Health Insurance 348 views February 25, 2019

How Health Insurance Can Benefit People With Low & Middle Income Levels?

  Government Role in Health Insurance in India

Indian families continue to look at health insurance as a matter of choice than an imperative inclusion in one’s investment portfolio. According to details published in the National Health Profile 2018 released in June 2018, only 27 percent of the Indian population has health coverage. This comes as a surprise in a country where there is no social security or health cover and a major portion of the population is still unaware of how paying small amounts of premiums regularly can defray the huge medical expenses later, if and when required.

Health Insurance Benefits for Low and Middle-Income Levels People in India

The health insurance sector is currently on an overhaul as the Central government has come with health insurance schemes in an attempt to include the poor and financially deprived under the ambit of a necessary health cover. Currently, there are six government-sponsored health insurance companies that are gaining attention among Indians, especially those dependent on government aid owing to their precarious financial conditions. These schemes include:-

Rashtriya Swasthiya Bima Yojana (RSBY)

Employment State Insurance Scheme (ESIS)

Central Government Health Scheme (CGHS)

Aam Aadmi Bima Yojana

Universal Health Insurance Scheme (UHIS)

PM Jan Arogya Yojana (PMJAY) also referred to as Ayushman Bharat

However, the allocation of the budget towards necessary healthcare is less than 1 percent of the country’s GDP and has been falling each year. As medical costs continue to high and have been increasing at the rate of 12-14 percent every year, it is important that Indians belonging to the low and middle-income group buy health insurance plans that would enable them to offset their medical expenditure in the long run.

Why should low and middle-income families buy health insurance plans in India?

Buying a health insurance policy with an adequate amount of sum assured ensures that people, especially those belonging to the low-income categories do not have to dig deep into their savings to pay the hospital bills. An unforeseen and sudden need for treatment can result in families paying for the necessary treatment by withdrawing from their savings or liquidating their investments for the same. Moreover, many health insurance companies ensure additional benefits too, which means that the insurance policy assures necessary medical help along with peace of mind. Though many customers opt for the reimbursement of expenses option, the cashless benefit, if chosen ensures that the patient avails a seamless treatment option sans the need to pay anything from one’s own pocket, thus, relieving the insured to deposit money in advance for any surgery, if required.

Top Best Health Insurance Companies in India

There are multiple insurance companies that sell health insurance plans in India. Taking into consideration, the top 10 health insurance companies in India include:-

Apollo Munich Health Insurance Company Limited

A renowned name in the health insurance industry, this company provides health insurance policies to one and all at affordable premiums. Apart from promising a sum assured that may range from Rs. 1 lakh to Rs. 15 lakhs, it provides cashless benefits to its customers at a wide range of multi-specialty hospitals. In addition, the company provides additional benefits like portability and lifetime renewability. Policyholders can avail no-claim bonus in the form of increased sum assured at no extra addition to premium rates. The “Restore Benefit” ensures that the policyholder can avail the health insurance benefits even after the claim is exhausted during any particular year.

Star Health & Allied Insurance Company Limited

A unique feature provided by this company is the direct in-house settlement which means easy and hassle-free claim settlement process. With cashless hospitalization and reimbursement facilities available in more than 7000 network hospitals across the country, policyholders could not have asked for more.

Max Bupa Health Insurance Company Limited

Health insurance plans sold by this company cover all kinds of hospitalization and treatment expenses inclusive of room rent charges. Reimbursement of pre and post-hospitalization charges is also included subject to certain conditions included in the policy. Buying the plan for two years ensures a 12.5 percent discount on premiums paid during the second year. During emergency hospitalization, the cashless facility can be availed at the nearest network hospital.

SBI Health Insurance Company Limited

Wide coverage from Rs 50,000 to Rs 5,00,000 means that policyholders can seek a sum assured as per their need and budget. In addition, policyholders aged below 45 years and with no medical history will not be required to undergo any medical test. Other benefits include family floater benefits, flexible plan options, pre, and post-hospitalization expenses and cashless mediclaim benefits.

Religare Health Insurance Company Limited

The minimum entry age is 91 days while there is no cap on the maximum age at which one can buy this kind of insurance. The waiting period is from 30 days to four years in addition to policy renewability benefits.

Cigna TTK Health Insurance Company Limited

Policyholders can claim pre and post-hospitalization expenses in addition to the recovery of the amount spent on daycare treatment and certain specific procedures. Bonus sum assured at the time of renewal, irrespective of whether the policyholder has made the claim or not.  

Bajaj Allianz General Insurance Company Limited

Policyholders can access cashless hospitalization across 4000 hospitals empanelled in its network. Pre and post-hospitalization expenses are covered for 60 days and 90 days respectively. No claim bonus includes a higher sum assured amount starting from 10 percent to a limit of 50 percent more on the original sum assured. Lifelong renewability option is available.

New India Assurance Company Limited

Room rent, boarding, nursing expenses, ambulance charges recoverable. Policyholders may also recover the expenses made on AYUSH treatments.

Oriental Insurance Company Limited

Apart from cashless treatment in-network hospitals, comprehensive health coverage is available to policyholders. Daily cash allowance and quick claim settlement options are also available under this plan. Lifelong renewability and portability are other features that explain the pervasiveness of this plan.

National Insurance Company Limited

Expenses of more than a hundred daycare treatments sans any need for hospitalization is also covered. Policyholders can also claim on the expenses incurred during hospitalization and treatment pertaining to organ transplantation. Policyholders preferring ayurvedic treatment or homeopathic treatment facilities need not worry as these expenses can also be claimed. While the critical cash benefit can go up to a maximum of Rs 10 lakhs, policyholders are allowed a discount of 5 percent on the base premium determined while buying the policy initially.

With such a multitude of health insurance options available, India might soon reach its target of having its entire population under the ambit of health cover within the next few years.