As more people begin to take their health seriously, they naturally gravitate towards buying health insurance plans. Fortunately, the Indian health insurance market offers various plans to accommodate varied insurance needs. Individual health insurance policies and family floater plans are the market’s two most popular and commonly available plans.

Also Read – SAFEGUARDING MOTHERHOOD WITH METEERNITY COVER IN HEALTH INSURANCE

You can pick whatever policy type matches your requirement. Unmarried individuals with no significant responsibility tend to choose individual health insurance policies, while family people choose family floater plans. People with dependent parents can get inclined toward family health insurance plans too. But what if your requirements change over the years? It has happened with many and can happen with you too.

For example, you may have felt that an individual health insurance plan can be perfect for you, but later, you might feel the need to add your parents to the same coverage. So is adding your parents to your current health insurance plan the wisest option? Not really. Read along to find out why policyholders should think twice before adding their parents to their existing health insurance plan and the best alternative.

Effect on Overall Health Insurance Premium

If you have invested in a family floater plan or are planning to switch from an individual to a family floater plan, adding your parents to the coverage can result in a high premium. Older people are more vulnerable to diseases, illnesses, or other serious health hazards than young people. It is why including them in your current plan can significantly increase your premium amount. 

There are better ways to secure your parents than adding them to any existing policy. Having your parents covered under policies offering special coverage benefits for older people or covering more illnesses or diseases is way better than any regular health insurance plan. You should look for health insurance for parents with specialised coverage for senior citizens, and the premium is reasonable.

Also Read – SAFE AND AFFORDABLE DRINKING WATER: ESSENCE OF KNOWING HEALTH WATER

Pre-existing Illness Might Increase the Premium

Many senior family members have some existing disease or illness, mild or severe. In such a case, if you choose to add them to your current coverage, be prepared to pay high premiums. It can also affect your overall coverage; the total might become too small to cover every member’s medical requirement.

You can start filtering out policies designed especially to meet the needs of senior citizens. For such cases, it is best to look for separate health insurance plans that cover illnesses or diseases your parents are diagnosed with. Plans with a comparatively lesser waiting period, better coverage, and reasonable premiums should be your choice.

Your Chances of Claiming No-claim Bonus can be reduced

You would know about the no-claim bonus if you already have a health insurance plan. It is a reward insurance companies give to policyholders through discounted premium rates during policy renewal. It can only be availed if you don’t file claim requests for a set of consecutive years. Depending on the insurer, it can be two consecutive years, three years, or more.

When you include senior citizens in the policy, it is doubtful that you will not file claims for two or three years straight. However, there can always be exceptions. Since older people can easily catch a new disease, infection, or illness, they may require immediate medical attention and treatment at the earliest, which will require you filing for claims. Hence, buying a separate health insurance plan is best, so you don’t have to worry about losing the no-claim bonus benefit in your existing policy.

Also Read – DIABETIC EYE DISEASE – HOW IT AFFECTS YOUR EYE VISION?

Existing Coverage Might Become Insufficient

Individuals with a spouse and two children require good coverage to meet future medical costs. If you add your parents to this equation, the existing coverage might become insufficient for all. The coverage can become insignificant if your parents have any pre-existing disease or illness.

If you still want to add your dependent parents to the existing policy coverage, consider buying some relevant add-ons to upgrade your health insurance coverage. Another option is purchasing a new policy to ensure the cover doesn’t fall short at any future date. The market offers various health insurance plans geared towards the requirements of senior citizens, so start investing in one of those.

Corporate Health Insurance Coverage is Not Permanent

Most corporate employees are covered under a group health insurance policy. Although group or corporate health insurance plans generally cover the employee or policyholder and their spouse, they can also cover dependent parents on request or additional payment. The terms and conditions will vary from one company to another, so it is best to get them clarified by HR.

Will it be enough if you get your parents covered under corporate health insurance? The answer is a big no. The biggest flaw with corporate health insurance policies is they’re valid only till you work with the particular organisation.

So if you choose to leave your current company, the insurance benefits will also cease for you and your parents. If you don’t want your parents to get deprived of insurance benefits, make sure you cover them in a separate insurance plan that offers generous coverage and whose validity doesn’t depend on your employment status.

