Get the Right Health Insurance Cover Under Portability

[Apollo Munich CEO]

Until portability was allowed for health insurance, customers were
wary of shifting to a new insurer, even if they were unsatisfied with
the existing one. The fear was the loss of accumulated loyalty
benefits or having to begin the waiting period for existing diseases
afresh. But now, with the option of health portability in place, they
can right their wrongs. However, it would be wise to keep a few
factors in mind before shifting to another insurer.

“Customers can only take the policy in totality. So it’s important to
understand the benefits offered under the existing health policy and
to match those with the plan one wishes to port to,” says Apollo
Munich Health Insurance CEO Antony Jacob.

Those planning to port their services should look for an insurer with
a good track record in claim settlements and a large network of
hospitals. Besides these, there also are other conditions that should
be looked up to avoid being in a spot when making a claim.

Additional loading: Typically, if you have a hospital cash cover, you
can opt only for a similar cover with another insurer. Going by the
apples to apples logic, there may not be a wider scope for added
premiums or loads on renewals.

But insurers say every portability request is considered as a new
application. So, if a customer is considered a high-risk person under
an insurers’ underwriting norms, he may be asked to pay a higher
premium or extra loading. In such cases, unless the insurer is
offering a better cover, you should not port your services in a haste.

Co-pay and sub-limits: Companies often ask customers to share the risk
burden, and levy conditions like co-pay or sub-limits on treatments.
Under co-pay, a customer pays a percentage of the total cost, while
under sub-limits, he pays anything above the pre-decided cost limit
for treatment. For instance, Bajaj Allianz General Insurance levies
the co-pay structure, if the customer goes to a non-network hospital.

Customers could look at insurers that reward customers for prudent
usage of the cover. So, for instance, Apollo Munich encourages shared
accommodation or hospitalisation under its ‘Easy Health’ policy. As an
incentive, depending on the slab applicable, it offers Rs 300-500 per
day hospital cash to policy holders.
“The cash perks attached to them mean lower price on the product in
the long run,” adds Jacob.

Renewals: While insurers have been following 70 years as the average
age after which they refuse covers to individuals, customers should
now insist on lifelong policy renewals.

“There is no official regulation from the Insurance Regulatory
Development Authority (Irda) on the age limit and insurers have been
told that they cannot refuse health policy renewals. This, in effect,
makes lifelong renewals a must,” says Suresh Sugathan, head (health
administration team), Bajaj Allianz General Insurance.

Increase in cover with age: Given the rise in medical inflation, your
current cover may be insufficient at a higher age. While you may plan
to bridge the gap by buying a new policy, companies are sceptical
about covering those in the higher age bracket, as medical risks rise
significantly with age.

“Customers should, instead, approach their existing insurers, as they
are much more open to upgrades from own customers, subject to the
necessary medical tests,” adds Sugathan.

Doing this will also help a customer skip the waiting periods
applicable on new policies.

Wellness support: A number of companies now offer wellness support to
their customers through helpline set-ups for health tips, medical
camps and newsletters. These are value additions and part of awareness
campaigns insurers undertake.

But, experts warn, one should take into account the kind of support
offered, since the costs involved are met by insurers in premiums.
“How many people would really follow the advice dispensed by a doctor
on the other side of the phone helpline,” asks an official.

It would be better to see if the new insurer has tied up with
hospitals and offers discounted rates for out-patient procedures not
covered in the basic policy.