Immunity and financial security ensure our readiness for hard times. Insuring yourself and your family with the best health insurance policy is a convenient way to achieve peace of mind.
According to a report by Niti Aayog, around 70% of the Indian population is covered by health insurance under the Ayushman Bharat Scheme and individual or employer insurance after the pandemic. Although the number is far from reality and on paper, we must ask ourselves if we are covered enough.
If you are in the process of buying a health insurance policy, make a list of your requirements based on your age, marital status, existing health condition, and genetic history. Let’s examine the top 6 criteria for choosing the best health insurance for women in India.
Table of Contents
- Coverage
- Copay
- Pregnancy, Childbirth, and Infertility
- Coverage of Consumables
- Dental and Ophthalmic Cover
- Worldwide Cover
- Secret Santa of the Insurance World: Daily Hospital Cash Allowance
- FAQs
Coverage
With a hectic lifestyle, women are falling prey to diseases like breast, ovarian, and uterus cancer. Choose a health plan that covers common as well as critical diseases. Additionally, medical innovations lead to many modern treatments that your policy should cover.
Ensure your sum insured (the maximum amount you can avail of for treatment from your insurer) is sufficient to cover your future needs. For example, ₹ 2 lacs may be adequate for surgery today, but it won’t be enough after 10 years. Sure, you can enhance your sum insured at the time of renewal, but all the waiting period conditions apply to the enhanced sum insured.
Copay
Some insurers provide the facility of copay, an arrangement where you bear a percentage of your treatment while the company covers the rest. This leads to reduced premiums. Also, copay is mandatory if you purchase the policy at or above the age of 60 or if it is a zone-based policy. Since the cost of treatment in tier-1 cities is higher than that in tier-2 or 3, your premium may vary as per your residence address.
In such cases, the insurer may levy a copay clause to cover expenses if you receive treatment outside your zone. You can always purchase an add-on to cover the copay clause.
Pregnancy, Childbirth, and Infertility
Being a woman who plans to give birth in the future, this is the most important clause in a health insurance policy. Most basic policies do not cover maternity expenses. Therefore, you should opt for a maternity benefit add-on/ rider to your policy at the time of purchase. Keep in mind that no Indian health insurer covers infertility treatment at the moment.
Coverage of Consumables
Most health policies do not cover the cost of consumables like PPE kits, gloves, syringes, etc. Consumables aren’t constrained to these and cover ancillary items used in surgical equipment (for example, during cataract surgery). These charges form a substantial percentage of the whole bill. It is advisable to take an add-on cover for consumables for better coverage.
Dental and Ophthalmic Cover
Most insurance policies do not cover dental and ophthalmic expenses unless it is an accidental case. Corrective and restoration treatments for vision and teeth can be expensive, especially with increasing age. Choose a health plan that covers checkups and treatment to have a worry-free insurance plan.
Worldwide Cover
India is slowly and steadily becoming the hub of modern medication, eliminating the need to rush abroad for quality treatment. However, there may be instances when you may need treatment in a foreign country. If you have global exposure or travel a lot, opting for international insurance coverage to meet any planned or unplanned medical needs is better.
Secret Santa of the Insurance World: Daily Hospital Cash Allowance
Some companies provide you with a certain amount of cash for each day you spend in the hospital. While nobody wants to go to a hospital, at least you can earn money from your misery. Do read the policy about the maximum days covered under this feature. Most companies shell out cash allowance after one day of hospitalization up to 7 days.
When Purchasing the Best Health Insurance for Women
There are a couple of pointers you should keep in mind while buying a health insurance policy:
-Never lie to the insurer. If you have any pre-existing disease (PED), let them know. Make sure it is included in your policy document. Any PED will be covered after 4 years, or you can buy an add-on to cover them from day 1.
-Full disclosure works well for you at the time of claim settlement. For example, if you are a smoker or alcohol consumer, you should mention it to your relationship manager in writing. You may have to pay some extra premium, but the company cannot reject your claim based on your lifestyle preferences. Of course, this doesn’t apply to drinking and driving.
Before the grace period, Read the policy documents carefully, referring to internal sections. Clear all your doubts in writing.
Look for a lower insurer’s claim rejection ratio rather than a claim settlement ratio. You see, rejected claims also count towards claims settled.
-Don’t forget to collect your premium receipt to claim tax exemption.
-Don’t miss your renewal deadline. Stay insured forever!
Financial literacy is an essential tool for women’s empowerment. Take charge of your financial health like all other life spheres. If you haven’t purchased health insurance, don’t wait anymore. If you already have one, revisit and reassess. To learn more about financial inclusion, personal finance, and women’s empowerment, click here!
FAQs
Q. Should I buy health insurance other than what is provided by my organization?
A. It is a good idea to have small personal insurance along with the one offered by your company. The choice of individual health insurance will depend upon the sum insured and the features provided. Employer-provided group insurance is beneficial, considering coverage of pre-existing diseases and hassle-free claims. However, you should be covered in the unfortunate event of firing or a career break.
Q. When should I port my existing policy?
A. The policy portability facility is a valuable tool for customers the IRDAI provides. You should think about porting your health insurance policy to another insurer in case you find:
1. Lack of communication with your insurer.
2. Non-fulfillment of promised quality service.
3. Unjustified increase in premium.
4. Non-adaptability to evolving needs.
Q. When can I port a health insurance policy?
A. You can port your existing policy 60-45 days before your next renewal date.
Q. Does health insurance cover maternity expenses?
A. Not all health insurers provide maternity coverage. When choosing health insurance, please mention your requirements clearly to your relationship manager. Also, clarify the normal or C-section delivery rules and pre- and post-natal care.
Q. Should I buy an insurance policy through a mediator?
A. Some aggregators claim that purchasing a policy through them is beneficial at the time of claim. In my opinion, reputed insurance companies never reject a rightful claim. While web aggregators like Policybazaar may be useful for plan comparisons, it is up to you to purchase an insurance policy.
Q. What should I do in case of illegal claim rejection?
A. If your insurer rejects your claim, you should promptly register your complaint in writing with the insurer’s grievance cell. If your complaint is disposed of or you do not hear from them within a month, you can register your grievance with the insurance ombudsman set up by IRDAI.