Also Read – BENEFITS OF EXERCISING DURING PREGNANCY

A Better Option to Consider

Choosing the correct health insurance policy for your family is half the work done. If you have dependent parents, you cannot risk adding them to your existing coverage. Doing so will eventually make the total coverage insignificant for each member. To ensure every family member’s needs are adequately covered, you should always look for separate health insurance plans offering higher coverage. You can choose to keep an individual health insurance plan for yourself and buy another policy to cover your parents.

Health insurance policies designed especially for senior citizens offer better coverage and add-ons than most regular health plans, so start your search accordingly. Maintaining two policies can be challenging, but it will always pay off during emergencies.

Also Read – PAIN KILLERS CAN DAMAGE KIDNEYS

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Celebrating motherhood traverses beyond just a dedicated day. Stepping into motherhood is one of life’s most remarkable transformations. Apart from phenomenal strength and patience, one also needs to ensure overall health, wellness and financial security during pregnancy and childbirth. The cost of diagnostics, procedures and hospitalization is a common concern for couples planning a family.

Going by the stats, a normal or C-Section delivery can cost anywhere from Rs 50,000-Rs 70,000. If you stay in a metro city, the cost can touch a lakh and above. Coupled with pre and post-natal expenses throughout the pregnancy, the cost can weigh heavily on an average family. Moreover, though covered by corporate insurance, the amount does not sufficiently incorporate healthcare inflation, increasing at 18-20% annually. To shield yourself and your family against these costs, you must opt for maternity benefits in your health insurance. Here’s all that you need to know about it.

What is a Maternity Cover?

Maternity cover in health insurance is designed specifically for expecting mothers to protect them against delivery or pregnancy-related costs so they can be financially at ease about welcoming their new-born into the world. These are usually provided as an additional rider with an existing health insurance policy, covered under the scope of OPD-related expenses, or offered as a part of the group policy in the company that encompasses maternity insurance.

Why is Maternity cover required?

For to-be-parents, on one end, there are pregnancy jitters, and on the other, there is the dangling worry of hospital bills that may make their financial planning go haywire. This is likely to happen in the case of child-birth complications or C-section delivery, leading to extended post-delivery hospital stays, thereby ascending the overall medical expense that would include medicines and hospital charges. Hence, with maternity health cover, you will be able to save yourself from financial distress and from using the funds you had kept aside for your baby’s future in the first step itself, i.e. delivery. Likewise, it will also offer adequate financial coverage for treatment related to pregnancy and delivery costs. Available at a low cost if wisely bought as a part of an add-on to your existing health insurance plan, this insurance is vital for the well-being of the mother and the child.

When to purchase the Maternity Cover?

Many insurance companies have thoughtfully developed maternity plans targeted at couples aged 20 to 35 years. For instance, the Aditya Birla Active Health Platinum and Enhanced Plan offer a sum assured varying from Rs 2 lacs to Rs 2 crores, with a specific amount being allotted for maternity-related hospitalization lawful medical termination of the pregnancy, and new-born baby’s expenses such as medical treatments, vaccinations. However, with most companies offering a waiting period ranging from 2 to 4 years and a few 9+ months, it is ideally recommended to purchase this add-on upon getting married or even in the middle or at the time of the health insurance policy renewal. This way, the couple can timely eliminate the waiting span and plan a baby worry-free. An important factor, however, in this case, is to opt for the maternity cover before conceiving, so the insurance firms do not deny it considering pre-existing pregnancy.

Also Read: Health insurance policies need to be more women-centric : Study

What is covered?

The maternity insurance add-on is mainly a comprehensive coverage that guards against pre-and post-hospitalization expenses, ambulance charges, and the cost of the baby from delivery to 30-90 days. A considerable advantage is that most insurance companies deliver cashless claim settlements at all network hospitals. However, for non-network hospitals, the process is to submit documents, follow the reimbursement process, and get a claim settlement. It also helps save tax benefits of Rs 25,000 in one financial year under Section 80D of the Income Tax Act, 1961.

A recent addition has been the inclusion of infertility treatments like in-vitro fertilization (IVF) by a select few insurance companies. One such plan is Star Women Care Insurance Policy, available as both an individual and a floater policy. Apart from covering regular hospitalization and preventive health check-ups, it offers coverage for assisted reproduction treatment, delivery (pre and post-natal cover), multiple medical consultations,  voluntary sterilization, and child hospitalization. Females aged 18 to 75 years can avail of this for 1, 2 and 3 years without undergoing any premedical tests to avail this policy.

