The Insurance Bill that was passed by Parliament last week and became an Act has changed the definition of health insurance from covering risks only within India to providing service worldwide. That is, now health insurers will have plans to provide medical coverage outside India as well.
Till now, you would have to buy a travel insurance plan that covers only medical emergencies and evacuation costs. The new plans promise to provide overseas benefits like pre-diagnosed planned hospitalisation, second opinions, outpatient treatments, apart from sudden sickness during travel.
“The construct of international covers is different from a travel policy that covers treatment costs for medical needs arising during international travel. Also, the maximum term of such policy is generally up to 180 days,” said Somesh Chandra, COO and Chief Quality Officer, Max Bupa.
A few standalone health insurers, including Max Bupa, already provide some kind of international coverage that were introduced much before the Insurance Act. Max Bupa’s flagship product Heartbeat provides coverage for nine critical illness in 190 countries and up to a sum insured of Rs 1 crore. Condition being that you purchase a plan that has minimum sum insured of Rs 15 lakh and that the illness is pre-determined and diagnosed by a doctor in India. This coverage is targeted towards retired senior citizens, frequent travellers and their extended families.Religare Health offers worldwide coverage for certain specialised treatments with its Rs 50 lakh and Rs 60 lakh sum insured plans. The premium of a Rs 50 lakh plan for a 30-yr old individual is Rs 17,463, including taxes. Similarly, Cigna TKK’s plan covers only Rs emergency’ treatments.
Sum insurance ranges from Rs 2.5 lakh to Rs 1 crore, and the premium for a 30-year-old starts at Rs 4,045 and goes up to Rs 39,899.
“There is a sizeable segment of consumers, who for various reasons, prefer to avail certain specialised treatment overseas. Price is not a deterrent in this case and they are okay with opting for a higher sum insured to avail treatment abroad,” says Anuj Gulati, CEO, Religare Health Insurance, which already provides a worldwide coverage benefit.
What’s coming up
Going ahead, however, insurers are expected to offer comprehensive coverage. Bajaj Allianz General Insurance doesn’t provide an overseas indemnity health cover but plans to come out with a product soon.”The major difference between a regular health plan and the new plans with inter national coverage is that these plans will typically have higher sum insured. The premiums will also be higher considering the currency exchange rate,” says Renuka Kanvinde, Assistant Vice President Health Insurance, Bajaj Allianz General Insurance.
“The new plans will be add-ons or will be incorporated within comprehensive policies with higher sum in sured,” says Sanjay Datta, chief underwriting and claims, ICICI Lombard General. Eligibility cri teria will require you to be medi cally fit. “These covers may not be easily available to those with pre-existing conditions and critical illnesses,” adds Datta.
Also, it will be a regular annual indemnity coverage that covers in-patient coverage. Out-patient expenses will not be covered.
The coverage will be categories under two categories–elective planned hospitalisation and emergency treatment. “In case of emergency , immediate care will be covered but beyond a certain period the policyholder would have to continue treat ment in India to be eligible for claims In case it is a planned hos pitalisation,where the patient needs special treatment abroad, mostly you’ll have to take the reimbursement route as it is very difficult for the insurer to have such a huge global cashless network,” says Datta. So, insurers plan to tie-up with TPAs that service globally to facilitate international claims.
New plans may be slightly cheaper.”We are trying to come up with a cheaper variant that will cover most of the treatments in India but in case of emergency or special cases will let you access international healthcare facilities,”says Datta.
Should you buy one?
Right now only a handful of insurers provide this option. Till the industry comes up with better and more cost effective coverage, it doesn’t make sense to pay a higher premium for international plans with limited benefits. Assuming you would want to go for a specialised treatment only for serious ailments, a frugal option will be to purchase a critical illness plan combo with your regular hospitalisation cover.
If you pick a high-sum insured critical illness plan, you are eligible to get the full amount as lump sum.
Frequent-flyers can add a multi-trip travel plan to this.
The cheaper inter national travel policy will cover emergencies.