Home > Your Money > It’s time to read your health insurance policy again and look for these details
It’s time to read your health insurance policy again and look for these details

In a Zoom call with friends or colleagues, and in discussions at home, there is a topic that is like morning tea these days — health. With patient numbers due to COVID-19 climbing each day and the cost of treatment moving upwards, do you know exactly what all your employee health insurance covers?

To put it simply, your employer provides you with a group insurance plan, which is not enough. Understanding what your policy doesn’t cover will help you understand why.  

People being tested for coronavirus
Image: Sanchit Khanna/Hindustan Times via Getty Images

What’s not covered?

Out-patient services, quarantine facilities, pre-existing conditions, and preventive health check-ups are some of the health-related aspects that are not covered in insurance provided by your employer. Additionally, when admitted to a hospital there could be room-rent restrictions or co-payment clauses in your policy. This implies that while you are covered for a particular ailment, you may have to make do with the room type and/or pay half of the total bill during settlement and the doctor’s fees to top it off. Of course, the coverage is also negligible at an average of Rs 2 lakh per year. This may come in handy, albeit to only reduce the financial burden in a health emergency. An insurance that you buy privately should help supplement the costs or allow for a cashless transaction.

Often, only spouses and children are covered and dependent elderly parents are not. To be able to meet the needs of ageing parents, private health insurance becomes a must. It also allows you to claim tax deductions. With the gig economy and entrepreneurship on the rise, employee health insurance remains absent and private health insurance becomes a necessity. You should also know that you will lose coverage once you exit the company, a scary prospect when you hear news of pay cuts and job losses.

Health Insurance

How to buy health insurance?

When buying supplementary or private insurance for yourself, sit down and read what your group insurance policy leaves out. Asking a consultant would be beneficial if financial jargon scares you. The next step would be to go to an aggregator marketplace such as Policybazaar.com or Insurancedekho.com and filter out health insurance policies based on your requirements; you can pick them based on the price. However, a pertinent aspect is the claims settlement ratio (the higher the better). Additionally, if you have a pre-existing condition or have a hereditary tendency to develop diseases, it is better to buy a policy that covers those and an epidemic/pandemic. 

Coincidentally, most insurance aggregator websites now have a small icon on their health insurance panel, suggesting COVID-19 is covered. Lifestyle Asia India recommends Religare, Max Bupa, and HDFC Ergo health insurance policies, which include a claims guarantee and a network of hospitals for cashless claims.

All images: Courtesy Getty Images

Anam Naqvi

Anam is an astute writer who aims to demystify personal finance and wealth management for the common man. She has written on geopolitics, economics and politics as well for the Economist Intelligence Unit before moving to personal finance content strategy. Her penchant for storytelling and conversation has resulted in a podcast about human stories.