6 Add-Ons to Level-Up your Health Insurance Policy and Enhance its Coverage

While purchasing a health insurance policy, it is important to tailor the coverage to your specific healthcare needs. Here are six key enhancements you should consider to ensure your finances are secure during a medical emergency.

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When buying a health insurance policy, you must ensure that it provides sufficient coverage for all your needs.

A basic policy is designed to provide effective protection to a large section of the population at a reasonable price. You should look to tailor it further to your specific requirements to manage your healthcare cost better.

Here are 6 ways you can enhance your health insurance cover to protect you against specific risks you may face.

1. Medical Second Opinion

Enhance your health insurance policy by adding a cover for second opinion, in case of a listed critical illness or surgery being advised.

When faced with a new medical diagnosis, it is normal to feel confused. It may feel overwhelming to choose between multiple treatment options. How do you even verify whether the diagnosis is accurate?

This is where getting a medical second opinion can be a great help. As a healthcare consumer, seeking a second opinion equips you to make more informed decisions. The second opinion helps you:

With Medical Second Opinion cover, a few insurers allow you access to their panel of specialists for the second opinion on any surgery or critical illnesses listed in the policy terms and conditions.

2. Outpatient Treatment

Typically, health insurance coverage is available only in case of hospitalization. The cover for pre- and post-hospitalization expenses can only be claimed in the context of hospitalization for at least 24 hours.

That said, not all your healthcare expenses are tied to a hospitalization.

With an Outpatient Treatment cover, you can expand your health insurance coverage to include Out-Patient Department (OPD) expenses like charges for doctor consultations, lab tests, medicines, dental care, spectacles and hearing aids up to the specified limits selected.

3. Critical Illness Benefits

Given the medical advances over the last decade, you are more likely to live to a ripe old age.

Claim statistics from around the globe show that you are five times more likely to contract a serious non-communicable illness than die before the age of 65. You are much more likely to survive the illness than previous generations, but the treatment can severely drain your finances.

For example, cancer treatment costs Rs. 10 lakh on an average today, organ transplant can cost between Rs. 4 lakh to 20 lakh.

The fact remains that many of the deaths from heart diseases in the last decade could have been prevented if the families had a way to cover the expenses involved. A critical illness cover could be a boon in such a scenario.

A critical illness benefit added to the health insurance policy can help you focus on recovering their health rather than worry about the finances. It provides a lump sum amount on detection of any of the listed critical illnesses. This is independent of the actual expenses one may incur, and can be used to meet even the non-medical expenses that may arise.

4. Medical Inflation

Healthcare costs are growing at a much faster rate of inflation than the average inflation in the economy. Some reports estimate that medical inflation to be at 12%. Your health insurance cover also needs to grow to meet the rising expenses.

Towards this, a Medical Inflation add-on to your base health insurance policy can be a great help. With this, the Sum Insured is enhanced at a fixed rate, typically 10% of the Base Sum Insured, every Policy year up to a maximum of 50 % of the base Sum Insured.

This increment is available regardless of any claims filed during the policy year.

5. Emergency Air Ambulance

An emergency air ambulance can cost up to Rs. 1.5 lakh to Rs. 2 lakh per hour. Give the high cost and specificity of use, most base health insurance policies do not cover this expense.

Based on your particular requirements, you can enhance your cover to include air ambulance charges. Typically, the coverage is capped at Rs. 5 lakh and is not deducted from the base Sum Insured.

An air ambulance may be needed if:

  • You are injured on a trip and need to be transported to a medical facility near your home
  • One needs to be moved to another facility for a specialized treatment
  • One needs to be taken to a hospital immediately, but transport by road is not possible
  • Specialized treatment/ care is needed during transport as well.

6. Bariatric Procedure

Till a few years back, bariatric surgery and related procedures were a standard exclusion across health insurance providers. This has changed with obesity becoming more prevalent, and technological advances making bariatric procedures much more effective.

If you are obese or have a family history of obesity, you should consider enhancing your health insurance policy through a cover for bariatric procedures. This cover typically has a waiting period of three years. You can claim the cost of a weight reduction surgery provided:

  • Your BMI is over 40, or
  • Your BMI is over 35 and you have at least one of the below conditions:
    1. Coronary artery disease
    2. Type-2 Diabetes
    3. Obstructive sleep apnea
    4. Hypertension.

While these enhancements are available at an additional premium, the payback for themselves during an emergency. You should make an honest assessment of your healthcare needs, and use these to tailor your health insurance coverage to your specific requirements.

A health insurance policy may not make you better, but it can definitely take the financial pain away. With your finances secure, you can focus on the most important aspect of the situation – your health.


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