Best Health Plans From Top Insurers

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Sehwag PX

#Virukipolicy | T&C*

Sehwag PX

Best Health Insurance Plans From Top Insurers

#Virukipolicy | T&C*

Rohit is a 28-year-old investment banker working in one of the top investment banks in the country. Outwardly he is a very cheerful, optimistic and fit looking young man. However, his annual health check-up reports do not reflect the same optimism about his internal health. His lipid profile and blood sugar reports are both borderline and his physician has advised him thirty minutes of physical exercise daily combined with home-cooked food and good sleep.

Rohit enthusiastically takes up his doctor’s advice and after a month of regular morning walks, some yoga, meditation and fewer outside meals, he feels much lighter, healthier and energetic.

The financial year ending sees him burning the midnight lamp to meet stringent timelines. Owing to this hectic schedule and the resultant stress he misses a couple of days of his morning exercise routine initially, which then turns into a bigger break of three to four days, then a week or so and finally today Rohit is back to his routine prior to the health check-up i.e no exercise, frequently ordering food from restaurants (with food apps you are spoilt for choice) and binge-watching Netflix and other OTT platforms late into the night till his eyes can’t take it anymore.

Rohit’s story will resonate with many of us. The challenge we face is not with regards to starting a fitness regimen, it is with regards to continuing and maintaining a healthy lifestyle consistently over the long term. Technological advancements have made our lives very comfortable but the availability of most things on a few clicks has also adversely affected our physical health. Young and old alike are glued to the charms of their smartphones and exercising and nourishing the body and mind is often not a priority. We thus become excellent breeding grounds for various lifestyle diseases which are lurking around the corner.

What is Lifestyle Disease?

A lifestyle disease or non-communicable disease (NCD) is a disease which mostly occurs due to the way we live. Lack of physical activity, obesity, high consumption of processed foods, foods high in salt content, sugar-rich food, refined starches, lack of sleep, wrong body posture, consumption of alcohol, smoking, environmental factors such as pollution, etc are the major causes of lifestyle diseases. The lifestyle diseases enter into our system slyly, mostly they remain symptomless for years before rearing their heads and then do not lend themselves easily to cure. Over 61% of all deaths in India are due to lifestyle diseases.

Common Lifestyle Diseases in India

  • Obesity
  • Type II diabetes
  • Heart diseases
  • High blood pressure
  • Cancer 

Obesity: According to the National Family Health Survey, India ranks second with 155 million obese citizens and this number is increasing at 33-51% every year. Stress, fast food, and inadequate physical activity are the main culprits giving rise to obesity. If not controlled obesity can lead to several health risks such as heart disease, stroke, high blood pressure, diabetes, breathing, and sleep-related problems.

Type II Diabetes: Poor eating habits and a sedentary lifestyle are major causes of type II diabetes. India has the distinction of having the largest number of people with type II diabetes i.e 40.9 million diabetics.^^With more and more children also getting afflicted this number is rapidly rising. If not controlled, type II diabetes can lead to hypoglycemia, kidney diseases, eye damage, heart and blood vessel diseases, skin problems, etc.

High Blood Pressure (Hypertension): According to the National Family Health Survey, which screened 22.5 million people across India in 2017, one out of every eight Indian suffers from hypertension. It is commonly known as high blood pressure and contributes to 57% of stroke deaths, and 24% of coronary artery deaths.# This disease is also called a ‘silent killer’ as it usually doesn’t display any symptoms until it is very late. A reading of 140/90 or higher is termed as high blood pressure. Stress, hectic lifestyles, foods high in salt content, obesity and lack of physical activity are the major reasons for high blood pressure. If not controlled, it can cause heart attacks, strokes, and other diseases.

Heart Diseases: It is a group of conditions which affects the functioning of the heart. There are numerous types of heart diseases. Any irregularity or abnormality which affects the arteries and blood vessel walls and makes it difficult for the heart to carry out its normal functions can be referred to as heart disease. India ranks number one when it comes to cardio patients with 50 million suffering heart health issues.^^Stress, unhealthy eating habits, smoking, alcohol and tobacco consumption, diabetes, high blood pressure, lack of physical activity, etc are major causes of heart diseases.

Cancer: As per the Indian Council of Medical Research (ICMR) data, India had 14 lakh cancer patients in 2016 and this number is expected to increase. Stressful lifestyles, changes in eating habits, smoking, tobacco consumption, air pollution, obesity, etc are some reasons attributed to the increasing instances of cancer in India.

The lifestyle diseases can be combatted to a large extent by making small adjustments to our lifestyle in terms of physical activity, healthy eating habits, adequate sleep, keeping stress at low levels, reduced consumption of alcohol, smoking, etc. However, these are easier said than done. Caught up in our hectic lifestyles and the lure of modern life, health priorities often take a back seat. Hence it is important that we plan for a health contingency by way of a health insurance plan as many of the lifestyle diseases can catch us unawares and be a huge drain on our resources.

As per GOQii’s India Fit Report 2019, 38.3% people between the age group of 20-45 suffer from at least one lifestyle disease ranging from diabetes, blood pressure, cardiac issues to the thyroid, acute GI and acidity. Cases of cholesterol among people have increased from 10.1% to 14.1% this year, high blood pressure is on the rise, with an increase from 9% to 12%.

