Both health insurance firms and policyholders reevaluated their policies in response to the COVID-19 outbreak. By identifying weak points in the healthcare system, regulators were able to close those gaps and add new features, which improved and guaranteed health insurance subscribers’ protection. After the Pandemic, health insurance coverage has improved, as seen by the following modifications:
Experts claim that there have been major changes to health insurance both before and after the COVID-19 pandemic. Although certain changes were in motion prior to the outbreak, the crisis has accelerated a number of developments in the health insurance sector.
Experts claim that significant changes have occurred in the health insurance market both before and after the outbreak. Standard characteristics like waiting times, room rent limits, and cumulative incentives were the main focus of pre-pandemic health insurance, with the most popular plans placing a strong emphasis on these features. On the other hand, since the pandemic, there has been an increase in demand for complete health coverage.
“Most widely used plans now have provisions specifically related to pandemics and offer more extensive coverage for mental health and outpatient care. Senior citizen plans have evolved to better meet the special requirements of the aged, and as more people look for alternatives for their healthcare abroad, global coverage and sub-limits are becoming more popular. According to Rakesh Goyal, Director of Probus Insurance Broker, “the pandemic has unquestionably accelerated the evolution of health insurance, highlighting the necessity for robust and flexible coverage options that encompass a wide array of healthcare needs.”
The following are some advancements in several areas of health insurance:
Modular Strategies: Adapting Health Insurance Post-Pandemic
Health insurance modular plans are different from standard packaged packages that provide fixed benefits and options for coverage. Many times, the services offered by these one-size-fits-all policies weren’t required for every policyholder. An increasing number of insurance companies have switched to modular health insurance policies in response to changing consumer tastes and an increased desire for flexibility. “These plans give policyholders the freedom to choose and personalize the benefits that best suit their requirements while eliminating those that are unnecessary. According to Siddharth Singhal, business head of health insurance at Policybazaar.com, “the emergence of modular health insurance plans reflects a positive shift towards more personalized and cost-effective coverage options, granting individuals greater control over their healthcare expenses and the ability to tailor insurance plans to their unique requirements.”
Waiting Periods
Prior to the pandemic, waiting periods were commonplace; the majority of plans required a four-year wait for specific treatments and pre-existing diseases. But things have changed significantly; many policies now include ABCD (blood pressure, cholesterol, diabetes, and asthma) on Day 1 if the policyholder chooses to pay an extra 10% to 15%.
superior. The waiting period for pre-existing conditions might also be shortened to just one year for other illnesses.
Bonus for No Claim (NCB)
Prior to the pandemic, health insurers offered policyholders who stayed claim-free for the entire insurance year a maximum NCB of up to 150 percent. The importance of leading a healthy lifestyle is currently being emphasized by insurers, who in certain cases are offering renewal incentives that are up to ten times the initial value. Moreover, some plans offer substantial benefits even in the case of a claim,” continues Singhal.
Coverage of mental illnesses
In the past, many insurance policies sometimes limited or excluded coverage for mental health issues. But as the importance of mental health is now more widely recognized, many insurance companies are expanding their coverage for counseling and mental health therapies. Hospitalization costs related to mental illnesses are covered by a comprehensive health insurance plan for the policyholder. This covers additional hospitalization-related expenses as well as the patient’s accommodation and board. Many mental health problems, including anxiety disorders, acute depression, bipolar disorder, PTSD, mood disorders, schizophrenia, obsessive-compulsive disorder, and psychotic upheaval, are frequently covered by insurance policies.
Global Coverage
Many policies offered limited or no overseas coverage prior to the epidemic. These days, a growing number of health insurance policies offer global coverage, enabling policyholders to receive scheduled or emergency medical care elsewhere.
Senior Citizens Plans: As people age, they become more vulnerable to health problems. In the past, seniors who were classified as high-risk were subject to certain restrictions from their health plans. Senior citizen plans increasingly offer more extensive and comprehensive coverage, though, as the health insurance market continues to grow more inclusive. “After the pandemic, waiting periods and cumulative bonuses have changed, COVID-19-specific plans have become more popular, and there is a greater emphasis on out-of-pocket (OPD) coverage. Additionally, certain policies are now customized to meet the unique needs of the policyholder. According to Ashish Yadav, head of products at ManipalCigna Health Insurance, “We at ManipalCigna Health Insurance launched ManipalCigna Prime Senior in 2023, a special policy for senior citizens with a sum assured ranging from Rs 5 lakh to Rs 50 lakh.”
The Senior Citizen Red Carpet Plan, Senior Citizen Mediclaim Policy, Optima Senior, Varistha Mediclaim Policy, and Care Senior have already been introduced by insurance players like HDFC Ergo (formerly Apollo Munich Health Insurance), Star Health Insurance, New India Assurance, National Insurance, and Care Health Insurance (formerly Religare Health Insurance), respectively. A number of new competitors then joined the market with their own senior programs. In 2021, Niva Bupa, formerly known as Max Bupa, introduced the Senior First Plan for Senior Citizens. The Activ Health Essential plan was launched by Aditya Birla Health Insurance in 2021 with the goal of providing senior individuals with an inexpensive health solution tailored to their unique needs. ICICI Lombard introduced senior citizen-focused health insurance coverage in 2022.
