Value and premium are rarely offered in a single product. But in health insurance, a higher end package pushes more value into the product that beats expectations. A health insurance cover of ₹3 lakh would cost around ₹8,000 per year, while a ₹2 crore cover can start from ₹14,000 per year. Apart from the large cover, the features within the product are also on the higher end.
Health insurance is a cover for the unknown risk of a health emergency. The higher cover at a reasonably higher price point should not deter policyholders from upgrading to a large cover. The incremental features are an icing on top too.
Premium services
Worldwide coverage, hospitalisation at home, OPD consultation, maternity are the value added features in covers above ₹2 crore. But features that generate incremental cover, for instance, restoration and no claim bonus are not on a scale that entry level products offer.
With a cover running into ₹2 crore and above, the health cover should allow for best care in India or in other parts of the world. Three insurance policies allow for the same. ICICI’s Elevate, Tata AIGs Medicare Premier and Niva Bupa’s Health Premia allow for worldwide medical care for diagnosis made in India.
Two of the policies also allow for OPD consultations (outpatient consultation) as a feature of the base policy itself. Foremost amongst them is Niva Bupa’s policy which allows for ₹50,000 limit per year for consultations. So does Tata AIG but is limited to ₹15,000 per year. OPD is covered as an add-on that costs 2,000–5,000 per year in other policies.
But most of the higher-end policies cover up to 180/180-day pre/post hospitalisation expenses. While not exactly an OPD cover, any hospitalisation related expense resulting from a claim can be covered. This is limited to 90/90 days for lower end policies.
Hospitalisation at home allows policyholders to get medical care at home if the physician approves the same. This can be useful when there are no available beds (as in the case of a pandemic) or when the patient is unable to travel. The higher range policies have included this feature in the base policy itself, most of the times. In lower-end policies this can be absent. Niva Bupa, Aditya Birla, ICICI allow for entire cover to be used in home hospitalisation.
Maternity expenses are covered after a waiting period, but Care Health offers a ₹25,000 discount in their network chain without any waiting period. But after a waiting period of 2-3 years, limits of ₹2 lakh are available under large cover policies along with a similar cover to the newborn baby that extends up to 90 days. Niva Bupa and Star Health feature these measures comprehensively.
For most products, restoration of cover, a feature that allows policyholders to reuse health cover within the policy year, is limited to once a year. This is followed across policies except for ICICI Elevate, Star Health and Aditya Birla’s Activ One which allow restoration of cover multiple times a year.
No claim bonus has morphed into renewal bonus and at the higher end of cover, it is mildly disappointing compared to lower end which usually allowed doubling of cover in three–four years with accumulated bonus. In these cases, renewal bonus is limited to increasing the base cover of ₹2 crore by ₹1-2 crore additionally in steps of ₹20-60 lakh. HDFC Ergo and Aditya Birla’s policies on the other hand double the coverage on day one itself without the need for renewal bonus.
Price comparison
The ₹2-crore health covers have a wide range of pricing between them. There are value options which offer the base cover and few other features and high value options which cater to most of the needs. For instance, Aditya Birla Activ One Economy offers a ₹2-crore insurance at ₹14,000 and disease specific variant at ₹30,000-40,000. This policy offers a higher than usual policy issuance rate to policyholders with diabetes, cardiovascular ailments or hypertension. Similarly, ICICI Elevate has a value option at ₹14,500 or a Health AdvantEdge policy at ₹30,000 that covers worldwide covers, restoration and other features.
As mentioned, covers of ₹2-5 lakh are available at ₹8,000-10,000. But most of the insurers are not offering such policies. The significant jump in coverage and features at a marginally higher cost has led to a lack of interest in entry level policies. In addition, health covers of ₹10 lakh have become the most preferred options with a price that is similar to entry level coverage at ₹8,000-10,000.
Policyholders can avoid any financial risk from health emergencies along with a host of useful features with 2 crore health insurance policy.
