Overview of medical diagnostic industry in India

How Medical Diagnostics Has Improved Patient Care

Overview of medical diagnostic industry in India

Medical diagnostics help find the hidden secrets to our health. In most cases, the results from these tests are of critical importance and any delay can be the difference between life and death. Advancements in this field are essential in order to improve patient care. Read our white paper on the importance of turnaround time and about industry developments in medical diagnostics.

Group Health Policy Vs Individual Health Insurance Coverage

Does a Group Health Policy make Individual Health Insurance Coverage redundant?

Group Health Policy Vs Individual Health Insurance Coverage

A group insurance policy is an attractive way to lure bright minds to a company. And it is indeed beneficial because it covers the employee’s health care bills. And this perk extends to the employees’ spouse, children and dependent parents too. And that is why many people lull themselves into the misconception that the group policy is sufficient, especially because they do not have to pay a dime for the premium. And they push off purchasing an individual health insurance coverage plan till retirement. But if you are one of these people, this could really hurt you.

Is Group Health Insurance better than Individual?

 

The waiting period

A group insurance policy does not have any waiting period, but don’t forget that medical insurance plans for individuals come with this waiting period clause. A certain period of time (usually four years) has to elapse before you can claim the benefits of the policy. Suppose you purchase a policy in your sixties. If an illness is diagnosed right after, even if it is covered by your individual plan, it will not come to your rescue because of the waiting period.

Pre-existing conditions

Unlike a group health care policy, when you have to buy an individual health insurance coverage plan you will have to hand all your medical records over to your insurer. And if the insurer spots a pre-existing illness, the company may decline from selling you a policy. That is why you shouldn’t bide your time until you retire to get yourself an individual health insurance policy. An illness can strike at any time. And then it will be too late to buy a policy. Also, if you quit the company, then you will no longer be covered by your group insurance policy and you will be left unprotected.

Becomes expensive

The older you get, the more expensive individual health insurance coverage becomes. That is because you are more likely to become sick in your old age than in your youth. So insurers do a risk assessment and charge you a higher premium when you are at an advanced age (remember most insurers cap the entry age at 65). You would even have to undergo medical tests, which can prove to be a world of hassles. The younger you are when you purchase a policy the smaller the quantum of premium you have to pay.

Conclusion

Group health insurance alone cannot be counted on to have your back when your health fails you. You need individual healthcare plans as well. And the earlier you purchase it, the better.

Individual healthcare plans are very much essential and must not be left in disregard just because you are covered under a Group Insurance Policy. To know more about how Health Insurance policies actually work, read our blog on the same.

 

 

Why Healthcare in India is in a State of Crisis

Why Healthcare in India is in a State of Crisis

Why Healthcare in India is in a State of Crisis

Since the economic reforms and liberalization of 1991, India’s economy has witnessed a dizzying growth. The per capita income mirrors this trend. Thanks to the economic boom, millions of Indians have left behind them the shadow of the Below Poverty Level days and can now access quality education, food, and jobs. But this has not translated to an improvement in healthcare in India or rise in India’s Human Development Index. One of the most important yardsticks for measuring how the people of a country are faring is healthcare services. Even though India is making strident progress in medical science, the fruits of it remain beyond the reach of a large chunk of the population because health care is expensive.

What do the statistics say?

The National Health Profile in 2018 surveyed the actual percentage of GDP; different countries spend on health care. The survey found that India languishes almost at the bottom of the list. At present only 1.02% of the GDP goes into the health industry or INR 3 per person every day. The Modi government has promised to raise it to 2.5% by 2025, which still falls abysmally short of the global average allocation of 6%. The numbers are too nominal for a country like India which has a high Gross Domestic Product.

The health care allocation is so inadequate that out of pocket expenditure contributes to about 67.78% of expenses on health as compared to the world average of 18%. Among all the Indian states, Bihar allocates the least, only INR 491 per capita. On the other end of the spectrum is Mizoram, which reserves 4.2% of its GDP for medical care.

Why is the cost of medical services making people destitute?

The National Sample Survey found that in the financial year 2013-2014, 36 million families ratcheted up healthcare bills that exceeded the amount they set aside for food and other necessities, on a yearly basis. 25 million of these families are from rural India, mostly without health insurance. That is why one in five of the poorest households incur health care expenses that are catastrophic for their finances.

The Union Health Ministry discovered that 43% of India’s population directs it’s out-of-pocket expenses towards paying for medicinal care services. And that is why medicines are a burden for most families.

The cost of inadequate actions on part of the government has been disastrous. The National Crime Records Bureau revealed that between 2001 and 2015, nearly 0.39 million Indians committed suicide as they were unable to pay for healthcare. To add to the misery, the staggering costs of healthcare in India dragged 7% of the population below the poverty level.

Why didn’t the Change in pricing laws help?

Introducing major changes in pricing laws and including almost 750 medicines in the list of essentials the price of which will be capped by the government, has not really helped because many vital life-giving medicines have been left out of the pricing committee’s purview. 

