Medical treatment in India is expensive. Hospitalisation, even for milder infections or diseases can burn a hole in the pocket, let alone prolonged treatment for a disease. These have the potential to run your finances dry. Surely there must be a way through which you can prepare for such unexpected emergencies. Creating a medical contingency fund is wise surely, but there are smarter ways to help you get a cover for disease treatments. The answer lies in medical or health insurance in India offered by many insurance companies and players.
Unfortunately, awareness about health or mediclaim insurance in India is low. When one chooses a job, for instance, how many of employees check the medical insurance cover provided by the company for its employees? The penetration of private medical health insurance services amongst the masses, even educated people is surprisingly quite low.
What is covered under health insurance in India?
Health insurance protects the insured against multiple expenses on health services. Specified amounts of money are paid to cover treatment and other costs incurred. This can be a substantial cover that can be acquired by paying relatively small premiums, often paid yearly or in instalments, as per the insurance policy agreement. Normally, expenses covered are costs towards checkups done during illness, hospitalisation, tests, emergency room services, operations, ambulance charges and even prescribed medicines, in part or whole. Plans may be for an individual or family plans that cover all the members of a family as a single unit.
Options for health insurance packages
One can choose between disease-specific insurance and comprehensive health insurance in India. There is a significant difference between the two.
- Disease-specific insurance
This plan caters to a specific disease. It covers the insured against medical bills against that particular illness. It eliminates the need for long waiting periods that are normally built into insurance policies for treatment. It provides cover to all stages of the disease, irrespective of whether it is active, dormant or in an advanced stage.
- Comprehensive health insurance
This is what most people understand as general health insurance. It provides cover for a wide range of health issues, including well-known diseases, depending on the policy chosen. The flexibility here is that you get to decide the plan of action based on the health situation and treatment opted for. All major health problems are covered under this scheme.
Why is comprehensive cover better?
A comprehensive mediclaim insurance plan is the preferred health insurance of the two. Here’s why:
It ensures adequate cover for expenses and treatment to all the health issues. If you are looking for family floater insurance plans, then comprehensive is the obvious option as it covers low-risk members as well as high-risk members in your family through a single scheme.
Although most of the common ailments are covered under a single scheme, additional riders can be added to a comprehensive health insurance to cover more diseases as the case may be. For example, someone may have a family history of a certain ailment not covered under the basic policy; this can be added by paying additional premium, often a small percentage of the basic premium amount. This is obviously not possible in the disease-specific insurance.
- You can top up
Comprehensive health insurance cover can be topped up during the policy duration, and the super top-up would be equally applicable to all the diseases covered. In the case of disease-specific insurance, only that disease will be covered.
Many times, a primary disease offshoots and causes parallel complications and secondary diseases get triggered in a frail immune system. Disease-specific health insurance policy may not cover the additional ailments and it may become a practical problem to track the separate treatments for each. A comprehensive cover does not require such segregation and is thus more practical.
It is wise to have an adequate comprehensive health insurance cover for you and your family. A disease-specific insurance can be a supplemental insurance if one gets diagnosed with the particular disease or if there is a high likelihood of contracting that disease. Thus, the basic cover should always be comprehensive.
There are many players of health insurance in India. One must carefully study the policy options offered by each, compare the factors like premium amounts, duration of cover, waiting period, ailments and treatments covered, amount claimable each year (often a percentage of the total amount spread over some years), reviews and feedbacks of the policy from existing customers and the claim ratio. Choose a plan that best suits your requirements.