10 Things to Consider Before Renewing Your Health Insurance Policy

As discussed, renewing your health insurance is the perfect time to reconsider your coverage and make sure it still meets your needs. So, here are 10 important things to check before renewing a health insurance policy:

1. Check the Coverage Limits

With the new advancements in the health industry, new treatments and procedures are introduced regularly, and not all health policies automatically include them. If your plan doesn’t cover these, you might face unexpected out-of-pocket expenses during emergencies.

Review your policy details carefully to check if it includes modern treatments like robotic surgeries, advanced cancer therapies, or daycare procedures. If not, consider upgrading your plan or adding riders to ensure complete protection.

#Note: Always renew health insurance policy with major illness coverage and new-age treatments. This ensures you stay protected against rising medical costs.

2. Increase the Sum Insured as per Your Requirements

When renewing your policy, it’s important to check if your current sum insured in health insurance is enough to cover today’s healthcare costs. With rising medical inflation, treatments like surgeries, critical illness care, and hospitalisation can cost significantly more than they did a few years ago.

If your sum insured is too low, you may end up paying a large portion of the bill from your own pocket. Here’s the ideal sum insured recommended for different life stages in tier a 1 city:

3. Review What’s Covered and What’s Not

According to IRDAI, insurers can now revise policy terms without approval, but they will notify you 90 days before the changes. Hence, as a policyholder, if you assume that the coverage remains exactly the same, it can lead to surprises in future.

• Start by checking the inclusions. Look for any newly added benefits such as coverage for modern treatments, daycare procedures, mental health support, OPD benefits, or wellness programs.
• Then, proceed to check the health insurance exclusions. Certain treatments, procedures, or medical conditions may be newly excluded or capped. For example, insurers may introduce sub-limits on room rent, specific surgeries, or revise waiting periods for pre-existing diseases and listed illnesses. What was previously covered might now be restricted under revised terms.

4. Confirm Cashless Network Hospitals Availability

Before health insurance renewal, it is important to verify whether your preferred hospitals are still part of the insurer network. Insurers update their list of network hospitals. Some hospitals may be added, while others may be removed due to changes in agreements. Currently, Digit has 9000+ network hospitals in India for cashless treatment.

Also, check for network coverage in your city and frequent travel locations. If you have relocated, changed jobs, or often travel to another city, ensure there are adequate network hospitals in those areas as well.

#Note: Reviewing the updated network hospital list at renewal helps you avoid last-minute surprises and ensures you get access to cashless treatment when you need it most.

5. Enhance Your Policy with Add-On Covers

It is always worth spending time evaluating add-on covers in health insurance that can strengthen your overall protection based on your healthcare needs.

For example, one important rider to consider is the consumable cover in health insurance. Consumables such as gloves, syringes, masks, gauze, and PPE kits are generally not included in health policies. Opting for a consumable cover add-on ensures these expenses are covered by your insurance company.

Remember, every insurer has different add-ons, and these add-ons can only be opted after your underwriting approval and eligibility during renewal. Hence, you must always check with your insurer for add-ons available in your policy. 

#Note: While add-ons increase your premium slightly, they can offer better financial protection and reduce out-of-pocket expenses in the long run.

6. Consider Getting Top-Ups & Super Top-Up Plans

Medical costs are rising rapidly, and a basic sum insured may not be sufficient for you during major illnesses. When renewing your policy, it’s a good time to consider adding a top-up or super top-up health insurance plan to enhance your coverage without increasing your premium.

For example, if your base policy covers ₹5 lakh and you opt for a ₹10 lakh top-up with a ₹5 lakh deductible, the top-up will start paying once your expenses cross ₹5 lakh.

Top-up plans are ideal for you if:

• You feel your current sum insured is inadequate.
• You want higher coverage at a lower cost.
• You are planning for future medical risks without increasing premiums.

#Note: Before opting for a top-up, review key aspects such as the deductible amount, coverage scope, exclusions, and whether it aligns well with your existing health insurance policy.

7. Add or Remove Family Members

Health insurance policy renewal is the right time to review and update the list of insured family members to make sure that your policy accurately reflects your current needs. Any change in family structure can directly impact coverage, premiums, and claim eligibility.

• You should add family members if there have been life changes such as marriage, the birth or adoption of a child, or if dependent parents who now require coverage.
• Similarly, consider removing family members who no longer need to be covered under your policy, such as children who have become financially independent, family members who now have separate employer-provided health insurance or your parents are old and they need separate senior citizen health insurance.