What does the National Health Policy have to say?

The National Health Policy in 2017 advised lowering the price of medicines and other services further as a first step to help solve this crisis of healthcare in India. Other measures this body suggested were- increasing allocation and funding, and making supply chains more efficient.

The only solution to this grim scenario is to allocate a sizeable portion of the GDP to healthcare in India and make sure that the distribution of services is even and accessible to all across the lines of demographics.

The facts and figures speak for themselves to show that the status of Healthcare in India is truly in Shambles. You know about the numbers that back this pathetic situation that truly needs a lot of work. What are the actual challenges that are being faced in this regard? Keep reading to find out. 

Sources:

  1. Down to earth
  2. Livemint
  3. DNA India
How healthcare plans work

Revealed: How Health Insurance Plans Work

How healthcare plans work

You might have been told that purchasing a health insurance scheme is one of the best investments you will ever make. But, what exactly is it and how does it work? Simply put, healthcare policy is a legal contract between you – the insured and the insurance provider. 

And like all contracts, both parties have to adhere to certain terms and conditions. Rest assured both the insurer and the insured benefit from it. 

How do you stand to gain from a healthcare policy?

A health insurance policy offers you an impressive list of benefits-

Extensive Coverage

It covers a wide range of diseases. If you are hospitalized because of any one of them, you can register a claim and your insurance policy will take care of all the bills within your insured amount. 

Health policies cover the following: 

  • Doctors’ and nurses’ fees
  • Pre and post hospitalization costs
  • Room rent
  • Medicines
  • Diagnostic Tests
  • Surgery and prosthetic devices

Out-Patient department coverage

These days most health insurance schemes include Out Patient Department coverage. So if you come down with minor ailments, you will no longer have to pay for your treatment from out of your pocket. Insurers also do not require you to stay in a hospital for 24 hours as a prerequisite for filing a claim.

No Claim Bonus or NCB

A very useful perk a healthcare policy offers is the No Claim Bonus. If you do not make a claim on your policy for a whole year, your insurer rewards you with the NCB. You have the option of accumulating NCBs and then utilizing them for either as an increase in the sum insured or a discount on the premium.

And, if you want to switch to another insurer, you can transfer the NCBs to the new policy.

Network hospitals

All insurance companies work in tandem with reputed hospitals to bring you the benefit of cashless treatment. If you seek treatment in one of the hospitals your insurer has tied up with, you will not have to pay your bills first and then seek reimbursement later. The insurer will settle the payments directly with the hospital once your doctor discharges you.

Maternity cover

Almost all health insurance policies come with maternity benefits. It’s a boon for all young couples as it covers the expenses of running neonatal tests, ascertaining the health of both mother and baby, and vaccinations.

Tax benefits

Section 80D of the Income Tax Act exempts the sum insured from being taxed. Because the government does not consider it as a source of income.

What do you have to pay for these benefits?

Nothing comes free and this is where insurers benefit. They charge you a premium. Insures decide how much you have to pay through a process of underwriting. They do a risk analysis based on your age and medical history. If you have a clean chit, it means you are not very likely to fall gravely sick. Which means there are fewer chances of you making a claim. So, a healthy person pays the lowest quantum of premium. Note that you have to pay the premium on a regular basis or your policy could lapse.

Conversely, if you are elderly and have suffered from a number of ailments, you will have to pay a higher premium. Insurers may ask you to undergo health tests to gauge the risk factor.

If you are already suffering from an illness when you decide to purchase a policy, insurers might refuse to sell you one if they think the risk outweighs the gains.

Some other facets of healthcare policies you should know of:

Co-Pay

This is another means that insurers rely on to reduce the risk factor. Many health insurance policies require you to pay a portion of your health care costs. Your policy pays the rest. This also discourages people from making flippant claims.

TPAs

Third Party Administrators act as mediators between the insurer and the insured. They help with claim processing, disbursing payments and collecting premiums, providing ambulance services, preauthorization with network hospitals etc. TPAs are the backbone of the health insurance industry.

Exclusions

You need to peruse the list of exclusions meticulously. These are scenarios that your health insurance policy will not cover. Sometimes it could be something as vital as eye or dental check-ups. Some other exclusions include joint replacement surgeries, cosmetic procedures to enhance appearance and treatment for self-inflicted injuries. 

There is also a stipulation that states that if you are opting for non-conventional treatments like Ayurveda or homeopathy, you need to seek it from a government hospital or your policy will not cover it.

Conclusion

Health insurance policies should be an instrumental part of your budget, especially now that healthcare costs have soared and even the simplest treatments can burn a hole through your pocket.

Picking the right Health Insurance policy from the endless list of available options can be quite a tricky task especially because of the exclusions interwoven within. Which are the services not covered by your Health Insurance Policy? Read our blog on the same to find out. 

Sources:

  1. Moneycrashers
  2. Bankbazaar
  3. Policybazaar