zone they fall under.