Insurance plan

Is your health insurance plan suitable for your current lifestyle?

By Amit Ganorkar

“30 is the new 20” can be music to the ears. Medically, it seems, “30 is the new 40.” Diseases that were commonly associated with old age until a generation ago are rampant among young people. Today, it is common to see people in their thirties taking pills for high cholesterol or high BP or taking insulin injections. It is also common to see young people relying on inhalers to combat pollution-induced asthma attacks. The incidence of young victims of heart disease is also increasing day by day.

The double whammy of a sedentary lifestyle and long, stressful working hours means nothing but ruin. Lack of sleep, unhealthy eating habits, and the dark shadow of uncertainty cast by the pandemic are among the many other reasons behind the early onset of burnout, both mental and physical.

Identify your health insurance needs

With unpredictability becoming synonymous with life, the only way to exercise any semblance of control is to obtain comprehensive health insurance coverage. To get started, identify your health insurance needs and the optimal amount of insurance you need; Determine if you need a health insurance plan just for yourself or one that also covers your family members. Accordingly, you can opt for an individual plan or consider a family health insurance plan.

Then, narrow down the type and extent of coverage you need based on your age, family medical history, pre-existing conditions, if any, nature of medical expenses, medical inflation, etc. Since health insurance policies are lifelong renewals, it is relevant to opt for such policies from insurers with a strong brand image.

Financial liabilities such as loans or income tax savings are other things that should also be considered when purchasing a policy.

Read also: Should you subscribe to a multi-annual mutual fund?

Right age to buy a health insurance policy

Our parents usually planned to get health insurance coverage as they approached their 40s. However, in the wake of the early onset of lifestyle diseases, it is wise to take out a plan as early as age 30. Age is an important factor when purchasing a health insurance policy. The sooner one buys a health insurance policy, the better.

Most insurance companies require a pre-policy medical examination before issuing a health insurance plan and it depends on the coverage chosen and medical/health conditions, if any, apart from age . Whereas diseases such as obesity, hypertension, cardiovascular disease, diabetes, lung cancer, etc. generally stem from an unhealthy lifestyle, it is strongly advised to take out a policy when these conditions are absent or controlled without associated complications.

Get yourself some coverage before poor lifestyle choices take their toll and begin to reflect through deranged biomarkers. Second, depending on the health conditions an individual is suffering from – there is a strong possibility that the individual will be subject to an underwriting lens prior to acceptance of the proposal.

And remember that most health insurance policies do not cover pre-existing conditions from the first day the policy begins. Depending on the health insurance plan purchased, these pre-existing conditions are covered after a waiting period which is usually 36 or 48 months from the effective date of the policy.

It is also important to keep in mind the experience of the COVID-19 pandemic and therefore postponing the purchase of a health insurance policy would not be a prudent decision.

Choose the best health insurance

If your health report is all green, opt for a health insurance plan that offers comprehensive coverage and don’t look for any restrictions applied in the product, such as room category restriction, sublimits per illness/disease, capping of medical/surgeon fees, etc. -payout, OPD coverage and plan that provides a higher cumulative “no claim bonus” for each claim-free year. There are plans on the market that also offer annual preventative health checkups.

In addition, there are certain diseases that require significant expenses before and after hospitalization. In this case, opt for a plan that offers a longer period of coverage for pre/post hospitalization expenses. There are different plans with varying coverages and premiums and great discretion is required. With the pandemic highlighting the role of co-morbidities in recovering from Covid, it makes sense to choose a plan that covers medical expenses related to Covid-19 such as consumables (e.g. PPE/Gloves/Faceshield etc.) .

Immense research has taken place in the field of medical/treatment technology, both diagnostic and therapeutic, which leads to medical inflation. Therefore, plans with higher sum assured options (Rs. 10 lakh and above) are something one should look into. Second, access to health care abroad is another key thing to keep in mind. Insurers have started to offer comprehensive coverage in their health insurance plans. Opting for such a policy will be an added advantage.

Also Read: Rs 1 Crore Health Insurance – Do You Really Need It?

In the case of younger people, health insurance plans that offer maternity coverage should not be ignored. The need for this coverage must be aligned according to his needs.

The density of the insurer’s hospital network should also be researched when purchasing the policy. Individuals should check the availability of those network hospitals that offer cashless facilities in their city/neighborhood and then freeze the health insurance plan.

The bottom line

From a macro perspective, choose an insurer that has a strong brand image and a policy that has a large network of hospitals, no sub-limits on hospital room rent, covers consumable expenses, comprehensive treatment coverage, plans offering OPD coverage and definitely a hassle-free claims process.

The main thing is – Just get a blanket. The right cover.

(The author is Chief Operating Officer, Tata AIG General Insurance)