A study conducted by Bigdecisions.com, a personal finance advice platform, has revealed that about 95% of Indians don’t have adequate health insurance cover to meet some of the most common procedures and ailments. It further states that healthcare inflation is seeing double-digit inflation in India.* Health insurance can no longer be considered as a luxury or as a tax saving instrument, it is a necessity in current times. With the continuous reduction in the ages of people contracting lifestyle diseases, there is an urgent need among people in the 25-40 age group to sit up and actively give a thought to buying health insurance. Some important facts one should know regarding health insurance are as under:

  • Buy Young:  This may sound puzzling, “why would we need health insurance in the prime of our life” may be a line of thought which many of us may espouse. However, the following points can dispel this myth:
  • Insurance companies like young customers as the likelihood of ailments and hospitalizations are much lesser in this category. This, in turn, translates into lower premiums when you buy young. Premiums increase with age.
  • Your health insurance policy also covers accidents. After all, anybody irrespective of age can meet with an accident. An accident in the early years of your career can be a huge setback financially as your savings may be insufficient to meet the related expenses and you may end up spending all your savings or in debt to recover from the accident.
  • Ailments such as dengue, chikungunya, etc can strike at any age and may need hospitalization (depending on the severity and complexity one can end up spending Rs 40,000/- to Rs 1,00,000/- or more for dengue-related hospitalization). A health insurance policy can come handy during such times.
  • Being young also means that certain chronic ailments such as diabetes, hypertension, etc may not have reared their ugly heads. In the absence of any pre-existing disease during policy issuance, you are exempted from the waiting period for pre-existing ailments. A waiting period (usually 36-48 months from inception of the policy) is the period during which any claims arising from pre-existing diseases and their complications are not covered. Many health insurance companies also decline cover in case of a history of pre-existing ailments.
  • Over-reliance on employer’s health plan: Most of us do not feel the need to buy a separate health plan as we already have an employer-provided health plan:

Probably the points mentioned below can give some food for thought:

  • As premiums are rising steadily, employers are trying to rationalize the cover provided by adding restrictive factors such as co-payment (payment of some % of the bill by the employee), partial payment of premium by the employee and not covering parents.
  • Most of the employer-provided health insurance plans have modest coverage amounts ranging from Rs 1 lakh-Rs 3 lakhs. As healthcare costs are soaring, you need to realistically assess whether your employer’s policy will be sufficient to cover costs of treating critical ailments, major surgeries, procedures such as angioplasty, dialysis, etc.
  • If you are in-between jobs, you will be without cover. In current times, with job security being a concern, buying your health plan and not relying only on employer’s cover may be the right thing to do. The recent closure of a major airline has left many of its employees high and dry. Those employees who were reliant on their employer’s health cover may find it extremely difficult to handle a medical emergency now as the airline has suddenly ceased operations and left them jobless. As they scout for new jobs, a medical emergency can put them in a tight spot financially.
  • On retirement, your employer’s cover will cease when you need it the most. You will be required to pay all medical expenses from your pocket and this can cause a big dent in your savings. At this juncture, buying health insurance may be a very costly affair due to advanced age. Also, many of us may be suffering from some ailment by retirement. The pre-existing ailment clause may kick in and you will not be able to use the policy optimally in the initial years. You may even be denied cover in case of adverse health.
  • Those who are planning to take up entrepreneurship in the future should buy a health plan at the earliest even if you are covered by your employer’s policy today to benefit from lower age and waiting period clauses.

In case of finances is a constraint, you may look at supplementing your employer’s health plan with a top-up plan as the premium for top-ups is lesser than base health plans.

  • Hospitalization Is Not a Must For Making Claim: Many of us may be shying away from buying a health plan thinking that hospitalization is a must for making claims. This is no longer the case. Due to medical advancements, for certain surgeries such as cataract removal or procedures such as angiography, radiography, dialysis, chemotherapy, kidney stone removal, etc, the patient can go home after a few hours. These are referred to as daycare procedures. Every insurer has a list of daycare procedures they cover. Daycare procedures are those treatments which can be administered without requiring 24-hour hospitalization.

Further, out-patient treatments such as dental treatment, doctor’s consultation fees, alternative medicine treatments such as Ayurveda, Unani, etc are covered by health insurance plans (varies across plans).

  • Buy Sufficient Cover: The sum assured chosen should be well thought over considering your family history of illnesses and also your residential city. For people living in the metropolitan cities, the sum assured should be at least Rs 10 lakh given the high cost of living in these cities. Medical treatment is very high in metro cities as compared to the smaller towns. For people living in tier 2 and tier 3 cities, the sum assured insured should be at least Rs 4-5 lakh. 
  • Cashless Network: Cashless treatment facility can be availed only if the hospital happens to be in the network of the insurance company/TPA. While buying a policy do check whether reputed hospitals of the city are a part of the insurance company’s network. Also, check if the hospitals which you prefer are a part of the network. In case you seek treatment in a non-network hospital then the cashless facility cannot be availed. You would have to pay the bills. Subsequently, you can claim reimbursement from the TPA (third party administrator) by submitting the discharge summary, detailed hospital bills, test reports, prescriptions any other documents sought by the TPA.
  • Insurance Company’s Claim Settlement Ratio: Always opt for an insurance company with a high claim settlement ratio. The insurance regulator, IRDAI’s website provides the claim settlement statistics of all companies.

Conclusion:

The rising incidences of lifestyle diseases is a reality we need to face. Not only do we need to take necessary steps to keep these diseases at bay but we should also be prepared with a contingency plan to battle these diseases in case we or our loved ones happen to fall prey to any of these diseases. This is where a comprehensive health insurance plan can come to our rescue.

Sindu Ramankutty has 10 years of Life Insurance Operations and Customer Service experience. She has worked with two leading private life insurers. She has a PGDBM (General Management) from Narsee Monjee Institue Of Management Studies (NMIMS) Global Access, Licentiate from Insurance Institute of India (III) and ALMI from LOMA.