‘Men are from Mars, Women are from Venus’, a best-selling book by John Gray, an American psychologist, talked about the psychological differences between men and women. The title of the book, however, has become a catchphrase to highlight the differences between men and women as a whole. 

Women are definitely different from men, both in terms of their psychological needs as well as physiological ones. Then why is it believed that a basic health plan would be suitable for women too?

Women’s anatomy is different from men. They are prone to specific illnesses or ailments which men don’t suffer. For example, women suffer pregnancy related complications, breast cancer, cancer of the reproductive system, degradation of bones resulting in osteoporosis, etc. As such, women need a comprehensive health insurance policy which specifically covers these women-centric illnesses. But is this what women get?

Trends in health insurance for women

When it comes to covering women under a health insurance plan, the answer is most commonly a family floater policy. The policy provides coverage to all family members, including women. Additionally, if women are employed, they might also have a group health scheme sponsored by their employers.

Though women enjoy coverage under group or family floater plans, such coverage might not be comprehensive enough to cover them against illnesses that they specifically suffer. For example, most group health plans do not cover maternity. 

Health insurance for women – what women want?

For the woman of today, the following coverage benefits are a must –

• Maternity 
• Critical illness
• Other minor illnesses that they suffer

  If a health insurance plan offers these coverage benefits, women can avail of quality healthcare facilities without worrying about affording the same.

  So, for empowering women through health insurance, here’s what should be done –

• Enhancing the coverage of an existing family floater plan

  If there is a family floater policy that covers the women of the family, a review of the coverage is a must. You should check if the coverage is sufficient to provide an all-round coverage to women. The health insurance policy should be rejigged to provide coverage for the following –

• Maternity related expenses and complications suffered during pregnancy if family planning is on the near horizon
• Opting for a critical illness rider at the time of renewals
• Enhancing the sum insured of the policy for optimal coverage 

  If your existing policy does not provide maternity and/or critical illness coverage, you can always port to another, more comprehensive plan. Ensure the sum insured is at least INR 10 lakhs and above so that the plan covers the medical bills optimally.

• Buying a new comprehensive plan

  If you do not have a health insurance plan altogether, buy a comprehensive coverage ASAP. Ensure the coverage has maternity cover, optimal sum insured and the critical illness rider. You can opt for an independent women-centric health plan or a family floater policy for covering the entire family.

• Buying a standalone critical illness policy

  If the critical illness rider is not available or if you want to opt for a comprehensive coverage against critical illnesses, a standalone critical illness policy would be better. You can opt for a women-specific critical illness policy that covers women-related illnesses like the different types of cancers, burns, etc. The policy has affordable premium allowing you to opt for an optimal coverage amount.

• Buying a super top-up policy

  An optimal sum insured is a must. This fact cannot be stressed enough especially if you look at the rising costs of medical treatments. So, whether you buy a family floater policy or an independent plan, choose a high sum insured. If affording the premium becomes a concern, go for super top-up health insurance plans. Super top-up plans help in increasing the coverage at very affordable premiums. Choose a deduction that matches the sum insured of the base policy. This way, claims up to the deductible would be covered by the base policy while claims exceeding the deductible would be covered by the super top-up plan. 

Empowering women through health insurance – the road ahead

The healthcare needs of women require specialized coverage. If your normal health insurance policy is not equipped to provide the coverage that women need, it’s time for a change. Women are caregivers but they need care too. Empower women with a suitable health insurance policy that would take care of their medical needs. If you are a woman yourself, it’s time to take action. Invest in a suitable health insurance policy that provides an all-round coverage for your needs and take the next step towards financial empowerment.