#Note: You can also opt for family floater health plans separately for your family or add them to your policy with individual health policies.

8. Evaluate Change in Premium Carefully

At the time of health insurance renewal online, always compare the revised premium with what you paid last year. A higher premium is not uncommon, but understanding why it has increased is essential before renewing the policy.

There are various reasons why health insurance premiums rise, such as age-based slab changes, inflation, enhancements in coverage, newly added benefits, etc. However, it is important to understand whether the increase in premium is justified by the benefits offered under the policy.

#Note: Don’t accept a premium increase if it doesn't provide you with better coverage. Always review the reasons behind the change, evaluate the value you’re getting, and ensure the revised premium fits your healthcare needs and budget.

9. Check the Claim Settlement Ratio

A policy with attractive benefits is of little use if the claim process is complicated. While renewing your health insurance policy, it’s crucial to evaluate the insurer’s claim settlement experience. It indicates the percentage of claims settled against total claims received in a year.

However, apart from the claim ratio, pay attention to the speed of claim approvals and payouts, especially for cashless hospitalisations. At Digit, in the second half of FY 2024 – 2025, almost 75% of Cashless Health Claims were approved in just 30 minutes.

#Note: Don’t just go for numbers, look at customer feedback, online reviews related to claims, and customer support. If you are not satisfied with your current insurer, consider porting your policy as per your choice. 

10. Think About Portability Without Losing Benefits

During health insurance renewal, it’s wise to consider portability if you’re unhappy with your current insurer’s service, network hospitals, claim experience, or premium hikes.

Portability of health insurance becomes particularly relevant if:

• Your insurer’s claim settlement experience has been unsatisfactory.
• Premiums have increased sharply without adequate benefits.
• Your preferred hospitals are no longer in the network.
• You need better coverage features, add-ons, or a higher sum insured.

#Note: Portability requires advance planning. You must apply at least 45 days before your policy renewal date, submit accurate medical disclosures, and compare policy terms carefully before porting. 

Many policyholders treat health insurance renewal as a routine payment, but not checking the key details can lead to major financial setbacks during a claim. Here are some of the mistakes Indians generally make:

Not increasing the sum insured despite rising medical costs

Many people simply renew their existing sum insured without checking if it’s still enough. With medical inflation rising every year, a ₹5 lakh cover that was sufficient earlier may not cover even a single major surgery today.

Example: A family with a 5 lakh policy faced a hospital bill of ₹7.5 lakh for a cardiac procedure and had to pay nearly ₹2.5 lakh from their own pocket. Hence, they must have increased the premium to combat this inflation rate.

Ignoring changes in policy terms and conditions sent at renewal

Insurers often revise plan features during renewal, like adding copay clauses, introducing room‑rent limits, or modifying exclusions. Many policyholders renew the policy automatically without reading the updated document.

Example: A policyholder who originally had zero copay discovered only during a claim that a new 20% copay had been added at renewal, significantly increasing their out‑of‑pocket cost.

Not disclosing new illnesses or diagnoses from the previous year

Renewal is the time to update the insurer about new medical conditions. Failing to do so can lead to claim issues later.

Example: Someone diagnosed with diabetes after the previous renewal didn’t mention it. A year later, they were hospitalised for a diabetes-related complication, and the claim was rejected because of non-disclosure of the disease.

Missing renewal deadlines and letting the policy lapse

A missed payment can cause the policy to lapse, leading to loss of continuity benefits like waiting periods and cumulative bonus. Re-purchasing the plan may require medical tests or even rejection.

Example: A customer forgot the renewal date and the policy lapsed for 10 days. The insurer asked for medical underwriting again, and due to a recent health issue, the no-claim bonus was declined.

Not reviewing better plans or add-ons available in the market

Health insurance evolves every year, and sticking to an old plan might mean missing out on important modern benefits. Hence, adding certain add-ons or super top-ups can help with the rising health issues.

Example: A policyholder continued with a basic plan that didn’t cover consumables like gloves, PPE kits, or syringes, expenses that can form 10 - 15% of the bill. A newer plan could have covered these.

Renewing your health insurance policy is not just about paying the premium and moving on. It is a chance to review your coverage and make sure it still meets your needs. 

Before renewing, it’s important to check key details such as the sum insured, policy benefits, exclusions, network hospitals, add‑on covers, and any change in premium. These small checks can help prevent claim issues and unexpected expenses later.

Remember, health insurance works best when it’s reviewed on time. A few checks today can save you from major stress and expenses tomorrow.