Categories
Health Insurance

6 points to remember while buying a health insurance plan

Health Insurance is an emerging sector in India. Though the growth is encouraging but a study in 2014 found out that, more than 80% of Indians are not covered under any health insurance plan, and only 18 % (government funded 12%) of the urban population and 14% (government funded 13%) of the rural population was covered under any form of health insurance. (Source: Wikipedia)

But We believe it is important to get health insurance. And if you are planning to get one please keep these points in mind.

While, it is easy and economical to buy health insurance online, there are certain things which also need to be considered.

  1. Go with adequate coverage– The fierce competition in the health insurance segment has worked in favor of customers as various insurance companies are offering a wide range of health insurance policies with features like pre- & post hospitalisation, day care expenses, cashless hospitalisation, hospital daily cash, and much more.

 

So, while choosing a health insurance policy, go with an adequate sum insured. Factors like your age, current health state, market inflation, etc.; can help you decide the right sum insured. Further, if you have a family history of ailments like hypertension, cancer among others.; choose a health insurance policy which is sufficient to deal with these diseases. Considering the current medical inflation, you should have minimum Rs 5 lakh health insurance cover for a family of 4, father, mother and 2 children. If you have elderly living with you, then it would be wise to look for policies that have better acceptability for existing conditions.

 

Tip: While choosing a health insurance policy, don’t go just by premium only, but carefully compare all the features to get the best possible coverage at a price which you can easily afford. Further, keep increasing the cover limit from time to time to take care of inflation.

 

  1. Check lifetime renewability clause– Though, our current lifestyle has made even younger citizens susceptible to health issues, one can’t deny the fact that as we grow old, our body becomes more prone to diseases.

 

Therefore, while choosing a health insurance policy, go with that policy which comes with a lifetime renewability clause. There is no point in having that kind of medical insurance, which ceases to exist once you cross the age mark of 50 or 60.

 

Tip: Go with a health insurance policy that comes with a lifetime renewability clause, even if it has a higher premium.

 

  1. Pay heed to restoration feature– Opt for a health insurance policy which comes with a restoration feature,e., it restores your sum insured in case it gets exhausted in the middle of the year. This feature would come handy in case of multiple hospitalisation in one policy tenure.

 

Tip: Go with restore feature in your health insurance policy even if it means paying the extra premium.

 

  1. Go through co-payment clause=-In every health insurance policy, there is a co-payment clause which says, that you would have to pay a portion of the claim at the time of claim settlement. In certain medical policies, the clause is there for some particular ailments only.

 

For instance, you have a health insurance policy which comes with 20% co-payment clause. It means, if a claim is Rs 40,000, you would have to pay Rs 8,000 and the remaining Rs 32,000 would be borne by the health insurance company. A higher co-pay also lowers your premiums. Therefore, if you are young and healthy with no past medical history, you can think of going with a high co-payment to save on premium costs.

 

Tip: Before going with a high co-payment, don’t forget the fact that a certain premium portion would have to be borne by you, so think twice before opting for a high co-payment clause.

 

  1. Go with a family floater health insurance plan– If insurance premiums are going beyond your budget, you can consider buying a family floater health insurance plan which covers all the family members under one single plan. As all your family members would be covered under one plan, it leads to a reduction in your medical insurance premium costs as well. Under most of the family floater health insurance plans, you can include self, spouse, dependent kids, brothers and sisters.

 

Tip: Under a family floater plan, as the sum insured is divided among all the insured members, make sure it is sufficient enough to cover all of them. Also, ask for a restoration feature in the policy so that even if one family member exhausts the entire sum insured, the insurer restores the cover for the other insured members.

 

  1. Check exclusions-While; it is necessary to understand the coverage available under a health insurance policy; it is equally important to know what is not covered. For instance, most of the health insurance policies cover pre-existing ailments after a waiting period of say, 3 or 4 years. So, it is essential to have a complete understanding of the exclusions to avoid a situation where the insurer rejects your claim just because it falls under the exclusion head.

 

Tip: Read the policy document carefully or talk to the health insurance company to seek clarification on exclusions in order to avoid nasty surprises later.

Considering the rising inclination of people towards the natural treatment in recent times, you can also look for AYUSH coverage in your health insurance policy. It will cover hospitalisation expenses incurred on natural procedures like Ayurveda, yoga, homeopathy, etc.

Then some health insurers reward you with wellness points if you maintain healthy living. These points can be redeemed to avail such services which are usually not offered by health insurers like OPD consultation, diagnostic expenses, dental expenses, etc. Check whether your insurer offers wellness reward points or not.

Then various health insurance companies are offering online health plans with tenure up to 2 years. It means, you only need to pay a premium for once to enjoy the coverage for two years in one go. Remember, the purpose of health insurance is to insulate you against soaring medical expenses, so be vigilant while choosing the mediclaim insurance. After all, your health is the real wealth!

 

 

 

Categories
Health Insurance

Dengue, a disease of modern times, treatment and management in India

Five decades ago, the dengue fever was known to just about a handful of nations. Today it is a deadly endemic that has enveloped more than 120 countries. In 2016, there was an abnormal surge in dengue inflicting over one lakh people pan India and the numbers this year have already crossed 11,000. The unreported numbers run in millions. Like every coin has two sides, advancements in various fields have arguably been one of the major causes of this rampant disease.

