1. Annual limit
This is the most the plan will pay in one policy year. Treatment for cancer, heart conditions or major surgery at a private hospital can be very expensive, and some treatments run over many months. A higher annual limit protects you in a really bad year.
Ask: Is the limit per year, per disability or both? Does it reset every policy year?
2. Lifetime limit
Some plans cap the total they will ever pay. Others have no lifetime limit. If you are young, a plan without a lifetime limit, or with a high one, is worth considering because you may hold it for decades.
3. Room and board
The daily room rate the plan covers. If you choose a hospital room that costs more than your limit, you may have to pay part of the whole bill, not just the room difference, depending on the plan’s terms. Pick a rate that matches the private hospitals near you.
4. Deductible and co-payment
- Deductible: you pay a fixed amount per year or per claim before the plan pays.
- Co-payment: you pay a percentage of each bill, often up to a cap.
Both lower the premium. They make sense if you have company medical cover to pay the first part, or savings set aside for it.
5. Waiting periods
Most medical cards don’t cover illness in the first weeks after the policy starts, and certain specified illnesses have a longer waiting period. Accidents are usually covered immediately. Don’t cancel an old policy until the new one’s waiting periods have passed.
6. Pre-existing conditions and disclosure
Conditions you had before buying are generally excluded. On the application, declare everything: past hospital stays, medication and test results. Non-disclosure is one of the most common reasons claims are rejected.
7. Outpatient and other benefits
Check whether the plan covers cancer treatment, kidney dialysis, day surgery and emergency accident treatment as outpatient, and the pre- and post-hospitalisation periods.
8. Premium now and later
Medical premiums rise with age, and insurers may revise rates as medical costs go up. Ask how premiums are expected to change, and choose a plan you can still afford at 60 and beyond. That is when you’ll need it most.
Quick comparison checklist
| Check | What to look for |
|---|---|
| Annual limit | High enough for a serious illness at a private hospital |
| Lifetime limit | None, or high |
| Room & board | Matches the hospitals you would use |
| Deductible / co-pay | Only if you can cover that amount |
| Waiting period | Known, and old policy kept until it passes |
| Panel hospitals | Includes hospitals near your home |
| Premium path | Affordable as you get older |
Want help comparing? See medical card options with Lulu.