Health Insurance In India: Know The Right Coverage For Yourself & Your Family

According to a survey conducted by Apollo Munich Health Insurance covering 7 lakh health insurance policyholders in 82 cities in India, more than 51% of health insurance policyholders in India are not sufficiently insured. The coverage that most policyholders has is not enough in case of a medical emergency. The harsher truth is, the highest percentage of under-insured people fall in the oldest age-group who need sufficient health insurance coverage most. Here are the key takeaways from the survey.

  • In the 18-35 years age group, 38% of policyholders are under-insured
  • Above 45 years of age, 62% policyholders are under-insured
  • In the 61-65 years age group, 75% policyholders are under-insured

Why All These Policyholders are Under-Insured?

There are many reasons why majority of health insurance policyholders are not insured sufficiently. Some are misled by their respective agents despite of being able to afford higher coverage. Some other considered health insurance policy in India solely a means of tax savings.

Impact of not being Insured Sufficiently

Not having enough coverage can prove to be fatal in time of need. Policyholders might not be able to undergo proper medical treatments due to lack of coverage and their whole purpose of opting for health insurance can be defeated. Shortage of health insurance coverage can force policyholders to shell out their hard-earned money that they might have saved for children’s education or marriage.

How to Determine the Right Coverage?

Working the right Sum insured of health insurance plans can be tricky as it varies from one person to another. Therefore, one needs to assess one’s situation and fix the coverage amount accordingly. The following parameters sum up the assessment of one’s situation.

Age & Location

The first and foremost aspect that health insurance policy seekers need to assess is their age. As a person grows older, his or her health complications also increases. Therefore, the coverage which is enough for a 30 years old person is insufficient for a 50 years old. Similarly, those who live in metro cities or tier I cities should opt for higher coverage than those who live in tier II cities and suburbs and villages because medical expenses are higher in metro cities and tier I cities. Here is an estimation of the coverage of an individual health insurance plan as per the age and location of the consumers.

Age

Location

Sum Insured

20-29 years

Metro, Tier I or Tier II city

Rs 5 lakh

30-39 years

Metro, Tier I city

Rs 7 lakh

Tier II city

Rs 6 lakh

40-59 years

Metro, Tier I city

Rs 9 lakh

Tier II city

Rs 8 lakh

60 years onward

Metro, Tier I or Tier II city

Rs 10 lakh

Affordability

Once one checks out one’s age and location, the second important thing one needs to evaluate is one’s affordability. A person with meager income cannot opt for high coverage as one’ is not able to pay premium and continue the policy year after year. If the person really needs higher coverage than his affordability he can start small by opting for lower Sum Insured and gradually look for health insurance riders and top-up plans which enhances the basic coverage at a lesser cost. Here are some useful health insurance riders that one can consider;

  • Critical Illness Cover
  • Hospital Cash Benefits
  • Personal Accident Cover
  • Maternity Cover
  • New Born Baby Care

Medical History of the Family

To ascertain the right coverage, it is crucial that one is aware of the medical background of one’s family members. If one’ ancestors had lifestyle diseases, the chance of recurrence is higher and in that case one should go for higher coverage for one;s health insurance plan in India.

Past & Future Medical Expenses

One should also take one’s previous medical expenses into account while deciding on the right coverage. The amount of money that one has spend in past 2-3 years should be taken into consideration while working the exact coverage amount out.

Aside from past medical expenses, one should also consider the rate at which medical expenses are rising with each passing year. This will help one estimate how much coverage one may require after 10-15 years.

Lifestyle

Nowadays sedentary lifestyle triggers a lot of lifestyle diseases. Therefore, one should assess one’s own lifestyle before settling on the coverage amount. Lazy lifestyle coupled with addiction for smoking and other substances increases one’s risk of falling sick. So, people with such lifestyle should go for higher Sum insured so that they can cover the cost of the treatment for lifestyle disease.

Type of Health Insurance Plan

The type of health insurance policy that one chooses to buy also plays a part in determining the coverage. For example, if one is inclined to buy a family health insurance plans to cover all members, one has to go for a higher Sum Insured. If one want to buy senior citizen health insurance health policy for one’s elderly parents, it better to go for higher coverage as complications increases with advancement of age and so is the medical expenses.

Employer’s Health Cover

Many people make the mistake of considering their corporate health covers provided by their employers while working out the Sum insured amount for their personal health insurance plans. But, one needs to realize that their employer’s health plan won’t safeguard them forever. When one switches job, the new employer may not provide health cover. So, depending on employer’s health plan is a strict no-no and one should estimate the coverage irrespective of the plan offered by the employers.

Conclusion

In India, the average Sum Insured is less than Rs. 2 lakh among those who are covered by health insurance plans according to the Insurance Information Bureau of India. The inflation in healthcare expenses coupled with high medical expenses necessitate adequate health insurance coverage. While coverage and premium are the two most crucial aspects of health insurance, one should gain information on all aspects to ensure an informed choice.

GIBL, the premiere online insurance marketplace is the best choice to compare health insurance online in terms of coverage and premium and other features. GIBL also facilitates buying health insurance online on its web and mobile platform. Once you know the right coverage of health cover for yourself and your family, visit GIBL and get the best health insurance in India at the most affordable premium.

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