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Health Insurance:
Health insurance, as humans we are vulnerable to falling sick or getting a disease due to our hectic and stressful lifestyle. Sometimes even a minor change in weather can cause sickness. Health care of late is very expensive and more than the disease itself, it is often the cost of treatment that takes its toll on our peace of mind. The solution to these health-related expense worries lies in having a good Health Insurance Policy which covers medical expenses incurred during pre and post-specific period of time. Life insurance is a contract between an insurance policy holder and an insurer or assurer, where the insurer promises to pay a the insured’s nominee a sum of money in exchange for a premium, upon the death of the insured person. Depending on the contract, other events such as terminal illness or critical illness can also trigger payment. The policy holder typically pays a premium, either regularly or as one lump sum. Other expenses, such as funeral expenses, can also be included in the benefits.
Health care in india:
Health is a human right. It’s accessibility and affordability has to be ensured by the Government but the escalating cost of medical treatment is beyond the reach of common man especially in Tier II and Tier III cities (Rural areas). Health care has always been a problem area for India, a nation with a large population and larger percentage of this population living in urban slums and in rural area, below the poverty line. Under this situation, one of the ways for the government to reduce funding and augment the resources in the health sector was to encourage the development of health insurance. Currently (according to the Health Vertical Specialist team at Cognizant Technology) some of the challenges being faced in the Health Sector are :
- Increase in health care costs due to better quality treatment, more qualified doctors and other facility maintenance Costs in Urban Areas
- The poor are finding the escalating medical costs a huge financial burden
- Need for long term and nursing care for senior citizens because of increasing nuclear family system
- Increasing burden of new diseases and health risks – There have been disruptive lifestyle changes in the country over the past two decades mainly due to the rapidly evolving urban economy and the Indian middle class. It is estimated that around 130 million people may suffer from lifestyle diseases such as diabetes and obesity in the next few years, leaving a $160 billion hole in the national economy during the next few years
- Preventive and primary care and public health functions in Rural India have been neglected. Affordable care (government hospitals or community-based care) suffers from quality issues and is unable to cater to the basic healthcare needs of the growing population. While some private care delivery centers and professionals are accessible to the needy, they are not affordable for a majority of the population.
- Medical health insurance penetration is very low. Health insurance is a minor contributor in the healthcare ecosystem. Insurance payment structures are based on an almost indemnity-based payments. Indian insurance has been limited to critical illness coverage for inpatient surgical procedures.
So what is Health Insurance?
Health Insurance is a policy which covers the insured for Medical Expenses post hospitalization, whether it be a Sickness or Accident. This treatment could have major financial impact on the insured and their family and hence it is prudent for every individual to have sufficient Health Insurance in place. Some of the main coverage under the Health Insurance policy include:
- In-patient treatment (Cashless) including room rent, ICU, nursing, medicines drugs & consumables covered without as per the policy terms and conditions up to the Sum insured mentioned on the policy. Covered expenses include:
- Seek and receive advice and options patiently Room, Boarding expenses
- Nursing expenses Room, Boarding expenses
- Fees of surgeon, anesthetist, physician, consultants, specialists
- Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, medicines, drugs, diagnostic materials, X-ray, Dialysis, chemotherapy, Radio therapy, cost of pace maker, Artificial limbs, cost or organs and similar expenses.
- Pre and Post Hospitalization medical expenses: Medical expenses incurred normally up to 30 days immediately before hospitalization and normally up to 60 days immediately post hospitalization remain covered. The coverage period can be extended by submitting relevant documents to the insurer at least 5 days before the Hospitalization.
- Day Care Procedures: Most policies covers medical expenses for 120-150 different day care treatments which do not require 24 hours hospitalization
- Domiciliary Treatment: The policy also covers for the medical expenses incurred for availing medical treatment at home on the advice of the attending Medical Practitioner which would otherwise have required Hospitalization.
- Organ Donor: The policy covers Medical Expenses on harvesting the organ from the donor for organ transplantation.
- Dental Treatment (in case of Accident): The insurance company will reimburse Medical Expenses of any necessary dental treatment from a Dentist provided that the Dental treatment is required as a result of an Accident. Maximum liability shall be limited to the amount specified in the Schedule of Benefits.
- Ambulance Charges – In most cases the ambulance charges are paid by the policy and the policy holder usually doesn’t have to bear the same
- Cover for Pre-existing Diseases – Health insurance policies have the option of covering pre-existing diseases after 3 or 4 years of continuously renewing the policy without any break in period, i.e. if someone has hypertension, then after completion of 3 or 4 years of continuous renewal with the same insurer (depending on the plan offered and his age), any hospitalization due to hypertension will also be covered)
- Other Terms to be aware of:
- Sum Insured : The Sum Insured offered may be on an individual basis or on floater basis for the family as a whole.
- Cumulative Bonus (CB) : Health Insurance policies may offer Cumulative Bonus wherein for every claim free year, the Sum Insured is increased by a certain percentage at the time of renewal subject to a maximum percentage (generally 50%). In case of a claim, CB will be reduced by 10% at the next renewal.
- Cost of Health Check-up : Health policies may also contain a provision for reimbursement of cost of health check up. Read your policy carefully to understand what is allowed.
