The Importance of Health Insurance in Managing Chronic Diseases

BHASKARNERURKAR Head – Health Administration Team, Bajaj Allianz General Insurance

Sometimes our health condition may take unexpected turns. Even when we appear healthy, we may have underlying health conditions or symptoms that can suddenly change our future, especially if they are chronic. Managing long-term health issues can be draining emotionally and expensive financially. It may involve regular doctor visits, medications, and treatments. Chronic diseases, like heart problems, cancer, diabetes, arthritis, high blood pressure, and stroke, are major causes of death and disability. Some common risk factors for these diseases include smoking, drinking too much alcohol, not exercising, and poor diet. Sadly, some chronic diseases related to lifestyle and can't be cured, prevented by vaccination, or simply resolved over time. Their treatment can only contain the condition and last many years. Without the right treatment, these diseases can become life-threatening. Managing these health issues can be very costly, draining savings and imposing a significant financial burden on individuals and their families.

Factors to Consider Before Purchasing Health Insurance for Chronic Illness:

1.       Comprehensive Coverage:Dealing with chronic diseases can be expensive and stressful. This is why having comprehensive medical coverage is so important. It ensures that individuals with chronic illnesses like diabetes, heart disease, or cancer get the medical care they need. This includes regular doctor visits, tests, medications, and even surgeries. With comprehensive health insurance, these costs are covered, providing financial relief and allowing individuals to focus on their health. The coverage also includes hospital stays, outpatient care, and preventive services like check-ups. Additionally, it offers mental health services and support for lifestyle changes, helping people manage their chronic diseases effectively. It's the safety net you need to focus on your health without worrying about expenses.

2.       Waiting Period:The waiting period is the time between purchasing the policy and when you can start claiming its benefits. The duration of this period varies depending on the policy terms, insurance provider, and specific pre-existing conditions. It can range from a few months to fewyears. For example, if you purchase a health insurance policy with a 2-year waiting period for pre-existing conditions, you won't be able to claim benefits for those conditions until the waiting period is over. If you have a chronic condition, it's essential to consider the waiting period because you won't be able to claim benefits immediately. By buying health insurance early, you can ensure that by the time you need it, the waiting period has already passed, allowing you to start claiming benefits without delay.

3.       Co-payment:When you have a chronic illness, you often need regular medical care, including hospital visits, tests, and medications, which can become quite expensive. Co-payment, or co-pay, is when you and your health insurance share the cost of your medical expenses. This means that even with insurance, you will still have to pay some money out of your own pocket each time you receive medical care. For instance, if your insurance plan has a co-payment clause, you might have to pay a fixed proportion every time you see a doctor or get a prescription. Ideally, choose a policy without a co-payment clause. If that's not possible due to the nature of your chronic condition, opt for a plan with minimal co-payment to ensure that most of the expenses are still covered.

4.       Disease-wise Sub-limits:When managing a chronic illness, it's important to understand your health insurance and what it covers. Some insurance policies have disease-wise sub-limits, which means there is a cap on how much the insurance will pay for specific conditions. For example, if your policy has a Rs.50,000 limit for diabetes treatment, the insurance will only pay up to Rs. 50,000 for diabetes-related expenses, even if your total treatment costs are higher. This can be a problem because you may need to pay the rest of the costs out of your own pocket. To avoid unexpected costs, it's best to choose health insurance policies without disease-wise sub-limits. This way, your treatment costs are fully covered, helping you manage your chronic illness more effectively and prevent financial strain.

5.       Financial Security:Health insurance provides crucial financial support for managing chronic diseases. It helps cover medical costs, ensuring access to necessary services and preventing complications. This support allows individuals to focus on their health without financial stress, improving overall health outcomes and quality of life.

Chronic diseases are affecting more people of all ages, so being financially ready is very important. Getting health insurance for chronic illnesses can help pay for treatment costs without depleting your savings. Choosing the right insurance plan ensures you get the care you need. Remember, being prepared now can help you in the future and give you peace of mind.