Health Insurance Policy Selection: 5 Thumb Rules

Budgeting for health can be very costly. This is real under normal economic and health conditions and can scale exponentially during adverse public health situations and emergencies like the novel COVID -19.  Apart from making …

Old age couple smiling

Budgeting for health can be very costly. This is real under normal economic and health conditions and can scale exponentially during adverse public health situations and emergencies like the novel COVID -19. 

Apart from making deliberate plans, especially regarding nutrition, you may need to have plans to fund your medical care. This may mean out-of-pocket payments, which have proven a recipe for financial stress and bankruptcy. Is there another way? You can insure your health and let the insurance company stand in the gap in case of medical emergencies.  

Nurse showing reports to patient
 Now, most people think of property when they think of insurance. Have you heard of health insurance? Health insurance is an insurance product that covers an insured individual’s medical and surgical expenses. It repays the expenses incurred due to illness or injury or pays the care provider of the insured individual directly. This has saved many people from utter discomfiture during emergencies or serious bills that can prove overwhelming as most medical eventualities are. 

But did you know that it sometimes goes beyond just securing health insurance? Have you found yourself in a deadlock with an insurance policy limited to a particular area? You need many health insurances but a policy that will meet your needs. Here are five thumb rules to ensure you get a helpful health insurance policy: 

1. Health Conditions and Age

Old man on wheel chair

 Age and prevailing health conditions at the time of underwriting the insurance contract are vital considerations. The insurance company is in business, and like every rational one of us, they want to make reasonable profits and are very keen on their risk evaluation. The old and the sickly are considered risky categories, which may attract a higher rate, making both logical and economic sense considering the life expectancies and terminal illnesses. To benefit from a health insurance policy, you should go for it as soon as you join the majority age—18 years old—because you are considered less risky hence lower rates; plus, you will have more time to benefit from the cover. Also, don’t wait for sickness, but take precautionary measures to be safe in the hands of the keen and risk-averse insurers.  

2. Understand the policy terminologies

Signing insurance  

Like all fields, insurance has its technical terminologies used within its framework. It would be dangerous to interact with such terms as ‘indemnity,” premium,’ “co-payment,” and “deductible” and presume their simple linguistic meanings. You may sign a health policy presumptively and get something other than your desired health coverage. It is worth the effort to acquire basic knowledge of common insurance terminologies to ensure you make informed decisions and agreements in your policy. Ignorance and vulnerability are terrible risks in an attempt to cover your risk with an insurer. 

3. Know Your Medical Care Rights

Most people don’t know their healthcare rights. This ignorance may cut across medical providers, health insurers, and individuals. For instance, mental health conditions and substance use disorders have not been treated equally as other health disorders. Most people don’t still take mental health conditions to be illnesses like other common acceptable diseases that need medical attention. It should be essential to know that you have a right to appeal the decision if your health insurance plan denies a medical service. Government and most medical facilities will help you face any such discrimination. 

4. Plan and Network

Many insurance companies offer health insurance services; nowadays, there are specific arrangements with different medical care providers. You cannot walk just into any medical facility with your insurance card and demand services. This can also apply to geographical areas. To get the most favorable health insurance policy, you need to consider your preferred healthcare facilities —hospitals and pharmacies—and the networks your prospective health insurer works with to help administer healthcare.  

5. Premiums and other costs


Premiums are the amount you pay an insurance company every month for coverage, whether or not you use medical and pharmacy services. Failure to meet your premiums as agreed may lead to revoking the policy. You must consider the premiums because they will influence if you can actually manage the insurance policy.    

Apart from the premiums, there are costs like deductibles and co-payments. A deductible is an amount patients must pay annually out of pocket before a health plan will pay for most non-preventive health care expenses. This amount does not include premiums. Co-payment is cost sharing with the insurer. You should choose what will work best for you based on your needs and financial ability. 


Health insurance is a great way to cushion yourself against medical emergencies and possible financial stress resulting from overwhelming medical needs. You must be well informed to get a health insurance policy that best suits your medical needs. The above rules will help you secure the most favorable policy considering your medical needs and financial condition. 

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