Health insurance : Should one go for disease-specific cover or a regular policy

health-policyInsurance companies are gradually warming up to the idea of offering specially-designed health insurance policies to individuals with health conditions such as diabetes and hypertension, among others.

Recently, standalone health insurer Apollo Munich launched a health insurance plan specifically targeted at individuals suffering from diabetes and hypertension, among other conditions.

In August, New India Assurance had announced that it would not charge additional premium for those suffering from diabetes and hypertension at the time of buying its regular policy. Star Health had introduced products aimed at HIVpositive individuals and those suffering from diabetes much earlier.

However, the big question is whether one should sign up for these special plans or settle for regular insurance plans with extra premium and/or restrictions on pre-existing diseases. "Illness-specific plans are not meant to cover those who can obtain regular covers. Only those insurance-seekers who are not eligible for regular health policies will evince interest in them," Antony Jacob, CEO, Apollo Munich Insurance.

Regular health insurance policies do extend coverage to pre-existing ailments, but only after a waiting period ranging of up to four years. The focussed covers, on the other hand, eliminate the waiting period.

However, they impose other restrictions like co-pay — where the policyholder has to share the claim burden, and sub-limits on room rent. They may also specify the treatment expenses covered. Apollo Munich's product requires policyholders to either accept the co-pay clause or pay a higher premium.

Such plans also specify the degree of ailment's progression or type. For instance, these plans do not cover Type I diabetes. Similarly, the plan meant for HIV-positive individuals will not be extended if their CD 4 count at the time of entry is lower than 350. "Even regular policies sell covers to individuals with pre-existing ailments, provided they are perceived as low risk. Only those individuals whose illness has reached a degree where they fall in the highrisk category will be denied a regular cover. Such illness-specific plans may be more suited to the latter category," says Sanjay Datta, chief, underwriting and claims, ICICI Lombard General Insurance.

source: economictimes.indiatimes.com

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