What should a woman look for in a health insurance policy?, Health News, ET HealthWorld

By Anuradha Sriram

A recent study shows that the percentage of women who have health insurance in India is still low. This is a trend that should cause concern, given that women need health insurance as much as men and in fact need insurance tailored to their specific needs. Statistically, women tend to outlive men, India and most parts of the world. This means that women live longer into old age – a time when health care needs are greatest and hospitalizations can be frequent. Women are also exposed to several diseases and conditions that are specific to them.

So it’s obvious that women need health insurance, but what should you consider when buying one? To find a policy that delivers on its promises, you need to consider the following considerations:

  • Certain diseases, such as breast cancer, cancer of the reproductive system, etc. are specific only to women. When these diseases strike, the cost of treatment is considerable. Treatment costs can become prohibitive, so look for a plan that covers these specific illnesses.
  • It is believed that men are more prone to cardiovascular disease. Not true. The three-year period Saffolalife study, which is India’s largest study of heart disease risk factors, found that three out of five of India’s 51,700 urban respondents are at risk of cardiovascular disease (CVD). Moreover, these risks manifest themselves as soon as 35 years in women. Your insurance plan should also provide adequate coverage in this area.
  • The costs of pregnancy and motherhood are considerable. Also, if there is any complication at the time of delivery, including gestational diabetes, you may incur additional medical costs. To cover these maternity costs, dedicated maternity health insurance schemes for women are essential.
  • Look for a plan that covers infertility treatments. You may never need it, but you’ll be glad you have it if you do. With pollution, adulteration and lifestyle-related diseases showing an upward trend, infertility is becoming more and more common, even among young couples.

These factors are the basics, the hygiene factors, if you will. There are a number of other factors that go into this decision, which help to ensure that you don’t overspend on insurance while being insufficiently covered. To decide how much coverage you need, you need to consider:

  • Lifestyle: Do you have healthy habits? Do you smoke? Do you live in a polluted urban center? What are the costs of treatment like in your city
  • Nature of job and salary: How stressful is your job? How many hours do you work? How long is your journey? Can you afford a higher bonus because of your higher salary? What is the coverage amount of your employer’s group health insurance policy?
  • Premium amount and co-payment: Are you comfortable with your premium amount and payment schedule? Do you know your co-pay percentage – this is the percentage of all medical bills you are expected to pay. Are lower co-pay percentages available in the market?
  • Waiting period: The waiting period is the period during which your coverage has not started – that is, when any claims you make will not be honoured. Consider the waiting period in relation to your own medical condition and family history. Sometimes it’s more affordable to wait a little longer than to look for a policy with a shorter waiting period. If you are in good health, a longer waiting period should not be a deciding factor.
  • Age and medical history: How old are you? Do you have a family history of certain illnesses? Remember: the younger you are, the lower your insurance premium and the better your benefits. Also remember that you are younger today than you will ever be – so if you haven’t purchased insurance yet, now is the time to do so.
  • Tax Benefits: Medical premiums fall under the tax exemption benefits of Section 80D of the Indian Income Tax Act 1961.
  • Factoring in inflation: Healthcare inflation exceeds headline inflation, so it’s important to factor it in. Usually, for all calculations, healthcare inflation is estimated at 15%. A simple way to assess your needs is as follows: think of a hospital you would like to go to in the event of a medical emergency, then check their basic and major hospitalization costs. Use an inflation calculator to determine what your needs might be in 10, 15 or 20 years and plan accordingly.

Women around the world play a crucial role in running and raising a family – they are, for all intents and purposes, the beating heart of the home. A mother’s illness and hospitalization can have repercussions that go far beyond the immediate trauma of hospitalization and/or surgery.

Medical science is doing its part – advances have been made in critical and chronic care, cancer treatment and prevention, and genetic medicine is developing by leaps and bounds. Women need to do their part by paying more attention to their health, getting regular medical checkups and getting the right insurance policy to give themselves the best chance of recovery.

By Anuradha Sriram – Chief Actuary at Aditya Birla Health Insurance

* DISCLAIMER: The opinions expressed are those of the author alone and ETHealthworld does not necessarily endorse them. ETHealthworld.com will not be liable for any damage caused to any person/organization directly or indirectly.


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Justin D. O'Neill