Guide to get health coverage

The Coronavirus pandemic has undoubtedly changed the course of things and the way people see and live life. The exponential rise in the number of cases has had a deep impact on all the sectors across the globe. The impact of all these events has been profound in the minds of people. Resistance to ease of doing business operations around the world due to the lack of availability of resources on account of a nationwide lockdown has led unemployment levels to reach staggering levels. Most developed countries failed to tackle the pandemic effectively despite having the best healthcare and medical delivery system. Most nations had healthcare infrastructure far superior to India. 

The COVID-19 crisis has made people realize the importance of maintaining a balanced and healthy lifestyle and has also underlined the need for security when it comes to being called ‘rightfully fit’. Though health insurance covers have existed for a long time, the driving force behind their rapid growth has been due to the scary nature of the current pandemic. 

Importance of Health Insurance during a pandemic

Society likes the idea of getting up early and being productive, but not everyone else can do that until much later on in the day. Energy is the most personal thing. As society tries to navigate its way through this pandemic, the inclusivity of heightened hygiene, regular exercise, higher water intake to keep the hydration levels intact etc have helped many. At an individual level, practicing these things will be helpful. It will ensure that people have the desired immunity levels to combat the disease. 

However, as a precautionary measure, it is essential to go the extra mile and buy insurance coverage against any untoward and unforeseen incident. 

India is a developing economy where the development of the medical infrastructure is still work in progress. Therefore, it might just take longer than expected to recover from the pandemic situation in totality. 

In this context, the focus on buying an insurance cover has to be of paramount importance. 

Layoffs, pay-cuts, increased mental stress and medical expenses have been the highlight of this year of pandemic. In a year of financial instability, the last thing you would want is a hefty medical bill. It is vital to mitigate the risks which have a massive impact on the purse even though the probability of occurrence may be low i.e. medical emergency. 

As the pandemic spreads and there is still a lot of uncertainty around the availability of a COVID vaccine, there is a sense of panic and despondence. The only way to be secured in an all-round manner would be to opt-in for a health insurance cover to avoid getting financially stressed in the event of any illness. 

The medical bill starts from the day of hospitalization, and the longer one suffers, the deeper is the financial brunt. It will burn a hole in your pockets as every step from testing, hospitalization, quarantine and post-recovery precautions have all become extremely expensive and out of the reach of the common man. 

Financial preparedness is the key to combat the coronavirus, and a health insurance plan with an adequate sum insured comes to the rescue in such trying times. It is only better to keep it on the higher side as with the increase in the cost of medical facilities; we may not want to take any extra burden. 

Things to keep a tab on while buying any insurance

Although there is no strict standard operating procedure (SOP) to be followed at the time of buying health insurance, there are few basic points to check on. An ideal insurance plan could be one providing maximum cover at an affordable cost, i.e. premium. Apart from the standard cost-benefit analysis, here are some points to consider choosing the right health insurance policy

  1. Check if a family floater plan works out 

The best way to reduce the costs and avail the maximum benefits is to look for a family floater plan. It would increase the number of family members covered in the policy plan and that would bring down the premium cost.

  1. Understand your needs and the insurance policy in detail

It would help if you looked through the agent’s assurances and understand the message between the lines. Don’t get carried away by the rosy picture being painted by the insurers but understand your own needs and requirements, family medical history and the impact of a hereditary or genetic medical condition if any. 

Also, one needs to keep in mind the budget allocation for health insurance given the tight budget constraints in the midst of a pandemic like situation. You should further check for free consultations / check-ups as an add-on to the policy and the frequency of the same.

  1. Check for claim settlement ratio

The policyholders must first do a background check and understand the insurance company. You can also read reviews of existing policyholders inquire about the seamlessness of the entire procedure and carry out a feasibility study for your plan. Whether the claim settlement is smooth and claims made are efficiently processed; should also be assessed.

  1. Check the coverage and the exclusivity clause of the plan

Check whether the policy includes both pre and post-hospitalization costs. You must also assess the network hospitals of the insurer and their standards of functioning during emergencies. Also check how smoothly they can help execute a cashless transaction in the event of an emergency.

Health Insurance Plans Available in India:

  1. Bajaj Allianz Health Guard Plan – This comprehensive plan benefits to by way of its medical coverage to individuals, family and at the time of pregnancy to the newborn baby. 

Keys benefits are as follows:

  1. In-patient hospitalization along with pre and post-hospital cost coverage
  2. Day-care procedures
  3. Organ donor cover (in case of organ transplant)
  4. Daily cash benefit
  5. Maternity expenses and newborn baby cover (hospitalization and vaccination cost up to 90 days of birth)

Exclusions
 

  1. This cover does not apply to any treatment outside India
  2. Medical expenses within the first 36 months of buying the policy will not be included 
  1. Digit Health Insurance – This type of policy plan covers unique illnesses like COVID-19, making it best suited for the current times.

Keys benefits are as under

  1. No age-specific co-pay clause is applicable
  2. Maternity benefits, psychiatric illnesses are covered
  3. Cumulative bonus is provided

Exclusions:

  1. Pre-existing diseases
  2. Hospitalization without doctor’s recommendations

The Bottom Line

Though the cost of premiums is likely to go up, there are top-up options available for the policyholders to reap the maximum benefits from the plan. Having health insurance in place for the family not only secures your health but also relieves from any unnecessary financial and mental stress. 

Policyholders should micro-target the benefits being offered by the insurers as they’d be investing in from their precautionary savings due to lower spending as a result of the pandemic. An extra sense of security with the help of a cover would go a long way and hence is of utmost importance during uncertain times like these when the questions on the relapse of the pandemic are on the rise. 

Guide to Health Coverage

Can You Get a Maternity Insurance if you are already pregnant?

It is highly unlikely. You see, for the company, this would look a lot like the scenario of a man on his deathbed buying life insurance. Most insurance companies have a waiting period that can last up to 3 years. This means that if you have any pre-existing conditions, you will have to wait for 3 years until the expenses of the treatment can be covered by the company. Now, most insurance companies consider pregnancy to be a planned affair, meaning that you would have to wait for 3 years until the expenses would be covered by the company. Since pregnancy lasts for only 9 months, this is impossible. However, you must never lose hope; there are chances that you could be offered a maternity insurance in your case even while you are pregnant.

Why health insurance is important during Covid-19?

Coronavirus has transformed the world in every aspect. The impact has been economic, lifestyle-based, and health-based. With the rapid rise in Coronavirus cases, health insurance has proved to be your best friend in times of uncertainties. There can’t be any debate on whether Health Insurance is beneficial or not. It is apt from both health and investment point of view.

Will health insurance premium increase due to COVID-19?

If you view this scenario from the economical side, then you can say that the demand for treatment and cover is very high whereas the supply is very low. Since demand for cover is more than the supply, cost should tend to increase, so as to establish the new equilibrium between demand and supply. Further, Insurance companies don’t have the clarity of the future about what will be the trend for post-COVID-19. The pricing models designed by the actuaries are very complicated due to the cost description prevalent today. All the estimates are not matching with the actual figures. This deviation between the actual and estimated data is one of the reasons for the spike in cost which is happening on a random basis.

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