Does The Family Health Insurance Plan Provide Adequate Coverage For A Variety Of Illnesses?

In any health insurance plan, you can expect the hospitalization expenses to be taken care of. What you should be looking for besides that is coverage for pre-and post-hospitalization expenses. You should also ask questions about the coverage for other health expenses such as ambulance services, vaccination, annual health check-ups, AYUSH/alternative treatment, and so on. A good health insurance plan should cover an extensive number of day-care surgeries as well.

Does The Insurer Offer Cashless Services At A Large Number Of Hospitals?

This is an important question to ask if you want to find the best out of the many health insurance plans for family coverage. If the insurer has a large number of network hospitals, that is the hospitals where one can access cashless treatment, it can really ease things for you. It takes away the need to get yourself involved in the claim process and arrange large amounts of money as the insurer tends to take care of that when it comes to cashless services.

How Dedicated Is The Insurer To Settling The Claims Of Its Policyholders?

This can be ascertained to a great extent by looking at the claim settlement ratio of the insurance company. It tells you how many claims an insurer solved in a year as compared to the number of claims they received. When finalizing health insurance plans for family needs, it is important to go for an insurer that has a CSR of over 90%.

How Many Members Can I Add To A Family Health Insurance Plan?

These days, insurers offer family plans for every type of family. In most plans, you can cover yourself, your spouse, dependent children and parents, parents-in-law, siblings, nieces and nephews, and so on. Plus, insurers that offer health insurance plans for families understand that families undergo changes. So, one can add or remove members as per one’s will. You can also purchase a family plan if you are a single parent.

What Are The Exclusions Of The Family Health Plan?

Looking through the exclusions category of any plan is vital. A plan that has exclusions for a large number of relevant diseases is better avoided. Usually, the exclusions are related to situations where the health expenses are caused due to war, nuclear activities, substance and alcohol abuse, and so on. In many cases, pre-existing diseases may not be covered for a certain period.

For many, their loved ones are their biggest treasures. The care and concern one feels for them can be expressed in practical form by securing their health and their future in the best way possible. Therefore, ensure to do ask these questions when you are looking through health insurance plans for family coverage.

Given the current scenario, you might have several questions regarding your presently active health insurance policy. Several policyholders are wondering whether they should increase their health insurance due to the pandemic to deal with the rising risks and medical expenses. We will attempt to answer that in this article.

As per IRDAI guidelines, the typical health insurance policy is expected to provide coverage for COVID-19 treatment expenses. However, there might be certain situations where your policy might not provide coverage. Let’s look at the following scenario for example.

Ramesh was diagnosed with COVID-19 and immediately hospitalized for treatment. During his treatment, he was given several bottles of oxygen. The overall treatment at the hospital cost Ramesh Rs 4.5 lakhs. Ramesh’s health insurance had a sum insured of Rs 5 lakhs. However, he could not pay the entire Rs 4.5 lakhs out of his health insurance pay-out as his health insurance doesn’t cover consumables. Consumables include oxygen bottles, PPE kits, gloves, sanitizer, and so on. He had to pay a significant chunk (cost of consumables) of the hospital bill out of his own pocket.

Furthermore, Ramesh was in the hospital for two weeks for his entire course of treatment. During this time, he had to take a break from his work and this affected his income severely. He had to dip into his savings for his hospital and household expenses. Being the sole breadwinner of his family, the situation was tough indeed.  

In this scenario, having a health insurance policy that focuses on the unique circumstances of COVID 19 might have helped Ramesh. To keep up with the specific needs of a COVID 19 patient, the Insurance Regulatory and Development Authority of India (IRDAI) has introduced two new COVID 19 specific policies: Corona Kavach Policy and Corona Rakshak Policy.  These two have certain distinct features that prove to be more suitable in the present circumstances. Let’s try to understand the two policies.

Corona Rakshak Policy – Health Insurance

Corona Rakshak Policy is a benefit-based plan which financially covers the policyholder in case of a COVID-19 diagnosis.

Even if you already have health insurance, you may increase your coverage by buying the Corona Rakshak Policy. Under this policy, you are eligible for a 100% pay-out of the sum insured in case you are diagnosed with COVID-19 and are hospitalized for 72 continuous hours or more. This lump sum amount can be used as you deem fit for any expenses that may arise in the course of your treatment.

The sum insured for the Corona Rakshak Policy ranges from Rs 50,000 to Rs 2.5 lakhs. Selecting a higher sum insured will take care of the rising expenses of COVID-19 treatment and help you get the medical care you deserve.

COVID-19 can cause severe complications and the treatment for the same may also lead to loss of income for a while. In such a situation, your household finances must continue running smoothly. Opting for a Corona Rakshak Policy would help compensate you for the loss of income due to your COVID 19 treatment so that you and your family can focus on recovery.

The infectious nature of COVID 19-19 means that your near and dear ones are at risk too if you have been diagnosed. That is why it is advisable that you also purchase a Corona Rakshak Policy individually for your family members to fully secure them.

Even if you already have a health insurance policy, opting for the Corona Rakshak Policy can help you fill in the gaps of your present coverage.

Corona Kavach Policy – Health Insurance

The Corona Kavach Policy is an indemnity-based policy that offers financial coverage for COVID-19 hospitalization and treatment. This policy acts like your normal health insurance plan, but only for COVID 19-related medical expenses. In case, you do not have health insurance. This policy can be immensely helpful to you given the current situation.

Major features of the Corona Kavach Policy

1. Wide coverage

A standard Corona Kavach Policy will cover the following expenses-

1. Hospitalization (this also includes hospitalization at any temporary, government-approved treatment center)
2. Pre- and post-hospitalization for a specified period as mentioned in the policy
3. Authorized AYUSH treatments
4. Telemedicine consultation
5. Home care treatment

Hospitalization coverage also includes consumables such as PPE kits, gloves, oxygen, and so on.

2. Sum assured of up to Rs 5 lakhs

While opting for the Corona Kavach policy, you can select the sum insured ranging from Rs 50,000 to Rs 5 lakhs.

3. No upper limit on room rent

Considering the present shortages of resources, hospitals are charging heavily for beds and rooms. Your normal health insurance might not help you with the finances here as most insurers have a capping on room rent while paying for hospitalization expenses. Under the Corona Kavach Policy, however, there is no such cap.

4. Also available as a family plan

This policy can be purchased for the whole family under the insurer’s Corona Kavach family health insurance plan.

It is important to note that the Corona Kavach Policy and Corona Rakshak Policy are available in short-term tenure options of either 3 ½ months, 6 ½ months, or 9 ½ months. A minimal waiting period of 15 days is applicable to both the policies. Normal health policies usually have waiting periods that can go up to 90 days which might not be suitable during a pandemic.

As we can see from the features of both the policies, while the Corona Rakshak plan may supplement your existing health insurance during these troubled times, the Corona Kavach plan can act as an insurance policy of its own. Being protected, physically, and financially, during a pandemic is of the utmost importance for peace of mind, and increasing your health insurance can help you achieve that.

However, it must be emphasized that these two plans are applicable to COVID 19-related expenses only. If you want a comprehensive health plan that includes coverage for other diseases and expenses, it is advisable to purchase a normal health insurance policy for you and your family.

Since Corona Rakshak policy and Corona Kavach policy are standardized policies, the coverages and terms and conditions remain the same across all insurance providers.

We hope this article has been helpful to you.