Adding heft to health cover

Adding heft to health cover

In a post-pandemic world, new-age add-ons help protect against a wider range of risks

In a post-pandemic world, new-age add-ons help protect against a wider range of risks

The COVID-19 pandemic forced the world and the insurance industry to encounter unprecedented health dangers. Moreover, it made digital insurance solutions the sole means of operation for a period. After more than two years of this interchange, the pandemic-hit world has been gifted with an evolved and more nuanced face of health insurance.

Technological innovation and customer centricity have helped health insurance evolve into a more comprehensive and ‘thoughtful’ offering.

The majority of improvements in the area have come in the form of add-ons or riders that address policyholders’ most critical pain points.

Today, one can hyper-personalize his/her health insurance policy by choosing add-ons intelligently. Here’s an overview of some of the most dearly-welcomed riders in new-age plans:

Out patient cover

Traditionally, a policyholder could only make a claim if they had been hospitalized and spent more than 24 hours as an inpatient. The problem with this approach was that one doesn’t always need hospitalization for every illness or injury. In fact, a majority of medical expenses typically include same-day doctor consultations.

Root canal treatment, dialysis, diagnostic procedures, pediatric consultation, or simply a fever-related consultation all fall under the ambit of OPD expenses. OPD expenditure accounts for more than 70% of healthcare expenses in India and until recently, these were all paid out of pocket.

For health insurance to be truly complete, it was essential for OPD expenses to be covered by one’s policy. An OPD cover helps achieves this.

It expands one policy to regular doctor consultations, lab tests, dental care and the like. The monthly cost of this cover is typically as little as what one country for one trip to the hospital.

Consumables cover

In the pre-pandemic world, one would have to follow a list of 199 items that would not be covered under their plan. This was an IRDAI-recommended list that included items such as medicines, masks and PPE kits. One would thus have to pay for them out of pocket. During the pandemic, this system was revisited as the cost of consumables started rising and accounting for as much as 20% of the medical bill.

This gave rise to the concept of a consumable cover. With this cover, a policyholder can have a truly cashless insurance experience.

No claim bonus

As a policyholder, you are entitled to the NCB or the no-claim bonus. This is a remunerative benefit for having a claim-free year. It practically rewards the customer for having not fallen sick in a said year. The reward can come in the form of a cumulative bonus or discount on premium. Now, it is natural for a policyholder to find these benefits tempting and to wish to protect the same.

This can be done through an NCB protection cover. This basically protects your NCB and doesn’t let it drop if your claim is below a certain amount. It puts you in a win-win situation as long as your claim is below the pre-decided amount.

Medical inflation cover

With medical costs rising rapidly, this is translating to higher premiums in insurance as well. This add-on helps protect yourself against inflation as it enhances your basic sum insured every year at a fixed rate. This is decided by the consumer price index or a similar metric which is an indication of inflation.

emergency air ambulance

This cover protects you if you ever need emergency evacuation and transport to the hospital during a medical emergency. Through this add-on, one can use the air ambulance which otherwise could cost a significant amount.

Vaccine cover

The importance of this cover has become quite apparent with the COVID-19 outbreak. This add-on provides vaccination cover for protection against diseases declared as pandemic or epidemic by the World Health Organization or the central or the State governments.

Maternity benefit

It is important for a pregnant woman to feel financially safe as they welcome their new baby into the world. This is what maternity coverage in health insurance does. It offers thorough protection against pre-and post-hospitalization costs, including ambulance fees. It even covers the expense of the newborn’s vaccinations from the time of delivery (Day 1) for a period of 30 to 90 days.

These policies also cover several kinds of complications related to pregnancy including C-section and neonatal care. Today, policies offer maternity benefits with a waiting period as low as one year.

The fact that most insurance providers allow cashless claims at all network hospitals is an advantage. Even at non-network hospitals, one can go through the reimbursement procedure, and get a claim settlement. This allows a couple expecting a child to focus on health instead of worrying about finances.

(The author is Head — Health and Travel Insurance, Policybazaar.com)

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