Your health insurance has many variants: Here’s what you must know

Health insurance has long evolved beyond the base variant in order to better serve policyholder’s specific needs. If one invests time in parsing through the fifteen odd variants offered by the same insurer, one can find the right fit for health insurance. From serving low-cost entry-level insurance to specific disease fit, the variants hold the key for every need.

We have classified the several variants into four broad categories so that policyholders can refer to the template while narrowing down their specific policy.  

High cover variants

Providing a health risk cover is different from other products in one critical aspect: size of coverage does not correspond to cost (annual premium). While a ₹5 lakh cover may cost around ₹8,000 a ₹1 crore cover can be purchased at ₹12,000. This allows insurers to focus on higher cover variants in several ways. In the most direct fashion, most of insurers out have a ₹1 crore variant along with base variant offering cover of ₹2-3 lakhs. The ₹1 crore policy will not have NCBs or restoration of covers, but will be similar to base variants in other respects. Niva Bupa also offers a ₹10 lakh cover with inbuilt ₹90 lakh top up cover as a variant.

Specific variants now allow accumulation of unused cover from past years till an upper limit of 5 to 7 times original cover. Care Supreme Direct or Niva Bupa ReAssure 2.0 are some of them. At the same cost as a ₹5 lakh cover at the start, a healthy individual can rack up ₹35 lakh cover over seven years in such policies.

Unlimited claims in a year and unlimited restoration of cover are other variants that offer higher covers.

Disease specific variants

Health insurance may be out of reach of the demographic which can benefit from it the most. Policyholders with hypertension, diabetes, asthma or other chronic conditions will have a high barrier to purchase and may often be denied covers. Most insurers are now offering policy variants which are specific to a disease. For instance, Star Health, Care Health or Aditya Birla offer policies for hypertension, diabetes, asthma or others conditions that may be existing at the time of policy initiation. The normal PED waiting period of 2-4 years may apply, but the policyholder can access a cover in the least. This may not be possible otherwise. They are on the higher side of cost, for instance, Diabetes plan from Star costs ₹19,000 which is double that of a normal plan or may come with a 20 per cent co-pay clause. These plans generally have no medical tests if already declared at the initiation.

Star Health also offers a PED buyback policy, which minimises the waiting period to one year. This can be a useful variant to policyholders with other known disease at the time of policy initiation itself.

Maternity plans

Medical care for maternity and related conditions is either covered after a waiting period or not at all in normal variants. Tata AIG Medicare, Niva Bupa Aspire or Care Health’s NCB Super Premium offer maternity-related variants. Day one cover is available in Care Health or Joy Tomorrow plans offer covers for newborn babies as well without a specific clause but for a limited time.

Niva Bupa’s plans offer a wider care in Aspire plans. Maternity, reproductive surgery, surrogacy or adoption and new born covers are covered in the plan. Despite the need, maternity variants are offered by only a handful of insurers.

Wellness or reward focussed

Pitched for the young and one’s with an active lifestyle, these plans focus on the rewards for maintaining a healthy lifestyle. Aditya Birla Activ suit of plans can offer upto 100 per cent premium waiver upon achieving certain number of active days in a year, though 30-40 per cent discount is more achievable. A personalised health coach is another feature of such variant from Niva Bupa. Star Health limits the age of entry to under 40 in Young star Silver plan and offers a strong discount in return close to 30 per cent compared to its regular plan. Policyholders with an active lifestyle confident of achieving the set milestones can go for these variants and save on costs of health insurance, which is unavoidable despite regular exercise.

Plain or lower cost variants are the most basic of plans from any insurer’s stable of products. Ensure at least 20-30 per cent discount in such plans which may not offer NCB, restoration of cover or other value added products. Arogya Sanjeevani, a standardised product from IRDAI may be one such variant across insurers. Some insurers also offer locking in entry age at the time of issuance, which implies that cost remains stagnant, apart from inflation, over yearly premiums.

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