- Minimum period of stay in Hospital : In order to become eligible to make a claim under the policy, minimum stay in the Hospital is necessary for a certain number of hours. Usually this is 24 hours. This time limit may not apply for treatment of accidental injuries and for certain specified treatments. Read the policy provision to understand the details.
- Pre and post hospitalization expenses : Expenses incurred during a certain number of days prior to hospitalization and post hospitalization expenses for a specified period from the date of discharge may be considered as part of the claim provided the expenses relate to the disease / sickness. Go through the specific provision in this regard.
- Cashless Facility : Insurance companies have tie-up arrangements with a network of hospitals in the country. If policyholder takes treatment in any of the net work hospitals, there is no need for the insured person to pay hospital bills. The Insurance Company, through its Third Party Administrator (TPA) will arrange direct payment to the Hospital. Expenses beyond sub limits prescribed by the policy or items not covered under the policy have to be settled by the insured direct to the Hospital. The insured can take treatment in a non-listed hospital in which case he has to pay the bills first and then seek reimbursement from Insurance Co. There will be no cashless facility applicable here.
- Additional Benefits and other stand alone policies : Insurance companies offer various other benefits as “Add-ons” or riders. There are also stand alone policies that are designed to give benefits like “Hospital Cash”, “Critical Illness Benefits”, “Surgical Expense Benefits” etc. These policies can either be taken separately or in addition to the hospitalization policy. A few companies have come out with products in the nature of Top Up policies to meet the actual expenses over and above the limit available in the basic health policy.
- Key Points to Remember when Choosing your Health Insurance Plan
- Sum Insured by the policy
- Co Pays / Deductibles / Sub Limits
- Waiting Period for Pre Existing Diseases
- Insurer’s List of network hospitals across India and Claim Settlement Ratio
- Reputation and Claims paying capacity of the insurer
- Premium to be paid for the coverage
- The most important things to consider while choosing an optimum health insurance plan include:
- The Optimum Sum Insured – every individual should first decide on the sum insured / coverage that they need given their current health exposure, age, risk factors etc.
- Exclusions and Waiting Periods under the Plan – these are critical features to be considered while choosing the right plan. Even though most plans have comparable exclusions and waiting periods, one must still do a quick comparison to be aware and opt for the plan with the lowest waiting periods and minimal exclusions.
- Benefits under the Plan – this is the key factor that decides the premium. It is strongly recommended to opt for a plan with more comprehensive benefits, even if it comes at a slightly higher premium. If one considers only premium, the coverage could be reduced significantly which may cause financial duress at the time of a claim.
- The Right Insurance Partner – the insured should opt for an insurance partner based on their claim settlement capabilities and claims settlement ratio.
- Strong and Wide Cashless Network – One must also ensure the insurance company has a reasonable strong cashless network across India because the insured could be hospitalized anywhere in India.
- Day Care Procedures / Pre & Post Hospitalization – these are also a few important features that must be present in the proposed plan. Day Care procedures are those surgeries and medical interventions that don’t require hospitalization.
- Co Payment by the insured – plans where the premium is low for a comparable sum insured could have a higher co pay, which is the % of the claim expense payable by the insured and vice versa, where a higher co pay will mean a lower premium. So whatever the insured is saving on premium will need to be paid as part of the co pay at the time of a claim.
- Lifetime Renewability.
Group Insurance Plan Coverage of Employees – this is typically a family floater coverage for all the members of the family. In this case, if the employee is leaving the organization, he/she can approach the existing insurance company and request them to offer a family floater for the family with the same sum insured limits. The only difference in this case will be that the premium payable will be higher than the Group policy offered by the employer and hence the insured will need to agree to pay the higher premium. Secondly and importantly, the insured should request the insurer to provide a pre existing continuity benefit under the new plan. This will avoid the insured and his family going back to a 48 month pre existing waiting period. For example, if the employee was employed for 2 years and covered under the Group Plan of the Employer, then he/she can request the insurance company to continue the waiting period already crossed and hence under the new plan, the waiting period will only be 24 months, rather than starting from the first month and having a 48 month waiting period all over again.
Individual Insurance Plans for Employees – this is a far more easier option where all the insured will need to do is to apply for a portability of the existing policy to the same insurance company or another insurer. Assuming that the individual premiums earlier were being paid by the employer, the individual will now be required to pay the premium after leaving the organization. This same process holds good for the dependent members also. Since the policies are ported from the earlier insurance plan, the pre existing waiting period continuity will be ensured.
The health insurance sector is easily one of the fastest growing segments in the insurance space in India. Ever increasing medical costs and increasing awareness levels are contributing to this growth, especially over the past few years. India is one of the most uninsured markets across the world with less than 20% of the population having some type of insurance coverage and in rural areas this falls to as low as 15%. Given this growth of health insurance, the industry is seeing significant changes in the range of plans which insurers are offering to customers. This is precisely why the IRDAI also offered licenses to insurance companies only focussed on Health Insurance, known as Standalone Health insurance companies (SAHI). These SAHI companies are leading the product innovation game and are at the forefront of unique product launches. So one shouldn’t be surprised to see a diabetes care or plans specially designed for cardiac patients. As mentioned earlier, the rising cost of medical treatments, inflation and the increased incidence of diseases (given the sedentary lifestyle) today have made health insurance a much needed insurance policy. A health insurance plan covers hospitalization expenses of the insured. Some of the more popular plans a
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