We are all aware of the rising costs of healthcare facilities in the country and how a health plan can save the day. However, choosing the right mediclaim policy can be challenging. While there is no shortage of health insurance plans available today, most can be categorised into two popular types: standard and comprehensive. The key difference between the two lies in their scope of coverage. Choosing between them can be a tough decision, as expanding the scope of coverage typically means higher insurance premiums. Let’s take a closer look at the signs that suggest you should upgrade your health plan to a comprehensive one.
What is a Comprehensive Health Insurance Plan?
A comprehensive health insurance plan is a type of healthcare policy that offers financial protection against a wide range of medical services. This plan provides extensive coverage, such as in-patient hospitalisation, pre- and post-hospitalisation, daycare procedures, domiciliary care, AYUSH treatments, ambulance charges, organ donor expenses, and free annual health check-ups. Due to the broad scope of coverage, the premiums for comprehensive health plans are higher than those for basic individual plans or family health insurance.
Benefits of a Comprehensive Health Insurance Plan
Comprehensive health plans offer several advantages, including:
- Extensive coverage: This is one of the most important benefits of a comprehensive plan. It helps reduce out-of-pocket expenses, whether for an emergency or a planned procedure. Coverage includes hospitalisation, pre- and post-hospitalisation, domiciliary care, daycare procedures, AYUSH treatments, ambulance charges, organ donor expenses, and more. You can also benefit from preventive care, such as routine screenings and wellness programmes.
- Availability of add-ons: With a comprehensive health plan, you can opt for additional covers to further enhance the scope of coverage. Although add-ons come with an extra premium, they provide enhanced protection against specific health risks.
- OPD treatments: With a comprehensive health plan, you can claim compensation for outpatient treatments, doctor consultations, diagnostic tests, etc. Basic health plans typically do not provide OPD coverage.
- Cumulative bonus: If you don’t make any claims during a policy year, you will receive a cumulative bonus. This can either increase your sum insured by a certain percentage at no additional cost or offer a premium discount. You can avail of this benefit during policy renewal.
- Tax benefits: You are eligible for tax benefits under Section 80D of the Income Tax Act.
When is the Right Time to Upgrade to a Comprehensive Health Insurance Plan?
There are many reasons to consider upgrading your health insurance plan, including:
- Inadequate sum insured: If the sum insured by your current health plan is insufficient to cover high healthcare expenses, you should opt for a comprehensive health policy. Due to medical inflation, you may require a higher sum insured.
- Increased medical needs: You should consider purchasing a comprehensive healthcare plan when your medical needs increase due to age, or if you or a family member have a chronic medical condition, such as diabetes, heart disease, or hypertension.
- Adding family members: If you need to add your spouse, parents, or parents-in-law to your plan, you should choose a policy that offers comprehensive coverage.
- Major life events: When you experience milestones such as marriage or planning for a baby, upgrading to a comprehensive health insurance plan with maternity benefits is advisable.
- Additional benefits: If you require additional benefits such as coverage for wellness programmes, hospital cash benefits, or OPD cover, a comprehensive healthcare plan is the best choice, as these are generally not included in basic plans. Additionally, if you want protection against lifestyle diseases or life-threatening ailments like cancer, stroke, or kidney failure, a basic health plan may not suffice, making a comprehensive plan essential.
- Increased earnings: As your earnings increase, you can afford a plan with comprehensive coverage, ensuring financial security against any emergencies without depleting your savings.
Who Should Buy a Comprehensive Health Insurance Plan?
Ideally, everyone should consider purchasing a comprehensive health insurance plan for financial security against a wide range of medical services and expenses. Standard plans offer only basic coverage, which may eventually lead to higher out-of-pocket expenses. While the premium for comprehensive policies is higher than that of basic plans, the extensive coverage they offer can reduce your financial burden. People with chronic conditions (like diabetes, hypertension, or heart issues), those planning to start a family, and the elderly should seriously consider purchasing a comprehensive health insurance plan.
Conclusion
A health insurance plan should serve its purpose—coming to your aid when you need it most. If it doesn’t, it can be incredibly frustrating. This is often the case with standard health insurance plans that provide only basic coverage. The ideal plan for extensive coverage is a comprehensive health insurance policy, which will give you peace of mind during medical emergencies. Before purchasing a plan, ensure you check the scope of coverage, benefits, inclusions and exclusions, network hospitals, and terms and conditions to ensure you get maximum protection.