Health insurance policies are designed to support a policyholder during hospitalisation procedures by offering financial protection. So, it’s all about funding for the medical expenses incurred AFTER you fall ill. But what about preventing such ailments altogether? Do health insurance policies fund such preventive measures too?
Well, YES! From vaccinations to OPD coverage, health insurance plans for preventive care have much to offer their policyholders. And, since the preventive care procedures in the medical industry are not exactly pocket-friendly, having significant funding in the form of a health insurance plan can be quite helpful.
However, not all health insurance plans offer coverage for preventive treatments and procedures and you need to be specific about the kind of procedures that you want coverage for. So, here’s a look at all you need to know about preventive care in health insurance and the best health insurance policies that cover these.
Preventive Care in Health Insurance
What is Preventive Care in Health Insurance?
Our sedentary lifestyle, unhealthy food habits, and the residual impact of the pandemic have left us vulnerable to a diverse range of ailments. Subsequently, we need to take preventive steps to stay healthy or detect ailments as soon as possible. Unfortunately, this involves a list of diagnostic tests, vaccinations, visits to doctors, and other pathological procedures that incur substantial medical bills.
Taking into account the recent prioritisation of preventive medical measures, health insurance providers offer some preventive care in their health insurance policies.
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What are the types of Preventive Care in Health insurance?
Preventive care in health insurance plans ideally comprises the following offerings-
- Vaccination - Whether it’s a newborn’s vaccination or that of an adult for animal bites, usually vaccines have a course of multiple injections across several seatings. Such vaccinations are expensive and are covered by some health insurance plans (some maternity plans offer coverage for vaccinations for newborns and mothers).
Drawbacks: We don’t usually recommend maternity health insurance policies since they spike the premiums unnecessarily, have long waiting periods, and sub-limits on the treatment charges.
- Doctor consultation - Not all ailments require hospitalisation. A visit to your doctor and a few follow-up visits to him/her may suffice at times. A solid health insurance for preventive care will cover such expenses.
Drawbacks: Health insurance plans with doctor consultation coverage usually have a cap on the total amount assigned to annual/per-visit charges. Moreover, you end up paying a significantly higher premium for such plans.
- Dental care - Health insurance plans usually don’t cover dental treatments unless the procedure is deemed medically necessary. However, there are a few plans that cover items like root filling, etc.
Drawbacks: Health insurance plans that cover dental charges are a rare find and such plans are not exactly comprehensive because they end up compromising on the other offerings.
- Radiology and pathology test - Say you have been diagnosed with viral fever. To stay on the safe side, your doctor prescribes you to undergo a few blood tests. Such pathological tests can amount to a substantial sum that will lighten/empty your wallet. On the other hand, a health insurance plan can help you out with this by offering significant funding for the same.
Drawbacks: Health insurance policies that offer coverage for radiology and pathology tests are rare. More often than not the additional premium that you pay may seem to be cumulatively more as compared to the charges you may have to pay out of pocket while getting these tests done yourself.
- Health check-up - An annual health check-up is crucial in the early diagnosis of any ailment or to check the progress of any existing disease. However, such check-ups don’t come cheap and weigh in significantly on your savings.
Drawbacks: Almost every top-notch health insurance policy offers a free annual health check-up. There are no drawbacks to this complimentary feature since you are not charged any extra premium for this. However, when choosing such plans, do make sure that there are no measly cappings on its check-ups and not many restrictions.
- Pharmacy concessions - Standard health insurance policies offer coverage for all kinds of medical expenses during your pre and post-hospitalisation days. However, once you go past this date, you will have to bear the costs of your medications. In case you have a preventive health insurance plan in place, you may get some of your pharmacy bills covered.
Drawbacks: These plans are especially beneficial if you have ailments like cardiovascular issues, high blood pressure, diabetes, cholesterol, etc. However, before you purchase the policy make a quick calculation to ensure that you do not end up paying more in your additional premiums than the total benefits you are expected to receive.
Why don’t all health insurers offer coverage for Preventive Care?
Preventive Care involves vaccinations, doctor consultations, dental, pharmacy concessions, etc. - all of these are treatments that are normally availed by all. If all health insurance plans and insurers started offering them as a part of their plan, they would soon be paying for substantial claims.
This would most likely cause an issue with their financial stability. In the future, health insurers will be forced to either - spike their premiums, deny legitimate claims or pay partial claims.
Thus, to prevent such financial fallouts, not all health insurance policies or providers offer preventive treatment coverage. The ones that offer preventive care coverage extend the perk as an in-built form or as an add-on. Such features don’t cover all the preventive care features under one plan.
Here is a look at some of the best health insurance policies for preventive care in India -
What are the Best Health Insurance Plans for Preventive Care in India?
| Best Plans | Coverage Details |
|---|---|
| HDFC ERGO Optima Wellbeing Rider (with Secure and Super Secure plans) |
|
| Care - Care |
|
| Care - Supreme |
|
| Niva Bupa Aspire |
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| Niva Bupa Health Companion |
|
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Should you avail of a Health Insurance Plan for Preventive Care in India?
Preventive care tests do incur a substantial bill. However, in case you choose a health insurance policy based on its features of preventive care coverage, then you might end up -
- Compromising with the priority features of no copayment, no room rent restrictions, no disease-wise sub-limits, etc.
- Paying higher premiums
Moreover, more often than not, these preventive test coverages come with a capping and some other restrictions. So, unless you come across a plan where there is a nominal premium spike on your preventive coverage options, it’s best to steer clear of prioritising this feature as a determiner while picking your health insurance policy.