What is not covered in Maternity Health Cover?

Some exclusions that should be considered by the policyholder as much as the inclusions before purchasing the plan are-

• Does not cover money spent on supplements, vitamins, or tonics as it is considered an additional expenditure.
• The maternity health insurance plan will not cover pre-existing diseases like high blood pressure, epilepsy, etc.
• Genetic medical conditions like Down syndrome, heart disease, or spina bifida in children before or at birth are not shielded.
• Existing pregnancy will not be covered at the time of purchasing a new policy

Who is Eligible to opt for the cover? 

The eligibility for purchasing the maternity cover is straightforward. You need to fulfil the entry age criterion that varies from policy to policy. Also, some insurance companies may have a cap on only two maternity claims except in case of loss.

As a closing remark, motherhood is a new chapter in women’s lives, and it is vital to ensure that the family gets all the financial and medical aid throughout the process. So, before choosing your policy, always compare online, and cross-check the waiting period, the inclusions and exclusions. Also, read the terms and conditions to obtain the maximum benefit and keep the process smooth and hassle-free.

Authored by:

Amit Chhabra

Head – Health and Travel Insurance

Policybazaar.com

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Any person is always eager to contribute to the well-being of his/her family. When you are shouldering such a responsibility, the mental and physical health of your family members is the priority.

The ideal way to ensure you and your family members are protected is to buy health insurance as soon as you can. Family health insurance ensures you are giving your loved ones access to the best medical care and securing their present and future.

It is a smart way to get your family under the cover of insurance without compromising on any of the benefits and controlling the premium as well. Family health insurance packages ensure all members of your family, old and new, are well looked after. You can customize the package as per your needs and get the best deal.

If family health insurance is so critical, then how do you decide which is the best fit for you? Here are a few things you might want to look at while making a decision.

Also Read – Health insurance policy : what is the need?

Factors to consider while buying health insurance for family:

1. Assess the members to be included – The primary factor to consider is how many members and who all do you wish to get insured. If you are a smaller family or just a couple of you, then the Family floater health insurance plan is recommended for you.

If you are a big family with dependent aged parents, then the individual family floater plan is recommended for you. The difference is that in the first one you get a combined amount which has to be shared amongst all family members while in the latter, every person is assigned a separate amount.

The kind of policy you should get is largely dictated by the age group of the family members you wish to insure. Older people generally require more medical attention and the plan you choose should reflect this requirement.

2. Calculate the premium of policies – Designing a health insurance plan around your budget can be tricky when you wish to take care of the whole family. The best tool at your disposal is the health insurance premium calculator that can tell you the premium you will end up paying each month.

This will not only allow you to chart a course for your financial journey through the year but also give you a fair idea of whether the policy chosen by you fits in your budget or not. A premium calculator is a handy tool when you are comparing different policies and want to consider the impact of the premium paid on your savings.

Since health insurance is one of the tax-saving options you have, the premium calculator gives you a fair idea of how much you are contributing to the tax-free pot monthly as well.

Also Read –Health insurance policies need to be more women-centric

3. Identify the benefits – Premium, settlement ratio, and other such statistical data would not make any difference if the benefits of the family health insurance policy do not align with your requirements. Here are a few benefits you wish to look at when you are considering buying insurance for your family.

a. Critical illnesses – You should consider investing in your family’s health rather than a specific policy. A policy that covers critical illnesses like kidney failure, heart attack, and so on is important especially when you have aged parents depending on you. With the drastic lifestyle change, it is also possible you may have to use this cover for yourself, irrespective of your age.

b. Accidental hospitalization – Mishaps cannot be predicted and this benefit is essential irrespective of the age group of your family members.

c. Annual health checkup – Prevention is better than cure and early detection of illnesses can save a lot of time and pain. Annual health checkups are important for everyone to be done to avoid difficult situations. Psychiatric benefit

Also Read – Demand for health insurance policies have increased

4. Consider buying the additional benefits – Along with the requirements of your current family, you also need to think about what you might need in the future. If you are planning to build a family soon, then you may wish to look at maternity benefits with newborn baby cover.

