Health Insurance Scheme– SAY NO TO OUT OF POCKET COSTS

The age of selling fear has started. Fear for your life, fear for your health, fear for your loved ones. The temptation to say no to the pesky neighbourhood insurance sales guy is strong within all of us. But before actually banishing him from your life, just stop for a moment and do quick ‘health check’. Health costs have been rising insidiously in double digits, year on year, for the last few years. Many of us are still clueless when it comes to the costs of a longish stay in a hospital. More importantly, costs can be far higher once the hospital part is done with. It’s the post surgery care that often eats large holes into our finances. This is rarely covered by the traditional mediclaim policy, which mostly covers hospitalization expenses.

Previously, our choices were limited, since mediclaim policy was the most widely demanded health care product. In more recent years, a few more options have come up. Life insurance companies have been offering riders that cover some critical illnesses. In the last year or so, insurance companies, both public and private, have started offering stand alone health policies worth considering. These don’t eliminate the need for the traditional mediclaim, but help you to top up and catch up with the raising costs. Health insurance schemes that complement current risk-sharing mechanisms can create an increased availability of affordable health care. It enables one to meet the costs of medical expenses in the event of illness or accidents within the pre-agreed limit, after payment of premium. It enables the family to smooth the out-of-pocket payments for health care over time and to maintain living standards at a sufficient level.

Out-of-pocket expenditure on health care comprises of costs for transport, co-payments for out-patient consultation and admission, costs for lab tests, medicines, consultation, operation and ward charges. Severity of illness, whether or not the illness is chronic, distance from the hospital largely determine the amount of health care expenditure; and this could result in a catastrophe if it threatens a household’s capacity to maintain its subsistence needs. For those with health insurance, the scheme covers the majority of the expenses, catastrophic spending is protected and reliance on out-of-pocket health spending becomes lower.

BY – DR. Prof. Rajesh Ganatra,

Ph.D., UGC NET, M.Com

SKIPS – Ahmedabad

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