Benefits of getting a Comprehensive Health Insurance

The world we live in today has become rather unsettled owing to the seemingly never ending battle with COVID -19. Everyone is cautious and increasingly aware of the need for access to quality healthcare.

The pandemic period has witnessed a shortage and increase in cost of healthcare facilities across the country. Consumers today are becoming increasingly aware of the benefits of Health Insurance schemes. There has been a higher uptake of health insurance policies over last two years and experts further believe that this robust growth would continue, and the health and medical insurance market would continue to grow at a CAGR of 19% for the period 2019 - 2024.

Digital means of purchase and payment have now become the norm in the industry and this has fast-tracked digitization of insurance purchase and servicing. Now most insurers allow customers to intimate claims online and also submit documents digitally and thus reduce the time taken to get their claim serviced.

In spite of this, several consumers in the recent past have opted for a stop-gap arrangement while purchasing a Health Insurance policy. Like choosing a COVID-19 related policy, which is far from being adequate to cover holistic healthcare requirements of an individual/ family. This does not safeguard them even remotely against the financial burden arising due to other life-threatening diseases. However, this can be seen as a first step by the hitherto underserviced segment of the market and makes it easier for them to upgrade their policies to a comprehensive cover as we move further.

The need for a comprehensive healthcare plan is all the more pertinent now than ever before as a consequence of various lifestyle changes.

Ascertaining the constituents of a Health Insurance scheme

While there is no age barrier for purchasing a Health Insurance plan,  it is always advisable to buy one early in life, for it can prove to be of great help as one ages. Ascertaining some crucial elements is necessary before signing-up for a  Health Insurance scheme.

• Assessing coverage option: The contracts governing insurance schemes have several clauses and sub-clauses that provide for a list of prerequisites and conditions. Consumers must try to ascertain the offerings and understand what all is included or excluded in the cover to be free from ambiguity. While focus on coverage for COVID-19 is common today, it is best to ensure whether the Sum Insured is sufficient in case of unforeseen critical illnesses that may get diagnosed or a major surgery that may be required. Buyers must also understand whether it is an individual or a family-floater plan.
• Plan comparison: Comparing plans from different service providers is the primary way to ascertain the best-suited plan. And with several insurance aggregators in the market, the job is made easier for consumers.
• Claim settlement ratio: Most insurers often communicate their claim settlement ratio, a crucial detail that consumers must pay due attention to. Buyers must also understand average time taken by the company to settle a claim as it would help them in understanding the insurer’s servicing potential.
• Peremptory conditions and other restrictions: Before taking the final call buyers must read and understand all the preconditions associated with the scheme. They should be aware of the limitations and sub-limitations on procedures like  cap on room rent, coverage OPD expenses etc.

• Wellness benefits: Wellness aid the overall Health Insurance space by providing a wholesome Curative and Preventive coverage. It covers individuals for Outpatient consultations, Diagnostics and Pharmaceutical expenses. Categories like Dental services and Vision are also covered in such programme. Hence, it is essential that an individual keeps in mind the range of such value-added services that go beyond hospitalisation expenses.

• Hospital network: Last but not the least, consumers should not forget to check the enlisted/network hospitals list of the respective insurer.  It is in their best interest to be aware of the nearby hospitals that would provide cashless hospitalisation.

Picking up a comprehensive Health Insurance  policy

After understanding the Health Insurance policy essentials, next stage is to choose a  policy that best suits your requirement.

• Individual health coverage: Individual Health Insurance plans meet the requirements of an individual. These plans can vary according to age, sum insured etc. Separate premiums have to be paid for each beneficiary as they do not cover more than one person in a plan.
• Family floater plan: More than one member of a family gets covered under a family floater plan without any additional premium.  Parents, spouses and children can be covered under these plans.
• Wellness services: Wellness services in Health Insurance are custom-made to suit economic needs of all segments of society. Including wellness products in your Health Insurance plans creates a win-win situation for the consumer. These benefits help the policyholder maintain a healthy life by getting access to quality healthcare on a day to day basis; and the same time help avert occurrence of major health issues by constant health monitoring - therefore minimizing the instances of critical illnesses and hospitalisation at large.
• Critical illness plans: Ailments with prolonged  treatment periods and expensive treatment costs are covered under 'Critical Illness Health Insurance Plans'. Such policies help  consumers meet their long term financial requirements for medical treatment of such diseases.
• Covid-19 insurance plans: With the outbreak of the pandemic, Health Insurers started providing standard indemnity policies that cover COVID-19 related costs; known as Corona Kavach, these plans that do not cover other illnesses.
• Comprehensive plans: Health Insurance policies that provide comprehensive coverage for hospitalisation expenses in acute or chronic illnesses, accidents, viral infections like COVID 19 etc. come under the category of Comprehensive Health Insurance plans. These services are available after the completion of stipulated waiting periods.
• Top-up plans: Plans providing additional cover on an existing Health Insurance plan are known as Top-up plans. So if you have coverage of 5 lakhs, you can take a Top-up plan of say 20 lakhs that kicks in if the cost of treatment exceeds 5 lakhs, and this comes at very affordable premiums.

Consumers must exercise discretion and make an informed decision when buying Health Insurance policies. While opting for an ailment specific cover may appear to be a cost-effective approach, one must choose prudently for the long term and invest in comprehensive Health Insurance policies. The minor difference in premiums can make a big difference by securing them against financial stress arising due to medical emergencies.