There are a few additional factors that you need to consider. For example, if you prefer alternate treatments like Ayurveda, Unani, Siddha, or Homeopathy, you can have that additional benefit added to your family health insurance.

If you plan to move during the year, you should consider looking at the zone upgrade which allows you to get access to medical attention in a different city (zone) with any hiccups along the way.

5. What is not covered? – Just like you need to be aware of what is covered under your insurance policy, you should also be aware of what is not covered under it. Reading the fine print ensures you are not stuck in a sticky situation when you need the help of your family health insurance policy.

Pre-existing illnesses have a waiting period before the clause of the health insurance policy is applicable. During the waiting period, no claims can be made concerning the critical illnesses declared before.

Pre-natal and post-natal medical expenses are not covered unless it leads to hospitalization. Generally, hospitalization that is not recommended by the doctor is also not covered under the family health insurance policy.

Also Read – What is health insurance policy

The factors to consider while buying family health insurance may seem daunting but they make your life easier in the long run. The impact of these policies may be deeper than anticipated by you.

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To address the increasing number of Kidney Failure patients in India, the Insurance Regulatory Development Authority of India (IRDAI) has released the much-awaited policy guidelines to include Peritoneal Dialysis (PD) in the ambit of private insurance coverage. According to the guidelines, patients taking treatment of PD can make reimbursement claims on a monthly basis through an approved pre-authorization procedure.

The provisions of the new guidelines have been in effect from 1st October 2020. According to Pradhan Mantri National Dialysis Programme (PMNDP), in India, 2.2 lakh people get affected by ESKD who are on dialysis or transplant for treatment. Dialysis becomes the only option for these patients who are waiting for the transplant. There is a demand of 3.4 crore dialysis with only 4950 dialysis centres approximately in India.

The recent development allows kidney patients to avail the benefits of the home-based and cost-effective PD therapy which can enable both patients and nephrologists to put patients on PD rather than only hemodialysis to aid the kidney failure population in the country.This will also enable both doctors and patients analyze and choose their choice of dialysis treatment based on the patient’s lifestyle. The insurance companies’ long-awaited approval of PD’s inclusion in health insurance plans also comes at an opportune time when the public is cautioned to stay indoors owing to the COVID-19 pandemic and avoid hospital-acquired infections in a healthcare setting.

“IRDAI’s decision of including Peritoneal Dialysis under insurance policies will eliminate the exorbitant expenditure associated with carrying dialysis at home as until now, only the conventional Haemodialysis was covered under insurance policy. Around 63 million people on dialysis are pushed in debt due to expenditure related to health. At times patients miss their dialysis as they fear incurring out-of-pocket expenses. It is critical to understand that every dialysis session matters when a person is suffering from kidney failure. Patients should not be given a single reason to withdraw from the treatment at any point”Now doctors can prescribe the best therapy method to ensure patients receive best treatment without compromising on quality of life.

Dr. Sunil Prakash, Director & Head, Nephrology and Renal Transplant Service, BLK Superspeciality Hospital, New Delhi commented “IRDAI’s decision of including Peritoneal Dialysis under insurance policies will eliminate the exorbitant expenditure associated with carrying dialysis at home as until now, only the conventional Haemodialysis was covered under insurance policy. Around 63 million people on dialysis are pushed in debt due to expenditure related to health. At times patients miss their dialysis as they fear incurring out-of-pocket expenses. It is critical to understand that every dialysis session matters when a person is suffering from kidney failure. Patients should not be given a single reason to withdraw from the treatment at any point” Now doctors can prescribe the best therapy method to ensure patients receive best treatment without compromising on quality of life”.

Dr Mahesh Eswarappa, Professor and Head Department of Nephrology, M.S. Ramaiah Medical College, Bangalore, commented “Insurance policies covering Peritoneal Dialysis under their ambit will save millions of lives residing in remote areas of India. Dialysis demand is growing at a rate of 31 percent in the country. Even though most of the patients suffering from end stage renal disease start dialysis, about two-third of them withdraw due to financial barrier. Earlier IRDAI had recognised only Haemodialysis under insurance schemes but now with PD’s inclusion in insurance policies, we will be able to look at both the treatments at par in terms of coverage. The country has seen less adoption of PD through the years due to high costs. As we are covering it under insurance schemes, treatment through PD should increase now”.

