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Relevance of Health Insurance for Low and Middle-Income Groups

By Juhi Walia
19 October 2022, 4:50 PM

Nowadays, having access to quality medical care is a need. Still, due to rising healthcare prices, this is becoming more and more difficult, especially for people from low- and middle-income groups. Obtaining a health insurance plan, which will also serve as a financial safety net in medical emergencies, is one straightforward approach for individuals to accomplish this.

Regrettably, there is a low uptake of health insurance policies in India, but low- and middle-income groups can make sure they are covered in the following ways:

Support for Increasing Medical Inflation

According to research, India's medical costs are rising on average between 12 and 14 per cent annually. For low- and middle-income groups with health insurance policies to give financial support during medical emergencies, access to healthcare is getting more and more challenging due to this medical inflation.

Protecting Your Savings

Due to the escalating expense of healthcare, a significant health condition may cost a considerable amount, depleting one's savings. However, the out-of-pocket costs will significantly decrease if you have health insurance because the insurer would cover most of your medical expenses.

Affordability of Good Healthcare

Several consumers from low- and middle-income groups would not have access to high-quality medical care and pharmaceuticals without health insurance, or they could choose to put off getting the treatment they need. However, health insurance will pay for these costs, so you won't need to make this decision.

Pays for Hospitalisation Costs

Hospitalisation costs for illnesses and accidents, mental health problems, ambulance fees, and other things are all covered by health insurance.

Coverage Before and After Hospitalisation

Medical expenses can occasionally exceed the cost of your hospital stay. Therefore, pre-and post-hospitalisation costs are covered by health insurance. You incur these costs before being admitted to the hospital for therapy or after release. Among them are diagnostic tests, investigative techniques, medication, ongoing treatments, certain pharmaceuticals, and more.

Cashless Hospitalisation

Cashless health insurance is an additional health coverage benefit, particularly for low-income populations. You can receive the necessary care at one of the hospitals in your insurer's network, and the hospital will handle all financial arrangements with your insurance provider immediately. You can avoid paying money out of your wallet in this manner.

Protects Your Whole Family

One insurance policy can provide coverage for the entire family, including you. Family floater health insurance is a fantastic choice because it allows you to cover every family member for a single sum insured while maintaining affordable prices.

Available Additional Covers

Try to personalise your health insurance plan with various riders for excellent coverage if you are financially able to do so, because conventional health plans don't cover some circumstances. For example, you and your family might find it beneficial to riders like maternity health insurance coverage, critical illness health insurance coverage, personal accident coverage, or AYUSH treatment coverage.

Easy Online Purchase

The ideal health insurance provider for you and your family can be readily found by comparing health insurance plans available today. In addition, online insurance policy purchases are simple because they take a few minutes to complete.

Government Schemes for Public Health Insurance to Benefit These Income Groups

Several beneficial government health insurance programs have also been set up expressly to assist low- and middle-income people in affording high-quality medical procedures and treatments. They consist of:

The Central Government Health Scheme (CGHS) - The employees and pension holders of the Central Government, as well as their families who reside in Indian cities, are covered by the Central Government Health Scheme (CGHS) for medical expenses.

Employment State Insurance Scheme (ESIC) - Employee health services are provided by the Employment State Insurance Scheme (ESIC) in factories and retail locations (as well as their dependents). Additionally, it gives monetary compensation for disability or other income loss.

Rashtriya Swasthya Bima Yojana (RSBY) - Families living below the poverty line can receive up to INR 30,000 in coverage, and hospitals across the nation that are RSBY authorised can give cashless care.

Ayushman Bharat - A health insurance plan that gives poor and vulnerable households INR 5 lakh in coverage each year, enabling cashless access to medical treatments.

Additional programs that provide unique health advantages include:

Aam Aadmi Bima Yojna (AABY) - This provides support in the event of death or disability and covers people (between the ages of 18 and 59) living in rural regions below the poverty level.

Janashree Bima Yojana (JBY) - It is a life insurance programme for those who live in poverty that offers policyholders a payout range of INR 30,000 to INR 75,000 at a low price.

Pradhan Mantri Matritva Vandana Yojana (PMMVY) - Pradhan Mantri Matritva Vandana Yojana (PMMVY) - This is an INR 5,000 cash benefit given to expectant mothers and lactating mothers upon the arrival of their first child.

Additionally, there are specific government health insurance programs for people with disabilities:

Nirmalya Health Insurance - It provides medical treatment coverage for those with a mental disability up to INR 1 lakh.

Swavalamban Health Insurance - For disabled people between the ages of 18 and 65 (as well as their spouses and children) whose yearly family income is less than INR 3 lakh, Swavalamban Health Insurance provides coverage of up to INR 2 lakh.

Conclusion

So, even if some people find it challenging to acquire healthcare due to India's rising medical prices, there is a solution. Health insurance will provide financial stability, especially for low- and middle-income populations.

While acquiring private coverage with a low premium is possible, various government programs work to lower the cost of receiving quality medical care.

Read more -

FAQs

1. At what age should low- and middle-income individuals start buying health insurance?

The ideal time to get health insurance is typically when you are young. This is because the premiums are far less expensive, and the waiting periods may be completed much faster.

2. Why is health insurance crucial for those with low and medium incomes?

Many additional costs, including ambulance, domiciliary charges, OPD, alternative treatment options, room rents, etc., are covered by health insurance policies. Those with low incomes typically find this expense to be a significant hardship during medical emergencies.

3. What is covered by low- and middle-income groups' health insurance?

A health insurance policy will pay for pre- and post-hospitalisation costs, mental support, childbirth, accidental hospitalisations, regular and severe illness hospitalisations, and even routine annual checkups.

4. What if you do not have health insurance?

Lack of a health insurance plan may make it more difficult for you to receive the best care and force you to pay astronomical medical bills out of pocket.

5. What insurance policy would be best for low-income individuals who need a high sum insured?

It is advisable to compare various plans offered by the insurers online to decide which policy or plan would suit best to your income. These days, many insurers offer plans with high sum insured that can cater to different sections of the society. However, you can also use a premium calculator online to know better about the affordability of your health premiums.  

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