When it comes to your health and well-being, prevention is always better than cure. However, in our busy lives, health often takes a back seat until issues become unavoidable.
This is why preventive health checkups have become a necessity in modern healthcare. They emphasise the importance of early detection to reduce medical expenses and improve overall wellness. These checkups allow you to identify potential health issues before they become severe and ensure you are wary of any issues for better healthcare & early treatment.
What is a Preventive Health Checkup in Health Insurance?
A preventive health checkup – usually a part of health insurance benefits – is a set of medical evaluations and diagnostic tests to check your health overall health condition. Many insurers now offer this as an included benefit or as an add-on and allow you to undergo regular tests without additional costs. These checkups commonly include routine assessments such as blood pressure, cholesterol levels, and sugar tests to identify potential health risks early on.
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Benefits of Preventive Health Checkups in Health Insurance Policies
Here are some benefits of preventive health check
- Early Detection of Diseases
One of the most significant advantages of preventive health checkups is their ability to catch illnesses early, often before the symptoms manifest. Conditions such as diabetes, hypertension, or even certain types of cancer are far easier to manage and treat when identified in their initial stages. Early detection not only increases the chances of successful treatment but also prevents the condition from worsening, which could otherwise have led to more invasive procedures and higher medical costs.
- Cost Savings on Routine Tests
Preventive checkups can save you a considerable amount of money, as they are covered under most health insurance plans. Routine diagnostic tests, which might otherwise be an out-of-pocket expense, are included, making healthcare more accessible and affordable. This financial relief ensures that you do not delay important tests, leading to better health outcomes in the long run.
- Improved Long-Term Health Management
Health checkups enable you to monitor your health regularly, helping you plan and manage your well-being more effectively. By staying informed about key health metrics, you can adopt timely lifestyle changes, follow prescribed treatments, and avoid severe complications down the line. This not only reduces the risk of chronic illnesses but also fosters a healthier lifestyle over time.
Drawbacks of Preventive Health Checkups in Health Insurance Policies
While beneficial, preventive health checkups come with some limitations:
- Not available in all health insurance policies
While preventive health checkups offer undeniable benefits, they are not always included in the base health insurance plan. In some cases, policyholders must purchase this feature as an add-on, which increases the overall cost of the policy. This can be a deterrent and limits access to preventive care.
- Exclusions in Full-Body Checkups
Despite being labelled as ‘comprehensive’, many preventive checkup packages exclude certain diagnostic tests. For instance, assessments of vitamin levels or alkaline balance — critical for identifying specific deficiencies — are often not covered. This partial coverage limits the scope of preventive care and may require you to bear the cost of additional tests out of pocket.
- Limited Coverage in Family Plans
Family floater health insurance policies, while convenient for households, may sometimes fall short when it comes to covering preventive checkups for all members. Some plans prioritise the primary policyholder or adult members, leaving children and or parents excluded. This limitation can reduce the effectiveness of family health planning, as not all members benefit equally from preventive care.
Eligibility for Preventive Health Checkups in Health Insurance
Eligibility for preventive checkups depends on the policy's terms and conditions. Key factors include:
- Policy Renewal: Some insurers offer checkups after completing a certain number of policy years, usually one or two years.
- Cover Amount: Policies with higher coverage amounts often include preventive checkups as a standard feature. However, in some policies with a lower sum insured, they are either not included or not covered every year. Some policies may also cover a more comprehensive list of tests with a higher cover amount.
It’s important to read the policy document carefully to understand the eligibility criteria and frequency of these benefits. However, we understand that going through a health insurance policy document is exhausting. This is why we at Ditto created a tool to help you understand policy documents with ease – Understand Your Policy Tool.
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Standard Health Parameters Covered in Preventive Checkups
Preventive health checkups usually include tests to evaluate overall health and identify common issues. These tests normally cover:
- Blood sugar & HBA1C levels
- Cholesterol (LIPID) profile
- Body Mass Index (BMI)
- Blood pressure levels
- Organ-specific evaluations like liver and kidney function
- Lung Function test (PFT)
However, some specific tests, such as vitamin levels & thyroid tests, are generally excluded.
Top Health Insurance Plans Offering Preventive Health Checkups
- HDFC ERGO Optima Secure
HDFC ERGO Optima Secure is a comprehensive health insurance policy that includes preventive health checkups. The insurer ensures that every policyholder has access to annual preventive health checkups, aiding early detection and management of potential health issues.
Additionally, Optima Secure offers unique features, such as doubling your base coverage amount right from day one through its Secure Benefit. Combined with good pre- and post-hospitalisation coverage of 60 & 180 days and no room rent restrictions.
- Aditya Birla Activ One Max
Aditya Birla Activ One Max is a health insurance policy that goes beyond traditional coverage by integrating wellness-focused benefits such as regular health checkups & gym memberships. These checkups are part of the insurer’s comprehensive wellness program, which includes the HealthReturns feature, where you can get up to a 100% discount on premiums for the following year, provided you are healthy. Policyholders earn rewards for maintaining an active lifestyle — tracked through wearable devices or fitness logs — which can be used to offset future premiums or other expenses.
The policy also offers unlimited restoration of the base sum insured, no disease-wise sub-limits, and room rent flexibility, ensuring that you are not only incentivised to stay healthy but also well-protected during medical emergencies.
- Care Supreme
Care Supreme combines affordability with extensive wellness benefits, making it an excellent choice for both individuals and families. The policy includes annual health checkups as an add-on promoting regular monitoring and preventive care. Additionally, Care Supreme offers unique wellness incentives, such as discounted gym memberships, which encourage a healthy lifestyle.
Care Supreme also has an unlimited restoration of the sum insured, no co-payment, and no disease-wise sub-limits. While the insurer’s complaint volume is slightly higher than some competitors, its affordability and wellness perks make it a compelling option for those seeking to combine good coverage with preventive care.
- Niva Bupa ReAssure 2.0
Niva Bupa ReAssure 2.0 is designed to prioritise both treatment and prevention, with preventive health checkups included as a standard benefit. In addition to its wellness benefits, Niva Bupa ReAssure 2.0 includes innovative features such as ReAssure Forever, which ensures unlimited restoration of the sum insured for every claim once triggered. The policy’s Lock the Clock feature allows younger policyholders to lock in lower premiums until their first claim, further increasing its appeal. While the insurer’s metrics could see some improvement, the plan remains a strong choice for those looking for comprehensive coverage coupled with good wellness benefits.
Tax Benefits on Preventive Health Checkups
If your health insurance policy does not cover preventive checkups, you can still claim tax benefits under Section 80D of the Income Tax Act. Expenses up to ₹5,000 for preventive health checkups are deductible, making these tests not only a health investment but also a financially smart choice.
How to Avail Preventive Health Checkups in Health Insurance
Here’s how you can avail of preventive health checkups under your insurance policy:
- Check Your Policy Details: Verify if your policy includes preventive checkups and understand the frequency of availability. Some insurers allow you to have a preventative check-up at any facility and file for reimbursement. However, some allow this test only at network hospitals.
- Choose a Network Diagnostic Center: Select a centre from the insurer’s list of empanelled diagnostic facilities.
- Book an Appointment: Schedule a convenient time for your checkup through the insurer’s online portal or customer service.
- Submit Documentation: Provide your policy details or health card at the centre for verification.
- Undergo Tests: Complete the tests included in your policy and ensure you receive the reports for your records.
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Conclusion
When it comes to your health, being proactive is always better than being reactive. By offering regular assessments and early detection, insurers help policyholders maintain better health and avoid costly treatments in the long run. As always, review your policy’s terms and make informed decisions to maximise these benefits.
