Private healthcare accounts for 60-80% of all forms of medical services available in India. This makes the healthcare system in India, one of the most privatised in the world. It is no secret that patients are made to pay through their teeth by healthcare professionals even for minor procedures. The cost of healthcare is indeed getting out of hand.
Government aided public health services can at best be described as abysmal, so turning to public healthcare system is not even considered an option by most. According to experts, prohibitive healthcare cost is the prime reason for many Indians to slip below the poverty line each year. In such a scenario where can one look for decent affordable healthcare?
The common man's salvation lies in buying a good health insurance policy. But blindly choosing and selecting a plan could turn counterproductive so one has to their fair share of homework before getting a healthcare plan that clicks.
A health insurance policy provides a financial cover for your medical expenses. It's a contract between the consenting parties to provide health cover to the insured person by the compnany in exchange for a premium.
The insurance sector regulatory body --Insurance Regulatory and Development Authority--on its consumer education website lists what charges should normally be covered by a health insurance policy. It also lists on what grounds the claim is denied. (https://www.policyholder.gov.in/What_Health_Insurance_to_Buy.aspx).
Firstly, a choice has to be made wisely in selection of an appropriate plan depending on one’s needs. There are different types of insurance policies for different needs. A hospital cash insurance policy gives a fixed amount of cash if you are admitted to a hospital. Critical illness insurance reduces the financial burden if a critical disease is diagnosed such as cancer etc. While, accident disability cover provides partial or total cover in case of loss of income from permanent or temporary disability due to accident. If you have a nuclear family, a family floater plan will augur well for you since premium-per-person turns out to be lower in these plans and all family members are covered under this.
Catch ‘em young
This is a strategic marketing mantra to get consumers hooked onto certain life>
Read the fine print
The devil lies in the detail and therefore it of utmost important to know your policy inside out. Your agent will definitely tell you the merits of your policy and what all charges and diseases it covers. But it is your job to know what all your insurance policy does not cover. For example, no insurance policies will cover pre-existing diseases, many diseases aren’t covered in the first year of policy cover and likewise.
Like all salespersons, insurance agents too have unrealistic deadlines and targets, not all but some agents do try to sell them by all means possible. Misselling is an ugly truth of the insurance business and therefore it is your duty to double check your agents’ sales pitch regarding the merits of the said policy.
Do the maths
In most cases the insurance agent will explain in detail about the ‘sum assured’. It is maximum cover an insurance company will give you at the time of claiming the amount. Also, the insurance company assumes that hospital bed amounts to 1 percent of the sum assured. Therefore, if your sum assured is Rs2 lakh, the cover for hospital will be Rs 2 thousand per day. If hospitalisation cost per day is any more, you could end up shelling the difference from your pocket.