How to choose different health insurance plans for different phases of life? Expert decodes
The focus on health insurance lately has taken a different trajectory especially post-COVID where most of us have at least understood that we should have some coverage available at all times.
The focus on health insurance lately has taken a different trajectory especially post-COVID where most of us have at least understood that we should have some coverage available at all times.
Now in this journey, it becomes critical to understand what policies will make sense for an individual depending upon his/her life cycle. For simplicity, let's define a human lifestyle into 5 different age groups -
1. 0-25 years - This is the most underpenetrated age group where it is conveniently assumed that health insurance is an unnecessary spend. As per the 2020 government of India report on family health and welfare, almost 41% of kids in the largest three populous states in India are underweight or anaemic. 65% of these situations have gone through without any proper medical care. These statistics just emphasise the need for health protection and thus an individual should be covered with a basic sum insured of at least Rs. 1-2 lakhs at all times as part of their parent’s policy. Buying a retail plan is the best as that can protect you all your life and at a younger age it would the cheapest option to pursue with.
2. 26-35 years - This is the age when individuals mostly have begun their careers. Least susceptible to medical care but have high chances of accidental hospitalization and maternity care. Thus this age group should have an accidental benefit rider on the health plan with a robust limit on maternity claims as most of them would also be getting married in this age group.
3. 36- 45 years - Continuation of the individual policy is always the best but if still not taken it’s not very late yet. Individuals should focus on enough sum insured covering themselves + spouse + children + parents. A sum insured with a bare minimum Rs. 5 lakhs limit is desired considering in mind the rising healthcare cost and medical inflation. If buying for the first time, individuals need to persist with the same for at least 3 years post which every hospitalization would be covered without any pre-existing condition exclusion. Also, another aspect that needs to be kept in mind is to have well-being benefits covering health checks and mental well-being besides including OPD solutions like doctor consultation, dental and vision checkups etc. which will have an increased share on the medical outgo on an annual basis as the age goes up.
4. 46 to 60 years - This is the most vulnerable age group where health insurance is like having oxygen every day. Owing to today's lifestyle, statistics say that the average cost of hospitalization in this age group could be anywhere between Rs. 1.3 lakhs to 2.4 lakhs and lead to Rs. 10+ lakhs in case of critical conditions. Thus, a minimum desired sum insured of Rs. 10 lakhs should be there at all times apart from the well-being and OPD solutions mentioned above.
5. 61+ years - Now for this age group if there has been no individual health insurance taken with retirement there is a big void on medical care at that age. Most companies would not issue a policy and the ones who issue would be only after a thorough medical checkup. Even after that, there will be a waiting period on the policy benefits for at least 3-4 years. It could be a disaster to reach this age group without an individual health policy as one serious hospitalization could wipe off whole life savings for most retired people.
Thus, the crux of the matter is we should take a health policy as early as possible in life to ensure we are covered from unforeseen medical expenses enabling us to lead a healthy, happy, and dignified life.