By Rahul M Mishra
To survive in a world influenced by uncertainties, people need to plan for the future. This is also applicable to medical emergencies, where a lack of planning can not only affect an individual's health but also add to financial setbacks. However, people can find comfort in a health insurance policy that is capable of meeting the specific needs of customers.
While purchasing health insurance may have seemed like an extravagant luxury in emerging economies like India, the recent pandemic served as a powerful reminder of its relevance in daily life. According to Statista's estimates, India's health insurance market size is projected to grow at an estimated compound annual growth rate (CAGR) rate of 6.76 percent between 2024-2028 from $89.45 billion (in 2024) and $116.20 billion by 2028 - reflecting people becoming more aware of health insurance as a necessity rather than simply another expense.
While buying health insurance has become easy, understanding the necessary details and picking the right policy is still challenging for many. Therefore, people need to consider the following benefits while picking the right health insurance policy:
While health insurance policies with low premiums might look attractive to first-time policy buyers, their coverage remains limited. Individuals should study and research more about the premium cost and coverage amount before purchasing a health insurance policy.
Lower premium policies offer limited coverage compared to policies with higher premiums offering extended coverage. For instance, when a customer opts for a policy with limited coverage, they might end up incurring expenses from their own pockets due to additional treatments pertaining to surgeries or chronic illnesses.
In the event of unexpected medical emergencies, one can be easily exposed to financial debt instigated by medical bills, diagnostic charges, and other hospitalisation costs. With the medical bills often running higher than the sum insured in the insurance plan, an individual's savings can take a direct hit. Thus, it's important for people to opt for a plan with a high sum insured to minimise expenses from their own pockets.
Cashless hospitalisation facilities have brought a positive impact on the healthcare space by enabling patients to receive healthcare treatment without having to pay upfront. After meeting the prerequisite terms and conditions, customers can add this facility while purchasing their health insurance policy to avail of its cashless benefits. At the time of admission to the hospital, patients need to present their insurance card, and they can easily eliminate the need for cash during emergencies.
The extensive hospital network across India has made it easier to allow for this facility, to streamline billing processes, helping patients focus on recovery and not on finances. The cashless facility allows patients to save hefty sums of money as their insurer settles the bills with the hospital directly. While opting for the cashless facility in the policy, customers need to remember that they can only avail of this facility if their treatment is in one of the network hospitals.
Health insurance policies and plans offer different types of coverage based on the premium involved. Customers may select an all-inclusive policy according to their requirements, with higher premiums covering all-inclusive services like medication, doctor fees, hospitalisation, surgery, daycare treatments, pre- and post-hospitalisation expenses, and pre-/post-hospitalisation expenses.
Policies with higher premiums provide comprehensive coverage; however, for additional safety customers can opt for policies offering all-inclusive AYUSH (Ayurveda Yoga Unani Siddha and Homeopathy). The Indian government actively supports this form of alternative medicine through initiatives designed to promote holistic healthcare and traditional remedies.
All insurance policies do not possess sub-limits, as selected insurers offer people the option to opt out of the clause. The reason behind this is that restricted coverage, particularly for room rent, affects the quality of healthcare. Individuals must check the network hospitals, and whether adequate room rent is included in the health insurance policy they are contemplating purchasing.
Premium-to-coverage comparison is a must to ensure the best value and thoroughly scan the policy documents, helping individuals understand all inclusions and exclusions. Compare policies online and learn more by getting increased insights to make informed decisions.
Family needs continue to evolve, and this is where no-claim bonuses and lifetime renewability come into the picture. No-claim bonuses reward policyholders for maintaining good health by enhancing their coverage amount without extra premiums. Alternatively, lifetime renewability ensures that coverage remains available regardless of health changes and age, offering families peace of mind.
Irrespective of age, time, and even financial planning, there is no doubt that a medical emergency can come unannounced in anyone’s life. This, in turn, makes people vulnerable to the risk of healthcare debt owing to the rising medical costs. One of the cost-effective ways to beat the medical treatment inflation is by opting for a health insurance plan that covers the benefits, as mentioned earlier, to aid the policyholder.
However, spoilt for choices in the market, most individuals dread the painstaking process of reviewing and comparing available policies in their search for the most suitable health insurance. By consulting the point of salespersons and credible insurance brokers, people can easily overcome this hurdle and foster financial security in their respective lives.
(The author is the co-founder and director of Policy Ensure.)
