If this ongoing pandemic has taught us anything, it is that health comes before anything else. However, health is an unpredictable entity, even in an ordinary world. Add a catastrophic epidemic and inadequate insurance coverage on top of that, and you have a recipe for potential disaster at your fingertips. No wonder that in recent times, awareness and demand for health insurance has increased exponentially. The uncertainty caused by COVID combined with ever-increasing medical inflation is forcing more people to rethink their priorities and look for a plan that covers most of the blind spots.
The effect of COVID-19 may be weaning for now, but that shouldn’t be a reason to lower your guard. When it comes to health insurance, the key is to think, plan, and prepare for the future. Does your health insurance guarantee the protection you need in these times or do you need to be reassessed?
If you find yourself asking this question, rest assured, you are not alone. Insurance is a thoughtful investment for the indefinite future, therefore, a lot goes into choosing the right policy. Here are some critical factors that will help you evaluate the current factor.
Sufficient insured amount to cover exorbitant bills
COVID-19 has made people powerless by putting their lives and livelihoods at risk. In such a scenario, an exorbitant hospital bill is the last thing one needs. Since COVID has wreaked havoc, it is not uncommon to come across hospital bills of Rs 85,000 to Rs 1 crore, especially in metro cities.
To help mitigate huge medical expenses, it is essential to choose a plan that offers an appropriate insured amount. The sum insured is the maximum amount the insured pays to the policy holder in the event of hospitalization. To put this into perspective, a plan that offers at least a cover of Rs 10,000 or higher can be considered sufficient due to the rapid pace of rising medical costs. Getting insurance will only benefit you if the amount doesn’t cover your expenses and you end up draining your personal savings. There are many plans from insurance companies like Max Bupa or Aditya Birla Capital that offer coverage up to Rs 1 crore at a very reasonable premium that can range anywhere from Rs 800 to Rs 1,000 per month.
Consider covering the expenses of home treatment
Home treatment occurs when a patient needs to be hospitalized but is being treated at home due to unavailability of the room or due to a common illness or critical condition of the patient. The devastating second wave of the pandemic remains an unfortunate reminder of how important it is to stay prepared. There was no dearth of cases – a lot of critical cases – who couldn’t find a hospital bed or resources and had to take care of them in the home itself. Illness brings a sea of vulnerability and uncertainty. Given these times, it is better to be safe than sorry and to opt for a policy that covers home expenses as well. These expenses include the costs of the home care package, medications, nurse/doctor fees, tests to measure vital elements, X-rays, CT scans, and a home ICU.
Check sub limits and co-payments
Many policies come with a cap either on the deposit amount or on room rental expenses during hospitalization. This basically means that there will be a limit on how much the insurance company pays, and the policyholder will have to pay some percentage when hospitalized. Under the joint payment clause, the policy holder is required to pay about 10-20% of the total hospital bill. For example, if the hospital bill is around Rs 10,000, you will have to pay any amount from Rs 1 to 2,000 out of your own pocket. Similarly, in the sub-limit, there can be a maximum room rent of 1-2% of the security deposit. So, if you have a cover of Rs 5 lakh and there is a room rent limit of 1%, the insurance company will only pay Rs 5,000 for the room.
Policies that have a sub-limit and a co-pay clause come at a lower premium compared to those without. But the important thing to note here is that you shouldn’t lose more than you gain in the long run trying to reduce your premium. Sub-limits may reduce your premium, but it can cost you more during hospitalization.
Outpatient clinics, consumables and additional fees
Hospitalization usually entails a large number of other activities such as – doctor’s consultations, examinations, tests, medicines and also the use of many items such as personal protective equipment, gloves, syringes, etc. All these consultations and examinations do not require the patient to stay one night in the hospital under the outpatient clinic or the outpatient department. On the other hand, medical aid items used during this whole process are known as consumables. Each hospitalization comes with these additional expenses. Therefore, it is important to ensure that you choose a plan that covers your overall medical costs, including overheads such as outpatient clinics and consumables.
Health insurance is an investment to secure your health and wellness in the face of adversity. Re-evaluate your current policy and make sure you make a comprehensive decision that covers all the bases.
(By Amit Shubra, Head of Health Insurance, Policybazaar.com)