Omicron Threat: Why You Should Review Your Health Insurance Plan

As the increasing threat of Omicron, the new variant of Covid looms large on the collective psyche, it’s time to review one’s health insurance policy. Scientists are fearing that the Omicron variant can affect even vaccinated patients.

In that light, it is important to ensure that your health insurance policy comes to your aid in case of any medical exigency in the future. It also helps to upgrade your medical insurance policy in view of changing lifestyle, health conditions, and new diseases spreading.

Here are some of the aspects you should look at when reviewing your health insurance policy.

Review The Sum Insured

During the earlier waves of the pandemic, a lot of people ended up spending lakhs of rupees on hospitalisation and oxygen supply, especially during the second wave. The bills ran up to Rs 10-15 lakh and in some cases more. Hence, it is important to review your sum insured.

“As far as the amount of insurance is concerned, it's better for a family of four members to have a cover of at least Rs 10 lakh. If your existing policy is below this value, you must seriously consider increasing it to avoid major erosion in your savings,” says Chenthil Iyer, founder, and chief strategist, Horus Financial Consultants.

Review Your Family Floater Plan

The biggest parameter to review a family floater plan is to analyse the risk of disease and medical expenses associated with it. “In the wake of covid that is likely to infect all the family members together, the policyholder must calculate the expenses with regard to the entire family,” says Naval Goel, founder and CEO, PolicyX.com, an insurance comparison portal. A family floater with a low sum insured may not be enough.

In case a policy doesn’t include a child, who is less than five years old, or offers a sum insured that is insufficient for all members, then the policy should be carefully reviewed, and the sum insured increased adequately.

Alternatively, one may also buy multiple floater policies. Each policy can cover different family members so that there is adequate cover for everyone. For example, in a family of four, one policy can cover the father and a child, while the other can cover the mother and the child. Elderly parents can have a separate policy as the age-related pricing may be different.

Co-Payment And Sub-Limits

Co-payment is the percentage of the amount that the policyholder agrees to pay from his/her own pocket at the time of treatment. “The medical expense can range from thousands to lakhs; therefore, the policy must offer the minimum or no co-payment as it can be challenging for the policyholder to pay from his/her pocket if they are not ready or prepared with extra savings,” adds Goel.

When it comes to sub-limits, different policies offer a variety of capping on different treatments and facilities that can sometimes pose a challenge or risk for the policyholder. Thus, opt for minimal sub-limits. 

“In the post-pandemic era, it is recommended that you opt for a policy that has no sub-limits. For example, your policy may have a capping of Rs 5,000 or Rs 10,000 as per your sum insured for room rent per day. We have seen how high the room rents went up during the pandemic in certain private hospitals. Therefore, even if you have to pay a higher premium, it’s better to renew into a policy without such capping or sub-limits,” adds Iyer.

There are some comprehensive health insurance plans that have no co-payment or sub-limits and offer complete cashless services.

Lastly, you must seriously look at the quality of service you are getting from a company. If you are dissatisfied, you may take advantage of the portability facility to move your policy to another company of your choice at the time of review. For this, you may have to intimate the new company a couple of weeks before the renewal date.