Earlier, only Haemodialysis was covered by health insurance policies but now, the latest revisions in the health coverage can be proven to be more comprehensive and efficient for the policyholders. PD allows patients to move freely at home and maintain a flexible lifestyle. One can perform the therapy as per convenience without having to worry about visiting a hospital unlike the conventional Haemodialysis which demands a patient to visit a hospital 3-4 times a week. PD saves patients multiple clinic visits and is generally more cost effective and scalable as it can be carried out at home and has lower infrastructural requirements.

Despite PD’s potential advantages, its penetration in the country is very poor. According to a report, there were just about 8,500 patients on PD in India in 2019. However, with effective reforms in our healthcare system, such progressive decisions can address challenges pertaining to accessibility and quality healthcare in the country to reach even the vulnerable and the marginalized sections of the society.

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Mumbai : Considering the higher incidence of mental health issues in India, especially during the on-going pandemic, Future Generali India Insurance Company Limited (FGII), announced the launch of an online mental health assessment test – Total Health Score. This unique self-assessment will enable an individual to evaluate the quality of one’s mental well-being. FGII encourages everyone to take their mental health seriously and emphasises that one’s mental health is as important as physical health to be healthy inside out.

The Total Health Score is a questionnaire & API based assessment that is designed by practicing therapists and counsellors who understand the early signs of potential mental health issues. Once the individual completes the assessment s/he will be attributed a score that outlines the current state of his/her mental health. In addition, s/he will have access to self-care content to understand & manage various mental health issues like stress, anxiety, depression and other related concerns. The self-care content is developed by mental health experts specially for Future Generali.

Anup Rau, MD & CEO, Future Generali India Insurance said, “Our objective is to be a lifetime partner for our customers and demonstrate expertise with a human touch. We can only achieve this if we truly understand India’s cultural norms & constraints and enable some difficult conversations. We all know that mental health is considered a taboo. As a brand, we want to steer healthy conversations around mental well-being and change people’s approach towards it. The starting point of this mindset change is to get people to understand that mental health is as important as physical health and give them quantifiable ways to measure it.  Hence, we created the Total Health Score, a simple questionnaire and API based score that helps quantify your mental health at the time of taking the test.”

Anyone interested in knowing their health score can take this assessment on FGII’s website or use the FG Insure app.

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Amidst the rising cases of COVID-19 reaching close to 9 lakh and the limited public healthcare infrastructure and resources in India, the surplus cases will go to private hospitals, which is beyond the affordability of a common man. As per reports, more than 80 per cent of COVID-19 patients are asymptomatic or have mild symptoms and do not require hospital care. In such a situation, home healthcare is helping address a substantial portion of the present healthcare requirement.

Demand for health insurance policies have increased:

As COVID-19 has expanded the market for home healthcare providers, the number of patients seeking home healthcare services will increase accordingly. Also, in the wake of the pandemic, there has been greater concern and awareness about health, and enquiries about health insurance policies have increased by 30–40%. The pandemic also provides an opportunity for insurance companies to innovate and serve the evolving needs of a more informed population. Several insurance companies have come forward and added home healthcare segments in their healthcare policies.

Recently, ICICI Lombard General Insurance has added benefits related to the treatment of corona virus to its existing health insurance indemnity policies. Apart from leading hospitals, ICICI Lombard has tied – up with top home care service provider — Healthcare at Home (HCAH). Our recent tie-up with ICICI Lombard, GIC has offered additional benefits to the insured patients, at no extra cost. This would enable the policyholders to derive maximum benefit from their health insurance cover. As part of this offering, insured patients can get themselves treated at home instead of having to avail hospitalization to avail of the insurance claim.

This will significantly benefit those patients who wish to avail treatment for any ailment in the safe environment of their home, rather than a hospital, thereby ensuring social distancing and reducing COVID-19 infections. This will also go a long way in benefiting the patients who will tend towards home healthcare and also help in increasing the number of health insurance seekers. Also, amid COVID-19, and after, the Indian home healthcare users are expected to grow significantly.

The most common symptoms of COVID-19 are fever, coughing, and breathing problems. Unless you have severe symptoms, you can most likely treat them at home, the way you would for a cold or the flu. Most people recover from COVID-19 without the need for hospital care. The role of the insurer while providing home care services is also worth mentioning here — when the treating doctors prescribe the insured to undergo home care treatment, the insured intimates the insurer for service which is facilitated with the help of network service provider having expertise in this line of treatment.

