The Indian middle class has always had healthcare anxiety. But steep premiums, mounting rejections, 18% GST & uncertainty despite holding long-term policies are now sending health insurance jitters across age groups.
“For decades, healthcare has been the singular nightmare haunting the Indian middle class. Since dependence on private hospitals makes treatment costs exorbitant, the thought of being one disease away from poverty is as real today as it was 30 years ago. “Some increase in premium rates is understandable. What’s scary is the combination of high premiums, claim rejection, and not having a backup corpus.”
And when one is quite literally paying a premium to continue with a personal health insurance policy, rejections are a rude jolt.
WHAT ARE THE OPTIONS?:
The combination of high costs and claim uncertainties has forced people to look for different strategies. doubled “The annual premium has be come very costly, but one also needs an insurance policy. The thought of not having one makes me feel vulnerable.”
According to industry players, premium rates have more than doubled across the spectrum over the past five years. Through the sharpest hikes are for policies that cover senior citizens, even people in their 30s and 40s have seen premiums go up sharply. “There are many who are turning proposers for their parent’s policies and keeping their individual ones. The 18% GST rate contributes to this. While Section 80D of the Income Tax Act offers a rebate of up to Rs 25,000 on premiums, it’s not enough to offset the rise in cost.”
MIGRATION POSSIBLE BUT WITH RISKS:
Policy migration is another way of lowering cost, but it has its pitfalls because new policies come with conditions attached, like waiting periods, so even for older people who remain within the coverage umbrella, they are risky. For example, a common procedure like knee replacement requires a minimum policy tenure of three-four years in most plans.
“Some companies do not offer the option of family floater policies if the policyholder’s dependents are above 65 years. As a result, policyholders begin scouting for options in the market and migrate their policies from one insurance company to another to avail benefits. However, it is difficult to part with an old insurance policy, especially given the cover for various critical ailments that it provides. In certain cases, senior citizens are forced to opt for individual policies, in which premiums are much higher. Those who can’t afford this have no option but to discontinue.”
BETTER PLANS NEEDED:
Delhiites who are 70-plus, in fact, now have access to two government schemes — Delhi govt’s own and Ayushman Bharat — giving them an effective cover of Rs 10 lakh. That is not without its own complications, like which hospital offers what treatment and under which scheme, but it’s a boon for those who previously worked with a health insurer in Delhi. “Age groups 36-45 and 46-55 show higher claims than premiums collected. This is the age group that places their children’s requirements and professional obligations ahead of their personal well-being.”
“Finally, you have to get your money’s worth. The way this is going, it’s not sustainable for anyone.” “Govt needs to keep private hospitals in check. Insurers need to negotiate better rates with hospitals. Why can’t standardized rates agreed for procedures? There can be variation, but if one is going for, say, an angioplasty, they should know that the cost cannot exceed a certain sum, no matter where you go. Why can’t insurers and hospitals reach common ground on this? It’s better for everyone. The health insurance sector has turned ‘consumer is king’ on its head. Here, the consumer is a beggar.