Transport networks that knit our world together have spread the mosquito across the globe and the explosion in urban living over the same period has ensured breeding grounds for them. Over the last few decades the rate of infection has increased 30 fold, say world experts on dengue. Dengue will continue to spread out across the world owing to the intensifying temperatures.

During dengue season in India, unavailability of hospital beds has become a serious concern over the last few years. Most people get hospitalised because of dengue scare resulting in a stress and panic situation. Very few people are aware of the fact that dengue patients need hospitalization only in extreme cases; by and large only supportive treatment at home is sufficient. People prefer hospitalization partially because home-care is not covered under the conventional health insurance plans.

Do you know that the economic burden inflicted by only dengue fever on India is a whopping $1.11 billion a year? Now, that’s a huge sum we’re looking at and who is going to finance it? Existing health insurance plans cover dengue but alarmingly only 4-5% of the Indian population have bought health insurance policies thus adding an immense burden on out-of-pocket expenditure.

Gap in healthcare financing for Dengue

  • Existing health insurance plans do cover dengue but only 4-5% of the Indian population has health insurance. Hence, there is an immense burden on out-of-pocket expenditure.
  • Home care and OPD expenses for dengue are not covered by any health insurance plan.
  • Premium of conventional health insurance plans is age sensitive and requires medical underwriting.

 

A large population of the country cannot afford to have a full-fledged health insurance cover. However, economical health insurance plans that cover tropical diseases like dengue can encourage such consumers to get their family and themselves insured for specific needs.

Apollo Munich’s Dengue Care

Bridging this gap, for the first time in India, Apollo Munich launched Dengue Care – an Over the Counter (OTC) standalone health insurance for the most widespread infectious disease, dengue fever. Dengue Care provides a standalone cover for dengue and that too at a surprisingly affordable cost of Rs 444 for a sum insured of Rs 50,000 and Rs 578 for a sum insured of Rs 1,00,000. It also provides coverage of Rs 10,000 for home care and outpatient expense like diagnostic tests, doctor consultation, home nursing and pharmacy, something that no other insurer offers.

Furthermore, premium of conventional health insurance plans is age sensitive and require medical underwriting, whereas Dengue Care comes at a flat premium for all ages and requires no underwriting. Unlike many health insurance policies, the waiting period of this plan is a mere 15 days. Another great feature of this policy is that there are no prior medical examinations required to avail it, regardless of age. People of all ages, gender and health conditions can buy this plan including those who have been rejected for traditional health insurance policies. To know more about Dengue Care, visit the link.

The dengue virus spreads and develops at a rapid rate, barely leaving time to protect oneself from the onslaught. So choosing a financial protection tool to protect yourself from issues that may arise later is your safest bet.

About the author

Antony Jacob_CEO_Apollo Munich Health Insurance (1)

Antony Jacob spearheads Apollo Munich Health Insurance towards achieving the aim of Uncomplicating health insurance for its stakeholders. As CEO, Antony has been steering the company up the growth ladder since April 2009. Being among the first employees of the health insurance sector, he brings enormous knowledge and vast expertise to the organization, besides enthusiasm and professional exposure in other sectors.

Before joining Apollo Munich in 2009, Antony was a Regional Finance Director, Asia & Middle East, based in Dubai, for the RSA Group. Between 2004 and 2007, Antony was the Managing Director of Royal Sundaram Insurance in Chennai, a company he was involved with right from its inception.Born in Chennai, Antony is a Chartered Accountant, besides being a graduate from Loyola College, Chennai.

 

 

 

Categories
Public Health

Is having insurance (private and public) really the answer to India’s healthcare issues?

Reading Dr Vikram’s post on “is-health-insurance-the-answer-to-indias-healthcare-woes?” made me think. Well, in the United States, despite healthcare being the highest capita spend of the GDP as per Organization for economic Co-operation and development (OECD) survey. But yet still we are unable to meet the healthcare needs of the population. That made me think – Is having insurance (private and public) the answer to India’s healthcare issues?

I would like to give my perspective whether we should invest heavily in insurance and the role of the government, based on my knowledge of Unites States healthcare systems.

Categories
Health Insurance

Understanding basics and challenges of U.S. Health Insurance and lessons India can learn from them

United States has predominantly two types of insurance – Private and Public.  Private health insurance is often offered through employers or other organizations. Public insurance is funded by government broadly through two categories – Medicare and Medicaid.  Medicare is funded through federal government for aged population who are age 65 or older. Medicaid is state-run government insurance program that helps some people with lower income for medical care.

Categories
Health Insurance

Is Health Insurance the answer to India’s healthcare woes ?

Well thats the question I have been asking myself all these years. Now seriously, the only country that spends 17 % of its GDP on healthcare and is ranked among the best healthcare systems in the world providing care to more than 300 million people is the United States of America. And the healthcare system there is run by Health Insurance firms.

India on the other side spends far lower, it is estimated that we spend about 5.7 % of its GDP on Healthcare. Almost 75% of it is in the private sector. As a matter of fact almost 80% of outpatients, pharmaceutical spend and ambulatory care is covered by the private sector. When it comes to inpatient it is 50-50 % with government and the private sector sharing the spend. It is only in the primary care and preventive space that government bears almost 95% of the spend. All immunization programs for example are run by the government.