Insurance for Surrogacy
The possibility for individuals to obtain surrogacy coverage is a notable advancement in maternity coverage. Recently, the Insurance Regulatory and Development Authority (IRDA) authorized insurance providers to offer up to 36 months of coverage for surrogate moms. Surrogacy provides a medical substitute for those who are experiencing
obstacles to natural conception brought on by health issues, making it difficult for them to begin a family. Given the advances in medical technology, the IRDAI circular is a step in the right direction towards providing coverage to these families and enabling them to realize their ambition of becoming parents. The chairman of Bajaj Allianz General Insurance’s health administration team, Bhaskar Nerurkar, states that this inclusive strategy guarantees these people access to high-quality medical care.
Health Insurance Plans with Riders: A lot of health insurance plans available today have riders that may be added to the plan for an extra cost, covering things like lab tests and doctor visits that are considered out-of-pocket. “This is quite helpful in paying for OPD costs associated with infections and acute illnesses that don’t need to be hospitalized. Along with the previously offered benefits like teleconsultation, doctor consultation, investigations (pathology and radiology), and annual preventive health check-up cover, Bajaj Allianz General Insurance Company has also introduced its redesigned and improved Health Prime Rider, which covers OPD expenses and offers coverages like emotional wellness cover, dental wellness cover, diet and nutrition consultations, and physical fitness coverage, according to Nerurkar.
Personalized Health Insurance Products: Insurers are better able to control risk the more information they have about policyholders. Personalized health insurance policies are being created using data, taking into account a customer’s income bracket, lifestyle, and family history. Fitness bands and other wearable devices provide insurance firms access to real-time health data from policyholders, which is a major step toward enabling them to customize coverage to meet the needs of specific individuals.
Now that they have access to a wealth of data, insurers may confidently provide customized plans. Personalized health insurance packages that include maternity plans, OPD-based health coverage, lab test and pharmaceutical coverage, and no room rent cap are some of the options that are becoming more and more popular.
Novel and creative products Unveiled through the “Use and File” Method
Through the “use and file” procedure, regulators have granted insurers greater latitude, starting with sandboxing. The ‘Regulatory Sandbox’ trial term was extended by IRDAI from six months to 36 months. The ‘use and file’ policy for non-life products was implemented in June 2022, enabling insurers to promote products without prior approval. This lessens the likelihood of protracted filing delays. “Use and file” frees insurers from sandbox restrictions, allowing them to do a thorough study and swiftly introduce a complete product. For example, the IRDAI permitted a “pay as you drive” (PAYD) automobile insurance add-on. As a result, we were among the first insurers to provide clients with PAYD services promptly. “Use and file” dramatically expedites the rollout of new policies, enabling insurers to provide policyholders greater options and more frequent introduction of distinctive products.
The Decision to Select a Cost-Effective Plan or Advanced Features:
Policyholders can now add or remove elements from their health insurance policies according to their requirements and budget, giving them greater flexibility. These need-based health insurance plans are made to meet the unique medical needs of the modern consumer. Insurance firms provide specialty solutions that let customers personalize benefits to suit their needs. Numerous insurance companies offer a variety of health plan alternatives, with more expensive versions offering more comprehensive coverage and more affordable basic options for individuals looking for more affordable solutions. Also, new health plans
Provide greater control over premiums by incorporating cost-management features like co-payment management, deductibles, and modifying room rent limitations. Plans with modular goods provide more flexibility because they let users compare features online and check terms, exclusions, and inclusions before deciding on a plan.
Expanded Insurance Benefits to Control Increasing Medical Costs
For many disorders that were previously thought to be incurable, there are currently several treatments available. But these therapies have a price tag, and we have to accept the fact that medical costs are rising. People are looking for greater health insurance coverage as a result. The growing number of serious illnesses and hefty costs associated with hospital stays have made customers realize how important it is to have adequate coverage with a larger sum insured. As a result, several insurance companies have launched programs with renewal bonuses of up to ten times the total insurance amount. Policies with an insured amount of at least Rs 25 lakh were unusual in the past. Higher-sum insured choices are now available from more insurance companies, nevertheless.
Budget-Friendly Product Introduction: In non-metropolitan areas, there is still a shortage of basic health insurance coverage. In these areas, a lot of people looked for reasonably priced plans that began with basic coverage. These products have been particularly well-liked by consumers on a tight budget, young adults and millennials, residents of Tier 2/3 cities and beyond, and people with low incomes. Standardized health insurance products, like Saral Suraksha Bima, Corona Kavach, Corona Rakshak, and Arogya Sanjeevani, were established by the IRDA. These products offer uniform benefits and coverage across different insurers.
Encouraging Health and Proactive Measures
Health insurers are now emphasizing the necessity of encouraging and rewarding consumers who develop better habits. “Health insurers give policyholders incentive points for adopting healthy behaviors and engaging in physical activities like cycling, running, or exercising, in accordance with the IRDAI’s recommendations. “These reward points can be utilized to pay premiums during renewal and can also be exchanged for savings on prescription costs, diagnostic fees, outpatient visits, and more,” says Singhal.
