We are nearing the third anniversary of the COVID-19 pandemic spread in India. The times were tough; somehow we overcame it. The common follow-up question is “Are we prepared for any future pandemic-like situation?”.
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 Ayushman Bharat Scheme, private, or employer insurance after the pandemic. Although the number is far from reality and on paper only, we need to 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 check out the top 6 criteria to choose the best health insurance for women in India.
Table of Contents
- Pregnancy, Childbirth, Infertility
- Coverage of Consumables
- Dental and Ophthalmic Cover
- Worldwide Cover
- Secret Santa of the Insurance World: Daily Hospital Cash Allowance
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 which should be covered in your policy.
Make sure your sum insured (the maximum amount you can avail of for treatment from your insurer) is sufficient to cover your future needs. For example, Rs. 2 lacs may be sufficient for surgery today but it won’t be after 10 years. Sure, you can enhance your sum insured at the time of renewal, but all the conditions of the waiting period apply to the enhanced sum insured.
Some insurers provide the facility of copay, an arrangement where you bear a percentage of your treatment while the rest is covered by the company. This leads to reduced premiums. Also, the copay is mandatory if you purchase the policy at or above the age of 60 or 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 avail treatment outside your zone. You can always avail of an add-on to cover the copay clause.
Pregnancy, Childbirth, 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 as of now.
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 too (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. The corrective and restoration treatments of vision and teeth can be expensive, especially with increasing age. Choose a health plan that covers their checkup and treatment to have a worry-free insurance plan.
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, it’s better to opt for global insurance coverage to meet any planned or unplanned medical needs.
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 some money out of your own 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 a maximum of 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 in your favor 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.
-Read the policy documents carefully and with reference to internal sections before the grace period. Clear all your doubts in writing.
– Look for lower claim rejection ratio of the insurer rather than 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 important 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!
Q. Should I buy Health Insurance other than 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 personal 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 facility of policy portability is a useful tool for customers provided by the IRDAI. 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 between 60-45 days prior to your next renewal date.
Q. Does health insurance cover maternity expenses?
A. Not all health insurers provide maternity coverage. Please mention your requirements clearly to your relationship manager while choosing health insurance. Also, clarify the rules for normal or C-section delivery and pre-and post-natal care.
Q. Should I buy an insurance policy through a mediator?
A. Some of the aggregator 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 how to purchase an insurance policy.
Q. What should I do in case of illegal claim rejection?
A. In case your claim is rejected by your insurer, you should register your complaint timely with the grievance cell of the insurer in writing. In case 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.
Informative piece of content. Didn’t knew rejected claims also amount to claims settled.
But would like to know on what basis do we come to a conclusion that there is an unjustified increase in premium amount?
Thank you Rahul for your insightful query. There are certain circumstances like a change in age bracket (in the multiples of 5), mandatory inclusions by the government (especially after COVID), additional benefits offered by the insurer, etc. where the increase in premium is justifiable. However, they need to inform you about the increase beforehand.
Some companies increase the age-based premium once every 5 years while others increase it every year. It’s your choice which one you prefer. I switched to the first one as the latter was hard on my pocket.
Hope this answers your query!