What is Health Insurance? Why it is Important for all?

What are health insurance plans?

Health insurance plans are a type of insurance coverage paying for health-related expenses. It can cover the costs of medicines, surgeries, hospitalization, day-care procedures, critical ailment treatments, and other medical expenditure the policyholder incurs.

Due to escalating healthcare costs, proper treatment for medical conditions can dent your savings. Also, when a crisis arises, unless you have the funds at hand, arranging for timely medical assistance can be challenging. Health insurance protects you from such financial strains. It ensures access to quality healthcare.  

Importance of health insurance plan in India

A health insurance plan is essential in India because of escalating medical care costs. Medical inflation is increasing at double the rate of overall inflation. According to the Government’s 2018-19 Economic Survey, the average retail healthcare inflation rate is an alarming 7.14%.

Moreover, in India, the burden of lifestyle disorders is also growing.

Chronic health conditions such as heart problems, cancer, and liver diseases, need long-term follow-up therapies. Studies show that 85.42% of Indian households facing economic instability due to health expenses have a critical illness in the family

Unfortunately, in the matter of health insurance, India is underinsured. As per the National Sample Survey (NSS), over 80% of Indians do not have health insurance. The Insurance Regulatory and Development Authority of India (IRDAI) says that out-of-pocket spending on medical care is 64%.

The lack of health insurance causes Indians to dig into their savings, sell assets, or take loans to pay for medical expenditures.

Therefore, if an unforeseen medical concern crops up, the cost of hospitalization and adequate treatment can derail finances. The situation becomes more complicated if the person whose earnings sustain the household loses their income due to ill health.

Paying a small premium for health plan insurance can help you avoid such financial uncertainty.

Why should you buy a health insurance plan? 

From luxury expenses like foreign holidays to necessary expenditures like children’s higher education, the need for funds are many. Effective arrangement for such funds necessitates planned investments. However, you may have to spend a large portion of your income on basic amenities and immediate needs. It may leave very little surplus for future requirements. Therefore, financial experts advise that before you consume your entire salary on day-to-day expenses, you should set aside a sum for the future.

The problem arises when the amount that you can save regularly is small in comparison to the funds that you may need later. Herein lays the need for wealth building, which grows the money you put aside. A money-saving plan helps in increasing your savings over time so that enough capital accumulates when the need for funds arises. Here’s a look at reasons for buying such plans.

• Provides financial security
• Diagnostic tests
• Doctor’s consultation charges
• Hospital bills
• Medicine prices, chemotherapy costs
• Ambulance charges
• Pre and post hospitalization
• Enables you to fight critical illnesses
• Helps you get the best treatment
• Covers hospitalization expenses
• Acts as income replacement 
• Takes over future premiums during ill health
• Provides a safety net against accidents
• Protects your family’s health
• Reduces income tax
• Arranges for transportation in medical emergencies

Important Features and Components of a Health Insurance Plan 

The notable components of a medical insurance plan include:

• Sum insured: The maximum amount you can claim against your medical expenses or the maximum payout the insurer guarantees on the detection of diseases covered.  
• Premium: The amount you pay to your insurer to enjoy the health coverage, either at one go or throughout the policy period
• Policy period: The duration through which your health cover remains active, and you can raise claims for health issues covered
• Network hospital: Hospitals having tie-ups with your insurance companies, allowing cashless treatment on admission
• Cashless treatment: Hospitalization without having to pay the bills yourself, on admission to the insurer’s network hospitals
• Deductible: The amount you must pay from your resources before your insurer starts paying their contribution towards your medical expenses
• Co-payment: The fixed percentage of medical bills you agree to pay yourself while the insurer pays the balance, effectively reducing the payable premium  
• No Claim Bonus: Increase in sum insured during policy renewal at no extra cost as a reward for a no-claim policy year
• Daily Hospital Cash Allowance: Lump-sum amount paid for each day spent in the hospital subject to a minimum hospitalization period
• Critical illness cover: Medical insurance against life-threatening, non-infectious health conditions, offering lump-sum payouts on diagnosis
• Policy lapse: Termination of health covers on missing premium payment on time
• Grace period: Timeframe the insurer permits for delayed premium payment after the renewal due date before the policy lapse
• Waiting period: Time gap from the policy start date before insurers start paying for claims
• Policy revival: Reinstating your health policy, allowed within five years from the date of due premiums

How do health insurance plans work?

A health insurance policy is an agreement between you and your insurance provider. You agree to pay a fixed premium. In exchange, the insurer promises to pay for the healthcare costs covered under your plan, arising during the policy period.

Health insurance can be classified into two categories:

• Mediclaim or indemnity medical policies
• Critical illness insurance plans

The payouts are based on the cover you choose and not on the actual expenses. Thus, you are free to undergo treatment from any hospital of your choice, even abroad. The monies help you meet costs such as

• Doctor’s fees
• Follow-up health check-ups
• Medicines and dietary supplements
• Physiotherapy and other rehabilitation treatments
• Monitoring devices

You can also use the payout to fund your family’s living costs, EMIs, your children’s education fees, and more. 

Who should buy health insurance plans?

Health insurance plans are a necessity today. The coverage opens the gates to quality medical care regardless of your family’s resources.

Therefore, if you have started earning, and want to protect your finances against rising healthcare costs, you must buy health insurance. You will stay financially prepared and free from anxiety in a health-related contingency. It can also maximize your tax savings.

How much health coverage do you need?

The amount depends on the following parameters:

• Age: At a younger age, you can settle for lower coverage. But health complications increase with age, increasing the chances of a health insurance claim. Hence, as you become older, the premiums also become costlier. However, with specific health insurance types like critical illness covers, regardless of age, the premium remains fixed. Thus, it is advisable to buy a sizeable coverage even at a young age.
• Health: If you do not suffer from any health condition, low coverage might be acceptable. But with health issues like obesity or hypertension, the odds of lifestyle diseases increase.
• Also, even if you are healthy, look into your family’s medical history. Some diseases like diabetes are often hereditary and lead to complications like liver damage later. It is better to secure coverage against such ailments in advance.
• Budget: An expensive medical policy that eats into your earning defeats the purpose of health insurance – safeguarding your finances. Hence, buy coverage with a premium you can serve throughout the policy term.

How to choose a good health insurance plan?

Anybody who has a health insurance policy will tell you that buying one is one of the smartest financial decisions by any earning individual. Now, that you have decided to buy a health insurance policy, you need to know how to select a good health insurance plan that will take care of all your needs. Here is a list of benefits any good health insurance plan should offer you:

• Protection against a large number of critical illnesses
• Flexibility to choose your health cover
• No increase in premiums during the policy term even if your health condition changes
• The long-policy term that covers you even in your old age
• Large hospital network for easy access to medical treatment