Millennials have become aware about the importance of a health insurance policy. They understand the need of a financial cover if medical emergencies strike and so, they are investing in a health plan for themselves as well as their family. Health insurance, however, is a technical cover and so, here is a simple guide to the policy if you are thinking of investing in it –

• There are different types of plans

  Health insurance is not only available for covering your medical bills in case of hospitalisation, there are different plans that you can avail of for comprehensive coverage. Besides the basic plan for covering hospitalisation, you can buy critical illness cover for protecting against major illnesses. Then there are COVID plans if you are worried about being infected. So, expand your coverage. Opt for other plans and build a layered coverage against medical contingencies.

• Check for sub-limits

  Some health insurance plans impose room rent sub-limits which restrict your coverage. Check for these sub-limits. Try and avoid plans which have such limits because your claim would be considerably affected if the actual amount exceeds the limit. Moreover, there are coverage limits on various benefits like ambulance costs, maternity expenses, AYUSH coverage, domiciliary treatment, etc. Check the limits when buying and try and opt for a plan which has a higher coverage limit so that your out-of-pocket expenses reduce.

• Riders are beneficial 

  Health insurance plans allow optional riders that you can choose by paying an additional premium. Riders like critical illness cover, maternity and new born cover (if you are planning a family), personal accident cover, etc. make for good coverage additions as they provide a wider scope of coverage. So, look for the available riders and try and add them for an inclusive coverage in your policy.

• A healthy lifestyle is rewarding

  Modern day health insurance plans reward you for living a healthy life. Daily exercising, walking, meditation, Yoga, balanced and nutritious meals, etc. not only keep you fit but also help in reducing your health insurance premium. So, if you are a health conscious millennial, use your healthy lifestyle to get rewarded under your health plan. If not, it’s time you adopt a healthy lifestyle, both for your health and your wallet.

• Insure parents separately 

  If you are buying a health insurance plan, try not to include your parents under the same cover. There are two reasons for this –

  1. Since your parents would be the eldest members, the premium would be calculated based on their age. This would drive up your health insurance cost
  2. If they make frequent claims on the policy, you would not be able to accumulate the no claim bonus

  So, opt for a separate health plan for your parents and buy another plan for yourself. Besides ensuring a suitable coverage, you would also be able to avail additional tax benefits on the premium paid.

• Don’t depend on your group health plan only

  If you are employed, your employer might provide you with a group health scheme. Though the plan provides the basic coverage, the coverage is limited and not customizable. Moreover, the coverage is available for as long as you are employed. Invest in an independent policy so that you can get optimal coverage that can also be renewed life-long. 

Understand the basics of health insurance and invest in a suitable policy. You might be a modern age individual in the prime of your health but, remember, contingencies come unannounced. Prepare yourself against medical contingencies by investing in health insurance plans. Believe me, you would be thankful that you did!

Buying a health insurance policy is important to face the rising medical costs. Thankfully, this awareness is slowly spreading across the Indian population and people are investing in health insurance plans for financial protection. However, when it comes to buying health insurance, buying the right policy is important so that the policy delivers on your expectations. Your health insurance purchase decision should, therefore, be backed by careful consideration and research. 

For simplifying the health insurance purchase process, here is a complete checklist which can guide you to buy the right plan –

• Choosing the right type of policy

  Health insurance plans come in different variants. As such, the first step is to pick the right type of plan. Here are some tips to do so –

  • If you don’t have health insurance coverage at all, buy a family floater health insurance plan. 
  • If you have a health plan but the coverage is low, you can opt for super top-up health insurance plans. These plans would help in increasing your coverage at affordable premiums
  • Critical illness health insurance plans are also essential as they pay a lump sum benefit in a critical illness. Add these plans to your portfolio for added protection
• Opt for an optimal sum insured

  After deciding on the type of policy, the next step is to choose an optimal sum insured. Remember that the health plan would cover you only up to the chosen sum insured. Given the high medical expenses, a high sum insured is essential. If the high premiums make a high sum insured difficult to avail of, go for super top-up plans and supplement your coverage. Whatever you do, ensure that your coverage is sufficient to cover the expensive medical treatments.

