A high value family health insurance or individual insurance is gaining a lot of popularity. Considering the ever-increasing medical expenses. The plan can help you prepare for a future of uncertainty as far as health is concerned. A high value health insurance plan has a sum insured in lakhs and in some cases up to 1 crore. The high sum insured amount ensures better peace of mind and the ability to deal with any medical condition without exhausting your savings.
A health insurance policy is without any doubt the need of the hour. However, coverage and protection are points of contention. A few years ago, a health insurance policy with a sum assured of 5 lakhs, or up to 10 lakhs, might have been enough. However, the same policy will leave you wanting for more today. It is primarily due to medical inflation in the country, which tends to be higher than the average inflation rate. It is for these reasons that high value health insurance policies have gained a lot of popularity in the recent past. Here is all that you need to know.
High Value Health Insurance Plan
High value health insurance plans are designed for healthcare treatments that are usually quite expensive. On average, the sum insured by such plans is about 1,00,00,000 or even higher. The major differentiating factor between high value health insurance plan and a standard plan is the sum insured. Apart from a higher sum insured, the plan also offers a host of other benefits and enhanced coverage as compared to a standard health insurance plan.
In most cases, a high value health insurance plan comes with lower deductibles, lower or no co-payments, and additional services to cater to the needs of policy holders.
Features and benefits of high value health insurance plans
Should you opt for a high value health insurance plan, the following are all the features and benefits.
1. No room rent limit
High value health insurance plans do not usually have any sub-limits on hospital room rents. It must be noted, that the terms of each health plan vary and depending on hospitalisation criteria might differ a bit.
2. Sum insured
One of the major perks of opting for high value health insurance plan is the superior sum insured. In most cases, some insured is usually a few lakhs, or even crores in some cases. This ensures financial protection against any medical expenses even in the case of critical illness treatment.
3. Comprehensive coverage
High value plans offer a host of features and coverage as standard offerings. You can expect features such as maternity cover, critical illness cover, expenses related to organ transplants, regular health checkups, OPD cover and more. Making sure that the plan is quite exhaustive.
4. Out of pocket expense
Since the sum insured is significantly high and so are the claim settlement ratios, the out-of-pocket expenses reduce drastically. The plan ensures that you do not have any financial worries while dealing with any health related issues.
5. Foreign treatment
The cost of treatment in some foreign countries can be quite high. However, if you are looking for specialised treatments that are available in limited countries, a high value health insurance plan can enable it for you. The higher coverage limits will allow you to undergo the treatments.
6. Cashless benefits
As is the case with most family health insurance plans in the country, you can avail of cashless benefits. On visiting a network hospital, you can undergo treatment without having to pay from your pockets. The insurance company will directly settle the costs with the hospital on discharge, ensuring that you focus on healing and treatment, rather than the cost of treatment.
7. Additional features
Since these are premium plans, you can expect additional features on offer such as dental cover, vision cover, support for mental health, alternate therapies, access to wellness programs, telemedicine, and more. These features make the policy even more attractive.
Drawbacks of high value health insurance
A high value health insurance policy offers a lot of perks and benefits. However, it also has a few demerits and drawbacks. Here are the most prominent ones.
1. High premium
It should not come as a surprise that the premium cost of high value health insurance plans is high. As compared to standard health insurance plans, the premiums of high value policies are quite high. Due to their higher premium costs, they are not accessible to everyone. People from low income groups might not prefer to opt for such a policy.
2. Co-payment for seniors
Standard health insurance plans also have co-payment clauses. However, a co-payment of 10% to 15% in a high value plan would result in a higher out-of-pocket expense for policyholders. This is particularly true for senior citizens.
3. Over insurance
Opting for a high value health insurance policy can be similar to over-insurance for individuals who are healthy and need minimal medical attention. It can be over insurance for individuals who already have coverage in some form from other sources. The policy offers a lot of additional benefits, which if not utilised would result in the premiums being a burden.
4. Limited network
Some of the high value health insurance plans offer you access to a restricted pool of healthcare providers. If you seek treatment within the network, you will have access to lower out of pocket expenses. However, the moment you step out of the limited network hospitals, you might end up with higher costs or at times even no coverage.
Should you opt for one?
A high value health insurance plan is not for everyone. It serves specific needs and its higher premium costs can be a big barrier as well. Here are the individuals who can benefit from such plans.
1. Family history of illness
For Individuals whose family has a history of serious illnesses or critical illness, opting for a high value plan can be a sensible choice. The health plan will ensure adequate coverage even in the unfortunate event of a diagnosis of critical illness. The higher coverage amount will give access to the best treatment out there.
2. Senior citizens
With age, the possibility of health issues increases significantly and with the rising costs, it can be quite difficult for seniors. Opting for a high value policy can be quite useful in such situations. It will allow seniors to receive the right treatment at the right time without burning through their retirement funds.
3. International treatment
Individuals suffering from unique medical conditions that need specialised treatment that is available at limited locations across the globe can also opt for high value policies. The plan covers the treatment in foreign countries, making treatment much more manageable.
Conclusion
A high value health insurance policy can be a lifesaver in quite a few instances. Individuals with a history of critical illness in the family or senior citizens can greatly benefit from such policies. The plan carries forward all the goods of a standard health insurance plan and adds a few additional features while enhancing the coverage and sum insured. Making it a very strong product in your financial planning.
Disclaimer: The above information is for illustrative purposes only. For more details, please refer to policy wordings and prospectus before concluding the sales.
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Published – December 26, 2024 03:21 pm IST
