Sound advice for getting a comprehensive health insurance plan during a pandemic

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Purchasing an insurance plan is always advisable. Although old age is not a hindrance, it is always better to buy an insurance plan early in life as it can prove to be of great help in old age.

The whole world is still grappling with the massive impact of the pandemic. Vaccines developed by many countries, including India, appeared to be a beacon of hope; however, the second wave of the pandemic overwhelmed the available healthcare infrastructure and also placed an immense financial burden on patients and their families. It has become difficult for many to access appropriate care in these difficult circumstances.

With the prevalence of the contagion for over a year now, consumers are beginning to realize the importance of health insurance; however, most of them opt only for COVID-related policies which may not be adequate. Managing medical emergencies at times like these can be challenging. Apart from illness, the financial burden could prove to be a nightmare for people with life-threatening illnesses. It is in the interests of individuals to purchase comprehensive health insurance policies to protect themselves from catch-22 situations like these.

There has been a significant increase in the adoption of health insurance purchases over the past year. According to reports from the General Insurance Council, health insurance reached a market share of 29.5% with a growth rate of 13.3% until March. Market experts believe that the upward trend would continue as speculations are rife that the pandemic will not subside anytime soon. While it is heartwarming to witness this interest being generated, it is pertinent to note that buyers need to make an informed decision. They should not rush to buy inappropriate plans with insufficient coverage.

Important things to check

Purchasing an insurance plan is always advisable. Although old age is not a hindrance, it is always better to buy an insurance plan early in life as it can prove to be of great help in old age. Certain things should be checked when deciding to purchase an insurance plan.

Analyze hedging options: Insurance plans offer a variety of benefits and each may have their own coverage limits and conditions. Buyers should understand the offers and be fully aware of what is covered and what is not. When purchasing disease-specific policies, one should also be prepared for the onset of other diseases that may impose a financial burden on the customer.

Hospital network: Health insurance plans provide information on contracted/network hospitals where insurance coverage is applicable cashless. It is in the buyer’s best interest to understand which nearby hospital would provide cashless treatment as provided by their insurance company.

Claims settlement rate: The claims settlement rate is one of the decisive factors to be considered. The buyer should also try to understand the average time taken by the insurance company to settle claims, whether cashless or reimbursed; because it is an important service parameter.

Compare plans: Buyers should compare plans provided by different service providers to select the most suitable plan. Insurance aggregators have made it easier for consumers; however, they must exercise discretion when making the final decision.

Room rental restrictions or other prerequisites: Understanding the prerequisites or clauses that may affect the services used is relevant before making a choice. The buyer should know if there is a ceiling on the room rent or a sub-limit on the procedures.

Choose the font that’s right for you

Once the buyer is sure of the insurance policy requirement, the next step is to choose the policy that fits his scheme of things. Knowing whether the policy would meet individual and family needs can help decide the next step.

Individual health plan: “Individual health plans” are specific to each person; consumers should buy them after considering the requirements of each individual. Seniors may need a different plan while a young person may opt for a different plan. Individual plans must be purchased in each beneficiary’s name with a different premium requirement for each individual.

Floating family plan: These plans cover more than one family member with no additional insurance premium requirement, i.e. at a predefined composite premium. Parents, spouse and children can be covered by these plans.

Critical illness insurance plans: Illnesses that require a longer recovery time and expensive treatment costs fall under “critical illness plans”. These policies help the buyer to get long term financial help as he receives a fixed amount upon diagnosis of these diseases.

Covid-19 insurance plans: Since the pandemic outbreak, insurers have been offering a standard indemnity policy to cover the cost of treating COVID-19. Known as Corona Kavach, these are short-term plans that do not cover other illnesses.

Complete packages: The multi-risk health insurance policy provides for hospitalization expenses in acute or chronic illnesses. They cover accidental cases and provide insurance coverage against viral infections like COVID after 30 days of policy purchase have expired.

Additional packages: Plans that provide additional help if hospital costs exceed a certain limit are called “supplemental plans”. It is advisable to make an informed decision while opting for insurance policies. While looking for coverage against particular illnesses may seem like a cost-effective idea, one should choose to invest in comprehensive policies, as these policies can also be useful in the event of other unforeseen illnesses or conditions.

(By Ajay Shah, Director and Head – Retail Sales, Care Health Insurance (formerly Religare Health Insurance)

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