my:health Women Suraksha - A health policy women should go for

The woman of today is hard pressed for time. With household chores at one end and professional duties on the other, her health often takes a back seat. There are increasing instances of health disorders, including hypertension and cardiac ailments, affecting young women, thanks to stress and lifestyle changes.

What is also worrying is that women are often not prepared to meet the medical expenses. In a survey done by the Ministry of Health & Family Welfare in 2016, it was found that only one in five women in the age group of 25-49 in India was covered by any form of health insurance. Remember, without sufficient insurance, you may have to use the savings that have been set aside for your retirement or child’s future.

Here, we review my:health Women Suraksha, a specialised critical illness (CI) health plan for women.

CI insurance basics

A CI policy is also a form of health insurance. How it’s different from regular health insurance covers, called medi-claim plans, is that in CI plans, the benefit is fixed and defined. At the first instance of the insured acquiring any of the listed illnesses under the policy, the entire sum insured (SI) is paid as a lump-sum irrespective of the cost of the treatment. Medi-claim policies, on the other hand, reimburse only to the extent of the hospital bill.

Serious aliments such as cancer, diabetes and heart conditions are covered under CI plans, which offer an SI that’s far higher than regular medi-claim plans. The other advantage in CI plans is that you can use the money to pay your non-medical expenses or expenses that are not covered by medi-claim plans, such as cost of diagnostic tests and OPD treatment expenses.

What’s on offer

my:health Women Suraksha is a defined benefit CI plan from HDFC Ergo that is specially designed for women. But before we dissect this product, you need to understand the necessity for a women-specific plan.

The regular CI plans in the market today cover only 10-20 critical illnesses and these mostly don’t include those that are common in women, such as osteoporosis. Also, many of the regular CI plans don’t pay for expenses in the pre-cancerous stage (carcinoma in situ ). There is an option to go for cancer/heart-specific conditions which may offer a more comprehensive coverage, including cover for beginning-stage cancer, and for heart conditions including angioplasty, but there is no policy which offers a combination of the heart and cancer cover and pays for other critical illnesses, too, such as end-stage liver failure and kidney failure requiring regular dialysis.

In HDFC Ergo’s my:health Women Suraksha, there is an option to get a comprehensive cover for all these illnesses. It offers six different plans. You can opt for cover for cardiac ailments alone, or only for cancer or both, or a comprehensive critical illness cover that will pay for 41 chronic illnesses, including kidney failure requiring regular dialysis, end-stage liver failure, Parkinson’s and Alzheimer’s along with the cancer and/heart plan. There is also a plan that covers expenses on treatment for bodily injury arising from assault and burns.

Under the Cancer plan, expenses on treatment of cancer in the breast, cervix, uterus, fallopian tube, ovary, and vagina, among others, are covered. Under the Cardiac Plan, open chest CABG, heart valve repair, first heart attack of specified severity, and coma of specified severity are among a long list of health conditions that are covered. In the critical illness plan, there are two options — the ‘essential’ plan and the ‘comprehensive’ plan. It is in the latter that you get cover for 41 illnesses. The policy also offers add-on covers that include protection for pregnancy complications, complication in new-born baby (that includes Down’s syndrome and surgical separation of conjoined twins), and loss of job due to voluntary resignation or termination from employment due to the diagnosis of any of the major illnesses or procedures.

Women aged 18-65 years are eligible for this policy. You can include your mother/mother-in-law, daughter/daughter-in-law and sister/sister-in-law in the policy if they are dependent on you.

Our take

All along, a woman who wanted a comprehensive health cover didn’t have many options. It was the regular cancer/heart/CI plan that she had to buy. But HDFC ERGO’s my:health Women Suraksha now offers a broader solution. It provides a very comprehensive cover under its cancer and cardiac plan. Its critical illness plan also covers 41 illnesses, including many chronic conditions where the treatment is expensive. Further, the Assault & Burn Injury cover is also essential, given the increasing risks women face in our society today.

We also like that the policy can include all women in the family under one cover. A woman in her 40s may have a teenaged daughter or sister/sister-in-law and mother-in-law, whom she can add to the policy by paying a single premium. Also, unlike most CI plans that have a 30-day survival clause for CI claims to be settled, in this plan, the survival period is seven days. Also, if a claim is made for any minor ailment, a 50 per cent discount in the premium is given for the next five years.

In the market today, the two insurers who offer specialised policies for women are Tata AIG and Bajaj Allianz. But Tata AIG’s Wellsurance Woman and Bajaj Allianz’s Women-Specific Critical Illness do not cover as many illnesses/conditions as HDFC ERGO’s product does. While Bajaj Allianz’s Women-Specific Critical Illness covers women-specific cancers, it has a long list of exclusions, too. Also, the maximum cover is ₹2 lakh. The insured has to survive 30 days after diagnosis of the disease for benefits to be payable. In Tata AIA’s policy, cancer of specific severity is only covered; early-stage cancers are not covered. It excludes angioplasty, key-hole/laser surgery and pregnancy-related complications. It also has a 30-day survival clause.

The premium of my:health Women Suraksha is also affordable. The premium for a 40-year woman for an SI of ₹20 lakh — that is split as ₹5 lakh for cancer, ₹5 lakh for heart, ₹5 lakh for comprehensive CI cover and ₹5 lakh for cover of assault and burn injury — is ₹8,497 inclusive of GST (cancer cover - ₹1,853, cardiac cover - ₹1,145, comprehensive CI cover - ₹5,098, cover for assault and burns - ₹401).

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