Introduction:
The COVID-19 pandemic has taught the world two critical lessons: health should be the top priority for individuals, and medical emergencies are unpredictable. Having learnt the lesson well, people have started prioritizing allocating funds for health insurance policies while making household budgets. With this, the number of people availing of health insurance policies has multi-folded in the country, and many prefer to choose a plan that tailor-suits their medical requirements and financial affordability. As a result, many insurance companies have started to customize their plans by adding numerous benefits to meet the growing demands.
Understanding individual health insurance plans:
A health insurance plan is a contract between an individual and the insurance company in which the latter agrees to cover the medical expenses of the former per the terms and conditions laid by the Insurance Regulatory and Development Authority of India (IRDAI). Insurance companies will have tie-ups with hospitals – called network hospitals – where policyholders can avail cashless Mediclaim. In other hospitals, the policyholder must settle the hospital bills and make a claim. Health insurance companies offer numerous health covers, and one of them is individual health insurance plans.
Individual health insurance plans are specially designed to provide health insurance coverage to an individual. The plans can be customized based on their medical requirements and financial affordability. Under this policy, the insured can cover hospitalization, pre- and post-hospitalization, pre-existing disease treatment and other related medical expenses. One can also enhance the extent of coverage of the policy by paying for add-ons. A policyholder can make multiple claims yearly, and many insurance companies will offer a cumulative bonus for every no-claim year. The plan, most of the time, comes with lifetime renewability. Though the coverage is provided only to the insured and not extended to their dependents under the plan, one can add multiple family members to an individual health insurance policy and provide separate coverage for each. Just like every other plan, the individual health insurance plans also come with a waiting period.
Insights on additional benefits introduced as a part of individual health insurance plans in 2023:
Insurance companies have started to include numerous benefits to their policies to meet the growing demand among the policyholders seeking several add-ons to suit their medical requirements. Some of them are listed below.
1. Enhanced coverage for critical illnesses: Due to the number of patients diagnosed with life-threatening illnesses and growing medical inflation, policyholders have started opting for plans that offer enhanced coverage. As a result, insurance companies have not only increased the coverage for acute illnesses but also increased the number of diseases that are classified as essential illnesses.
2. Coverage for mental health issues: In October 2022, the Insurance Regulatory Development Authority of India (IRDAI) made it mandatory for all general and standalone health insurance companies to cover mental health illnesses and directed them to comply with the Mental Health Care Act, 2017, provisions with effect from November 1, 2022. All insurance products in force on or after the act came into force should be deemed to cover mental illnesses. Since then, insurers have offered coverage for mental health consultations, therapies and treatments.
3. AYUSH coverage: Due to the general belief that Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy (AYUSH) treatment focuses on the complete well-being of a patient and not the illness alone, many have started considering it as an alternative to the standard medical treatments. The IRDAI has recently modified its guidelines and let insurance companies cover the treatment expense.
4. Technology-enabled solutions: The health insurance sector has started adopting automation, artificial intelligence/machine language, and digital tools for cost containment and digitization of health records. This integration of technology has created a significant impact on the insurance sector. This, in turn, is expected to reduce costs, serve policyholders better and improve the overall service.
5. Offering wellness benefits: Until recently, wellness benefits were accessible only to premium policyholders, but it has not been extended to everyone. This wellness and preventive programme encourages the insured to adopt a healthier lifestyle. In addition, it also gives reward points by monitoring healthy habits and lifestyle. The policyholder, in turn, can redeem the reward points against pharmacy bills, medical checkups, gym memberships, fitness classes and yoga classes. Some insurance companies also provide a wellness mentor to assist policyholders in improving health by suggesting healthy diets and workout regimes.
Conclusion:
The recent trends in health insurance policies reflect the growing demand for technology-enabled, personalized and comprehensive insurance solutions. This is due to the increase in awareness among the policyholders about the importance of health insurance policies, resulting in growing demand for value-added services.