The service provider provides treatment as per the prescription/standard clinical protocols. In case of admission required at the hospital, the insured is guided with the next course of action by the treating doctor/service provider. The insurer plays the role of the facilitator for cashless & reimbursement service. This is a very transparent process, which will help the insured patients, and invite more to seek healthcare insurance.

Mr Vivek Srivastava – Co-Founder & CEO
Health Care at HOME (HCAH)

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Plum, a Bengaluru based group health insurance startup, providing modern health benefits to corporates, has raised INR 7 Crores in seed funding. Plum is on a mission to enable employee health insurance for over 1.1 million companies in India by reinventing how health insurance works. The company plans to use the funding to scale business & engineering teams so as to solve some of the hardest engineering challenges in Insurtech and build innovative distribution channels. Within just 4 months of launch, Plum has managed to get over 100 companies as customers.

Plum, through its online platform, www.plumhq.com, provides employers & employees with customizable plans, transparent pricing, and high-quality healthcare experience. The platform understands the needs of a corporate and guides them on setting up their group health insurance in less than 60 mins. Plum combines modern technologies with robust processes to deliver unprecedented simplicity & efficiency.

Plum additionally helps employees with improved health benefits including doctor consultations, health check-ups, fitness & yoga, mental wellness, nutrition and dental care. The platform enables ease of experience for employees with guided claims support. Plum has an insurance intermediary license from IRDA. Taking the current situation into account, Plum also offers COVID-19 cover as an offering to its customers, however big or small they are.  Plum’s clients include Twilio, Instawork, Posist, RevvSales, The Label Life, Growfit, StayAbode, Fampay, myHQ, and Jiny.

India’s population will rely on employer-sponsored health insurance:

Plum was founded in late 2019 by Abhishek Poddar and Saurabh Arora who comes with rich experience in financial technologies and insurance distribution. Abhishek, a Stanford University alumnus has worked with Google and McKinsey and built technology companies. Saurabh led product & engineering teams at Freshworks (he had previously built Airwoot, an AI-based CRM company which got acquired by Freshworks). Abhishek and Saurabh were joined by Debankur Biswas, an FMS alumnus with 17 years of experience in building insurance distribution and has led operations for Insurtech player BIMA in Srilanka & Bangladesh.

Abhishek Poddar, Co-founder & CEO, Plum says, “When we look at other countries like the US, we see that a high percentage of the population is covered under employer-provided health insurance. We believe that India too will move in that direction, where a significant portion of India’s population will rely on employer-sponsored health insurance. With Plum, we want to enable every last company in India to provide a high-quality health cover to their employees, no matter how small or big they are. We want to be the de-facto platform for employee health insurance, initially in India, and later in other developing markets like SE Asia and Latam.”

Saurabh Arora, Co-founder and CTO of Plum, added,  “At Plum, we are imagining group health insurance products from ground-up. We have built underwriting and fraud detection rails with insurance companies that never ever existed. This has enabled us to offer pricing that may be up to 80% cheaper than existing market pricing, to companies as small as 7 employees. At Plum, we are building a truly online insurance platform that covers frontend (distribution) and backend (pricing, carrier and compliances).”

Nao Murakami, Founder and General Partner at Incubate Fund India said, “Health insurance is now becoming a “must-have” product in India, especially in the post-COVID world. It is an essential component for companies to attract talent. However, group health insurance is a very complicated product in nature and the entire customer process from buying to claiming is still very manual in India. So, there is a huge gap between insurance companies, employers, and employees. Plum is filling this gap by bringing transparency and efficiency through beautiful technology and product. Abhishek and Saurabh have a very clear vision which aligns with what we see as a future of health insurance in India”.

The group health insurance market in India, which is almost 50% of the total health insurance market, is expected to grow to INR 100,000 crores by 2025. It has seen an annual growth of about 25% in the last few years and is doubling every three years.  The seed funding round was led by Incubate Fund with participation from Gemba Capital and Tracxn Labs along with angel investors including Abhijit Gupta and Ram Sahasranam of Praxify Health, Sudheendra Chilappagari of Belong.co, Nitin Jayakrishnan of Pando and Alvin Tse of Xiaomi.

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