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Complete Guide to increase Health Insurance Policy Coverage

Team AckoApr 12, 2022

Quality healthcare is expensive and is an almost inevitable expense for most of us. It has the potential to eat through our savings and can even leave us bankrupt. However, health insurance providers safeguard us from this unfortunate scenario. They trade the burden of our medical expenses in exchange for a premium payable. In this article, we offer a guide to increase health insurance coverage.

Increase Health Insurance Policy Coverage

Is basic health insurance sufficient?

A basic health insurance plan alone might not be the one-stop solution we wish it to be. Here are the scenarios where a generic plan could fall short.

  • Lower premium health insurance policies often come with restrictions like sub-limits, deductibles, and copayment. That means a part of the claim amount would have to be borne by the insured.

  • Even higher premium health insurance plans come with sub-limits. Sub-limit is the highest amount an insurer will pay for a given condition. Beyond this limit, patients have to pay out of their own pockets.

  • With COVID-like infectious diseases, there are chances of multiple cases of hospitalisation in a family. This might mean simultaneous hospitalisation. In such situations, a common health insurance plan might be insufficient to cover medical expenses.

“But how do I increase the coverage of my health insurance policy to avoid these?”, you may ask. Read on to find out!

Tips to choose the right health insurance provider

Before increasing insurance coverage, it is important to first choose a reliable health insurance provider. Below are things to keep in mind while choosing a health insurance provider.

  • Crosscheck the credibility of the insurance provider by checking online ratings, reviews and testimonials.

  • Make sure the insurer offers a variety of plans to choose from according to your needs.

  • Check if they provide a cashless hospitalisation facility. This saves you the effort of collecting and submitting medical bills for reimbursement.

  • Make sure the waiting period for pre-existing diseases is low. This minimizes the risk to some extent, if you suffer from a pre-existing condition.

  • Check if the exit age of the policy extends to a reasonably old age.

  • Make sure the insurer has an online presence and efficient customer care.

Four easy ways to increase your health insurance coverage

Understanding how health insurance plans can be enhanced, will help you increase your health insurance coverage. Below are ways to help guide you while buying a health insurance plan.

1. Purchase a health insurance plan early

Health insurance might not seem like a priority at a young age. At this age, illness and other ailments are usually not on the horizon. Well, purchasing health insurance as early as possible has some significant advantages.

Below are reasons for purchasing health insurance as early as possible.

  • Ailments are a part and parcel of old age, so the premium charged by insurance companies is also higher at that age. Younger individuals are usually at lower risk of health issues, so the premium charged is a lot lower.

  • Relying on the health insurance offered by your employer (Group Medical Coverage) could backfire. This is true especially in the event of losing a job, retirement or while switching jobs. Thus, it makes more sense to have health insurance independent of the one offered by your company.

  • The exit age of health insurance is usually 65 years. Buying health insurance at a young age also allows you to enjoy coverage even after that age.

  • Paying for health insurance is tax-deductible under Section 80 D of the Income Tax Act, 1961.

  • Buying health insurance at a young age reduces the burden of medical expenses. This in turn allows you to focus your finances on other investments.

2. Choose a comprehensive health plan

A comprehensive health insurance plan refers to a plan that provides coverage for a wide array of medical expenses.

Below are the top ways a comprehensive health insurance plan can increase your coverage.

  • Your comprehensive health plan should cover both pre- and post-hospitalisation expenses. This is besides the general hospitalisation charges that a basic plan also covers.

  • It should cover organ donation, domiciliary hospitalisation (being treated at home) and alternative treatments.

  • Ideally, your health insurance plan should also include coverage for maternity expenses. This is usually granted after the completion of a designated waiting period.

  • If you have more dependents, then choose a Family Health Insurance Policy. Such plans cover your entire family including your spouse and two children. Some also include your parents and parents-in-law as well.

  • Your ideal plan can cover routine doctor visits i.e. Out Patient Department (OPD) consultation costs.

  • Ambulance charges and day care treatments less than 24 hours must also be covered in this plan.

  • Add-ons like maternity cover, personal accident cover, critical illness cover, etc, are available. Consider opting for one that is most suitable to your needs.

  • Your plan must provide coverage even for pre-existing medical conditions. Usually, such diseases are covered after a waiting period of 2-4 years.

3. Super top-up plans

Super top-up plans provide coverage over and beyond your existing insurance plan. They act as a cushion when your medical expenses cross the sum insured limit.

Below are the key ways a super top-up plan can increase your health insurance coverage.

  • A top-up plan and a super top-up plan are different. A super top-up plan can accept multiple claims, while a top-up plan offers only one claim (Please note that this is a basic explanation, please refer to the plan's policy wordings for details.). 

  • You can upgrade your health insurance plan by using a super top-up plan.

  • Super top-up plans offer exclusive plans for senior citizens. These can bring down the higher premium rates charged due to old age.

  • Also, under Section 80 D of the Income Tax Act, the premiums paid for super top-up plans are tax-deductible.

4. Port your health insurance to a different insurance provider

Portability is switching from one insurance provider to another. However, before changing plans, one should review the benefits offered by the new insurance provider.

Below are the ways in which porting can increase your health insurance coverage.

  • While applying for portability one can request for an increase in the sum insured. The new insurance provider reserves the right to accept or decline this request.

  • The insurer decides the percentage of increase. The customer's age, health status and claim record are the criteria considered for this decision.

  • To avail portability, one has to approach the new insurer 45 days prior to the ending of the existing policy. The new insurance provider will reply with the decision within 15 days.

  • A new insurer might cover several more aspects like less waiting period, fewer consumables charges, etc. and offer better services like app-based claims and more network hospitals.

In closing

Medical expenses can easily turn into financial burdens if you don’t get insured. Basic insurance offers only a limited cover on your medical costs. Increasing your health insurance coverage will give you a more holistic cover. Keep your dependents in mind while choosing a health insurance plan. Also, upgrade your plan if you think it does not cover your medical needs adequately. Finally, choose a health insurance provider you can count on.

Frequently Asked Questions

Below are the frequently asked questions on increasing one's health insurance coverage.

Can I upgrade my health insurance at any time?

Usually, health insurance can be upgraded only during the renewal cycle. However, please discuss with the insurance provider for details.

What is the best health insurance for low-income individuals and families?

For some, finding a health insurance policy that fits both their budget and medical needs can be a daunting task. Considering this, the Insurance Regulatory and Development Authority (IRDA) offers an affordable insurance plan called, “Aarogya Sanjeevani”. It offers standardised health insurance to cover basic hospitalisation expenses. To know more, read.

Why did my health insurance premium increase?

Below are the most common reasons for the increase in health insurance premiums.

  • Medical costs increase intermittently because of inflation. Your insurer increases your insurance premium to keep up with these rising costs.

  • Based on claims availed yearly, health providers increase the health insurance premium. You can check your claim history by going through the claims section of your policy document.

  • Increases in age can also affect the premium charged by your insurance provider. This is especially true for customers completing the age of 60 before or after the renewal cycle.

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