How to get health insurance if under high-risk category?

The health insurance needs differ from one person to another person. The health insurance policy purchased by your friend or associate may not fulfill your needs. Hence, you should explore the best and most appropriate health policy to fulfill your needs. Even though you have access to a health insurance plan provided by your employer, there is every reason to buy a personal health insurance plan as well. If you are under the high-risk category, you should buy a health insurance plan immediately.

If you fall into the high-risk category, you should not hesitate to buy a medical insurance policy. You should buy a health insurance plan at the earliest so that the existing health issues will also be covered in the coming policy years. When you subscribe to a health insurance plan for the first time, it will not cover the existing health issues. Most of the insurance companies will cover risks after the completion of one or two policy years.

Be Prepared to Pay Higher Premium

If you wish to cover the existing health issues, you can buy a health insurance plan by paying a higher insurance premium. If you fall into the high-risk category, the insurance company will take a higher risk by offering an insurance policy. Hence, it is quite natural that you should expect to pay a higher insurance premium.

If you fail to purchase a health insurance plan, the out of pocket expenses will be very high and it may lead to financial distress. The little premium of few hundred rupees that you contribute towards the health insurance plan will save you thousands of rupees through hospitalization and relevant expenses.

Here is how you can buy a health insurance if you fall under high risk category:

You Should Opt for Enhanced coverage

The insurance cover can be managed and enhanced for high-risk category people by choosing the following options to their advantage:

• Co-payment
• Sub-limits
• Undergoing tests
• Buying add-on healthcare policy

Be Ready for Co-Payment Plan being Applied by The Health Insurance Company

While offering health insurance plan for people under the high-risk category, the insurance company would like to minimize its exposure. Hence, co-payment clause will be applied while offering the health insurance plan.

If the co-payment is high, the insurance premium will be low. On the other hand, the insurance premium will increase if you opt for lower co-payment.

If the co-payment is 60:40, the insurance company will bear 60% of the healthcare expenses while the customer will bear 40% of the bills.

Get an Add-on policy

• Add-on policy is a better option to minimize the insurance premium. If you make a claim in a policy year, it is difficult to renew the policy for a higher sum. You will want to pay a higher insurance premium.
• If you undergo a treatment with the insurance policy, the insurance policy will underwrite the policy at a higher cost.
• The pre-existing conditions will cover after three successive policy years. In some cases, you will want to go for additional medical examination.
• By choosing a top-up plan, higher sum assured will be delivered to the customer.
• As it is not possible to forecast the disease or illness, you should be prepared to handle healthcare expenses by choosing the best available options.

Read the Sub-limits Clauses Carefully

The health insurance policy comes with sub-limits. The sub-limits are applied to certain kinds of illnesses and health conditions. For example, a health insurance plan will not cover 100% expenses that you incur towards the orthopedic treatment.

If the sub-limit of Rs. 50,000 is mentioned (on orthopedic-related issues) in the policy, the policyholder will not be able to claim more than Rs. 50,000 even though the coverage offered by the whole policy is more than Rs. 2 lakh.

Hence, you should go through the policy wordings in a very careful manner so that your healthcare expenses are met in the best possible way.

Buy a Policy that also Covers Medical tests Costs

• Some health insurance companies stipulate medical examination before offering a comprehensive health insurance plan. Especially, the medical tests are compulsory when you are buying a health policy with a coverage of Rs. 50 lakhs or above.
• The rules & regulations and criteria for medical tests vary from one insurance company to another insurance company.
• When you undergo the stipulated tests at a clinic referred by the health insurance company, you may get discount on the health insurance premium.
• As per IRDAI guidelines, the expenses incurred on medical tests should be shared by the insurance company as well as the policyholder. However, most of the insurance companies offer free medical tests or reimburse the money after accepting the proposal from the customer.
• If the insurance company is convinced of your health status, it will offer the health insurance policy in spite of the high-risk perception of the individual.

Benefits of health insurance policy

• Covers expensive treatment - Healthcare expenses are on the rise on a continuous basis. If you buy a health insurance plan, you can manage expensive medical treatment. You will not land into financial distress by choosing the most appropriate health insurance plan.
• Access to specialized treatment – The treatment offered at super-specialty hospitals will be very expensive. The hospitals invest money in procuring the latest equipment and it involves very high maintenance cost. The salaries paid for retaining specialist doctors, nurses and technicians will be very high. It is difficult to access quality treatment without buying a comprehensive healthcare plan.
• Income tax exemption – The government offers tax exemption on the premium paid towards the health insurance plan. Individuals can claim up to Rs. 25,000 in a financial year under Section 80D of the income tax act. The premium paid for senior citizens is exempted up to Rs. 30,000 in a financial year.
• Cashless treatment – In addition to cashless treatment, a multitude of benefits are offered by the health insurance plan. The room rent, ambulance charges, pre-hospitalization & post-hospitalization expenses free health check-up and other benefits are offered by the insurance policy.

Conclusion

Rising healthcare cost can be met by subscribing to the most appropriate health insurance plan. The individual should assess the risk and should choose a policy as per the age, hereditary issues, lifestyle, occupation and other aspects. You can compare the available health insurance policies to understand the features and cost of the health insurance plan. The best plan will help in meeting the hospitalization expenses and you can avoid financial distress.