• Cover all the family members

  The next step is to ensure that all family members are being covered under the health insurance policy. Don’t leave any member out. For parents, opt for a separate senior citizen policy. Do not include them in your family floater policy as it would drive up the premium and eat into the no claim bonus. Moreover, a separate plan would also give you additional tax benefits. So, buy a floater plan covering yourself, spouse and dependent children and another plan for your parents.

• Check the coverage benefits

  You should ensure that the health insurance plan has all the necessary coverage features that you and your family needs. If, for instance, you would are planning to have a child in the near future, ensure that the plan allows maternity coverage. Similarly, if there are frequent consultations and outpatient treatments, check for OPD coverage. The plan’s coverage benefits should suit your coverage requirements so that all possible medical costs get covered.

  Also, health plans allow optional coverage benefits too called riders or add-ons. Check the riders available in the plan. If the riders are suitable to your needs, add them to your basic plan for an enhanced coverage. For example, if you want coverage against critical illnesses and the plan offers the critical illness rider, choose the rider and get covered against critical illnesses. Similarly, the maternity cover can also be offered as a rider which you can choose if you would be planning a family in future.

• Check for coverage sub-limits

  Many health plans impose a sub-limit or restriction on their coverage benefits. The most common example is the room rent sub-limit. These sub-limits restrict the scope of coverage and incur out-of-pocket expenses. So, check the sub-limits applicable under the plan. Try and avoid plans with sub-limits, especially in case of room rent. Except room rent sub-limit, if there are other limits in the plan, like limit on ambulance cost, domiciliary treatments, AYUSH coverage, etc., check the extent of such limits. The higher the limit, the wider would be the scope of coverage.

• Check the no claim bonus and health check-up benefit

  Health plans allow no claim bonus if no claim is made in a policy year. This bonus can either be an increase in the sum insured or a reduction in the renewal premium. Check the bonus allowed. Try and opt for cumulative bonus which increases the sum insured free of cost.

  Moreover, free health check-ups are also allowed either annually or after 2-4 continuous years. Look for the limits of such check-ups and their frequency.

• Check the hospital list

  For cashless claims you need to take treatments in a networked hospital. So, when buying health insurance, consider the hospital network list. Ensure that the hospitals in your city and locality are featured on the list so that you can avail easy cashless settlements in emergencies.

• Check the exclusions

  Knowing what is covered under the plan is not enough. You need to know what is not covered as well. Check the exclusion list of the policy to find out what the policy won’t cover. Check the pre-existing waiting period, especially if you or any family member suffers from a pre-existing condition, to know when such conditions would be covered by the plan.

• Compare the premium

  Lastly, compare the premium charged by different health insurance plans when buying. Compare the premiums vis-à-vis the coverage benefits to ensure that you don’t miss out on the coverage while seeking out the lowest premium. Choose a plan which offers the widest scope of coverage at the lowest premium rate.

Tick off all the above-mentioned points when buying a health insurance policy. The checklist would ensure that you get a right policy which would cover you against medical eventualities. After all, if the plan is right, you get complete financial security, don’t you?

It is that time of the year again when all eyes are directed at the Union Budget which would be presented on 1st February 2020. As always, before the actual budget is delivered, industry experts make their assumptions on what possible changes are expected. This year is no different. With the last year largely overshadowed by the COVID-19 pandemic, the budget is expected to have considerable health reforms.

Health insurance has always been an important cover against the financial implications of a medical crisis. Many individuals have opted for the cover to protect their savings against expensive medical treatments. Moreover, over the last year, the pandemic highlighted the importance of having health insurance plans. With hospital bills amounting to lakhs in case of severe COVID cases, people woke up to the importance of a health insurance policy. Even the Insurance Regulatory and Development Authority of India (IRDAI) directed the launch of COVID specific health plans – Corona Kavach and Corona Rakshak – which found many takers. 

