health insurance

Why do you need health insurance?

As medical care advances and treatments increase, health care costs also increase. The purpose of health insurance is to help you pay for care. It protects you and your family financially in the event of an unexpected serious illness or injury that could be very expensive. In addition, you are more likely to get routine and preventive care if you have health insurance.

You need health insurance because you cannot predict what your medical bills will be. In some years, your costs may be low. In other years, you may have very high medical expenses. If you have health insurance, you will have peace of mind in knowing that you are protected from most of these costs. You should not wait until you or a family member becomes seriously ill to try to purchase health insurance.

We also know that there is a link between having health insurance and getting better health care. Research shows that people with health insurance are more likely to have a regular doctor and to get care when they need it.

The Need to spread Health Insurance Awareness

The condition of health insurance in India is pathetic. 85% of Indian population does not use health insurance to finance their medical expenditure. These people pay for their medical expenditure from their pocket. As a result, many of these uninsured individuals either end up with poor quality healthcare or have to bear financial hardships. The financial stress that is engendered due to rising medical expenses is believed to affect the lifestyle of all family members for years.

If the same continues, how will the people of India pay their medical expenses in the future? How will the efforts of medical care providers be fruitful, when there will be no one to avail medical treatment?

Thus, there is a need to increase the number of insured individuals in India. Working in this direction, every individual, every medical care provider and every health insurance company should play an active role. It is only then possible that people would be able to avail quality healthcare in times of medical emergency. Insurers have designed plans, but people should be encouraged to buy them so that the overall condition of medical care insurance in the country can be improved.

The products and offerings brought by different medical insurance providers vary from each other. The only point that should be brought to light is that people should buy these products to remove inconveniences from quality medical treatment. These products offer much relief to them and their family members at the time of medical emergency. There is no need for an insured individual to scramble for the arrangement of funds at the last hour. Hence, the Government and all the associated bodies should all offer their support in spreading health insurance awareness so that Indian citizens are aware of the right to seek quality healthcare without any financial thought.

The Government should educate people about the rise of medical costs and the importance of these products. Regulators should bring change in the guidelines, allowing only the right players to enter the health insurance market. Health insurance providers should design products, according to health needs of target customers and encourage people to buy them. The combined efforts of all these bodies will surely bring some improvement.

Apollo Munich, a pure medical insurance company, has emerged with the motive to Uncomplicate Health Insurance. Working in this direction, the company is looking forward to offering coverage to more than 500 million people over next five years.

Know before you buy:

  • Pre-existing diseases are medical conditions or illnesses that already exist at the time you buy health insurance. Such diseases are covered after a fixed duration of 3-4 years of continued policy. There might even be conditions attached to the pre-existing illnesses when covered. So if you already have a medical condition, when taking a health insurance, you must get all the clarification regarding pre-existing diseases cover.

  • Maternity or pregnancy related medical expenditures are generally not covered by insurance companies. There are some companies that offer this cover for people who have been already insured with them for a fixed minimum duration (2- 4years as per the policy). So if the medical expenditures due to maternity is one of your key criteria, you must check on which insurance companies offer it and related waiting periods.

  • Although all health insurance plans cover Critical Illnesses (except those listed under exclusions), users seeking extra critical illness coverage may opt for: a) a Critical Illnesses rider or b) a separate Critical Illness policy. In case of a rider, you get a greater cover if diagnosed with critical illnesses at a significantly lesser cost. In case of a separate policy, if you are diagnosed with a critical illness, you are paid the due treatment amount in lump sum.

  • Ambulance charges, although covered by most insurance companies have a capping attached for the maximum amount payable for ambulance (Rs 750-Rs.2000). Keeping in mind the city that you reside in and the quality of hospitals that you would visit, considering the ambulance charges capping is a good measure of preparedness.

  • Hospitals charge rent on the room that one takes up at the time of hospitalisation. Many insurance companies put a cap or limit to the amount one may avail as room rent. It might be a fixed amount, per day for a given number of days in a year or it may be a percentage of the total sum assured. Consider average room rent of hospitals you visit and compare with what your health policy offers. See if the room rent capping by the insurance company suits your requirements.

  • Most insurance plans have set age limits up to which you can renew your health cover. This is called the Renew Up to Age. After this, health insurance ceases and cannot be renewed. It is different from maximum age, the age up to which you can enter a new health policy. While the upper age limit for buying a new policy is up to 55 or 60 years, renew up to age may be higher or even lifetime as per different health policies.