Health insurance is a product that should be bought keeping in mind the specific needs of an individual. Meaning – elders will have different health demands or concerns as they age and would mostly like need hospitalisation or medical attention. Children don’t require medical attention unless there is a particular health situation. Men have to keep in mind what they are pre-disposed to, and for women as well there are several needs that they should ensure that their health insurance covers.
Buying Health Insurance for Women: Important Factors to Consider
Here’s what women should consider when choosing and buying health insurance:
Protection Against Critical Illnesses:
According to Cancer India, 1 in 28 women is likely to suffer from breast cancer in her lifetime. And this rate of incidence rises in the thirties and peaks at ages 50-64. While the health insurance would pay for hospitalization in case of critical illness, the major cost of treatment would be on an out-patient basis, which the regular health insurance usually doesn’t cover. Hence, a great way to ensure complete coverage is to check if the policy covers maximum number of critical diseases. If not, buy an additional insurance that does so.
Insurance policies that offer maternity benefits cover the cost of maternity-related expenses. However, not all policies offer this benefit. So, for women who may be expecting maternity costs in the future, buying a policy that offers maternity coverage is very important. You must also check if the insurance policy covers pre and postnatal expenses. This benefit allows the policyholder to recover the cost of lab investigations, doctor consultations, medicines, scans, etc.
Some policies also offer 50% coverage in case the child is born with a congenital disability. So, compare policies as per your requirement and then make a decision.
Day-Care Procedure Coverage:
Most treatments today do not require hospitalization. And usually, health insurance plans do not cover day-care treatment facilities. They have hospitalization for at least 24 hours as a prerequisite. So, health insurance for women should be chosen based on whether or not it covers the maximum number of day-care procedures.
Often, health insurance policies consist of a co-payment feature. And according to the co-pay feature, the policyholder must pay as much as 20% of the total bill amount. Now, this can come as a surprise if you’re unaware of the terms and conditions. Hence, while buying health insurance, women must check if the policy consists of this feature.
No Involvement of TPA:
Insurers pay hefty premiums to be able to smoothly file a health insurance claim and receive the maximum settlement amount. However, lack of information can create all kinds of hassle, especially when a Third Party Administrator (TPA) is involved since policyholders don’t have direct access to the insurance company. Hence, you must prefer insurance policies in which there is no involvement of any TPA.
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Room Rent Limits:
Most policies apply a cap on the room rent. This means that the policyholder can recover the room rent as per the category specified. And if the policyholder chooses a room whose rent is above the limit specified, the cost incurred on other hospitalization services increases proportionately. Hence, you must choose a policy that clearly specifies the room category so that there are no surprises. You may also look for a policy that doesn’t apply a cap on the room rent.
In case of commonly occurring and pre-existing diseases or disorders, almost all policies have a waiting period of 3 to 4 years. However, there are a few policies that allow reducing the waiting period, provided the policyholder is willing to pay a higher premium. But since you don’t know the probability of a disease occurring, it almost makes no sense to pay extra premium amount for life. Hence, buy a policy that offers comprehensive benefits over a policy that has a shorter waiting period.
Annual Health Checkups:
Some insurance policies offer preventive health checkups every year. And there are a few policies that include this feature, but only after 3 consecutive claim-free years. In any case, you wouldn’t want to miss out on this very important feature. But if you think that 3 consecutive claim-free years look like an impossible feat, you must go for a policy that consists of the health checkup feature.
Consider all these factors to make a wise comparison and you will be able to choose an insurance policy that is just right. To be sure, you can contact a policy expert while buying health cover and a claim expert to ensure that you receive the maximum payout.
This is a guest post by Anuj who co-founded SureClaim to fix the broken medical claim experience of insurance customers. He believes technology can play a major role in empowering customers. His is decade long stint in healthcare and health-tech companies strengthens his technological and insurance related expertise.