From the tax angle, health insurance plans allow deduction on the premiums paid under Section 80D. The deduction limit is INR 25, 000 on a policy covering self, spouse and dependent children. Senior citizens, aged 60 years and above, can enjoy a deduction limit of INR 50, 000. Moreover, for buying a policy for parents, you can claim an additional deduction of up to INR 50, 000.

Earlier, the additional deduction for parents was INR 25, 000 but in an earlier budget, the limit was increased to INR 50, 000. Experts believe that this year, as the importance of health insurance has increased, the Finance Minister can come out with enhanced deduction limits. It is expected that the limit of deduction for individuals below 60 years of age would also be enhanced to INR 50, 000 from the current limit of INR 25, 000. 

This limit enhancement would have two benefits –

• It would motivate buyers to opt for high coverage levels and opt for a comprehensive coverage
• It would drive the penetration of health insurance policies

Health insurance penetration in India is steadily increasing since 2015. From a 22% penetration in 2015, the number increased to 35.6% in 2018. (Source: Statista). However, the numbers are still not very impressive. For the penetration to cross the 50%-mark, aggressive reforms are needed, both by the health insurance segment as well as by the Government. While the health insurance segment is constantly reinventing itself, with better reforms in the 2020 budget, it is expected that the Government would also do its part.

What reforms would be proposed by the Government would be disclosed on 1st February 2020. Meanwhile, the outlook is positive about strong health reforms for the next financial year.

After almost a year of battling with the Coronavirus pandemic the vaccine for the illness has become a reality. Although the vaccine rollout program is still in its nascent stages, the road ahead is positive. Institutes and companies like Bharat Biotech, Pfizer and Serum Institute of India have already applied for the authorization to sell their vaccines in the market while the vaccine being developed by Zydus would be available by the end of the year 2021. Frontline warriors have already begun getting the vaccine shot and senior citizens have been registered for the same. What about the cost of such vaccination? Would it be covered under your health insurance policy?

If you are looking for a generic answer, the answer is ‘No’. The cost of vaccination forms a part of OPD expenses which are not covered by most health insurance policies, even COVID-specific health insurance plans. However, this is not the universal answer. In some cases the cost of the vaccination can be covered under the health insurance policy. Let’s find out how –

Case 1 – If vaccination is a part of inpatient hospitalization

If you are hospitalized for COVID and you get the vaccination shot as a part of treatment of the illness, the vaccination would be considered to be a part of your inpatient hospitalization treatment. In such cases, all health insurance plans would cover the cost of the vaccine.

Case 2 – If your policy has an OPD cover or you opted for one

Another situation in which the cost of the vaccine would be covered under your health insurance policy would be if you have OPD coverage in your health insurance plan. Though most health insurance plans do not allow coverage for OPD expenses, many policies have an inbuilt OPD coverage benefit. Moreover, many plans offer OPD coverage as an optional additional benefit. So, if your plan has OPD coverage as an inbuilt benefit or you have paid an additional premium to avail OPD coverage under the plan, the cost of vaccination would be covered.

However, under OPD coverage, here are a few points that you should remember –

• Plans with inbuilt OPD coverage might have higher premiums
• If you opt for OPD cover as an add-on, the premium would be increased
• OPD coverage is allowed up to a certain limit. If the cost of the vaccine is higher than the allowed coverage limit, you would incur out-of-pocket expenses

What should you do?

Check the coverage of your health insurance plan. If you are opting for elective vaccination and your plan does not have OPD coverage, you would have to bear the cost of the vaccine. Even if the plan has OPD coverage, check the coverage limit as you might incur additional costs on the vaccine. If, on the other hand, you are hospitalized for COVID and you get vaccinated, your health insurance plan would cover the cost of the vaccine. 

So, the coverage for the cost of the vaccine depends on your health insurance plan and when is the vaccine administered. Even if the cost is not covered in your health insurance policy, it would not be too considerable to be affordable. Getting vaccinated against the pandemic is important, even if you have to pay from your pockets, isn’t it?