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Should I Go for a Comprehensive Health Insurance Plan or a Disease Specific?

By Vikas Chandra Das
14 November 2022, 4:12 PM

You must have asked yourself a million times: Whether a comprehensive health plan that covers a host of ailments or a plan tailor-made for a specific disease? Frankly speaking, there isn’t a standard answer to this question. Instead, you need to understand your health insurance requirements and buy a cover that meets those needs. With health insurance companies offering niche covers for diseases like cancer, diabetes, hypertension and most recently, dengue, the question is what exactly one should opt for and whether disease-specific covers make sense.

Customer needs have changed with changing times, particularly during the COVID pandemic. So, in addition to the basic coverage, there is a growing interest in benefits tailored to the individual. Apollo Munich, for instance, offers specialised plans like Dengue Care, Energy, which covers diabetes and hypertension, and Maxima, which covers outpatient care. For a while, Star Health and Allied Insurance have offered specialised plans for diabetes (Diabetes Safe) and heart-related illnesses (Cardiac Care). The other specialised products on the market are Cancer Care by HDFC Life and iCancer by Aegon Life Insurance.

The most sought-after policies in the crucial health insurance plans cover specific diseases. The primary justification is that chronic or extended illnesses necessitate extensive, ongoing care, which is expensive. The disease-specific plan is additional insurance that only kicks in when the insured member is found to have one of the policy-covered diseases.

By having these plans, an insured person can avoid a potential financial catastrophe brought on by the cost of treating their illness. These programmes, however, are not included in the family, individual, or comprehensive health insurance. Therefore, it would make sense to ascertain whether any insured has a specific illness before taking such disease-specific plans. According to widely used research from WHO (World Health Organisation), 86% of Indians pay for their health insurance from their own pocket. Some large companies have developed unique COVID-19 policies in response to the epidemic. Additionally, more consumers are moving to purchase their health insurance online. All in all, the final decision is up to you as to whether you should go for a standard/ comprehensive medical plan or a disease-specific one.

Comprehensive Medical Plan

A comprehensive medical plan is also referred to as a traditional or standard health insurance plan because it selects a specific course of action based on the patient's health. The majority of medical issues are covered by the comprehensive medical plan, which is its main advantage. This insurance plan covers all respiratory illnesses, which includes coronavirus, under the condition that the policyholder was free of the virus at the time of purchase.

Disease-Specific Plan

A disease-specific plan, on the other hand, caters to a particular disease. People occasionally favour a plan that addresses a specific ailment, especially in India, where cancer, diabetes, and heart disease are rising. It avoids the protracted waiting period required by traditional insurance to pay for the specified medical conditions. The specific sickness is covered by health insurance at any point, including the start of the critical stage. As a result, a disease-specific plan may be necessary for someone who has a higher likelihood of developing a specific disease and who consequently needs the prescription right away at any time, as is typically the case when there is a family history of the disease. 

The Ideal Case Scenario

Everybody needs to have a baseline indemnity health policy that considers their lifestyle and health state, but they should also consider getting supplemental coverage for specific problems. For example, a person should get speciality coverage to avoid expensive medical costs if they have a solid potential to inherit a condition like diabetes or hypertension from their family.

People looking for a basic health insurance plan but hesitant to buy full-fledged coverage should also consider niche plans. For example, salaried people with basic health insurance may consider upgrading it with speciality policies. However, their insurance options will be pretty limited at the time of the job change.

Find out what coverage your health plan has to offer. It is preferable to have a comprehensive cover because the amount supplied in a disease-specific plan for a condition like coronavirus is modest. However, the disease-specific health plan is more expensive than the comprehensive health plan because it covers the disease at all phases. Moreover, there’s also the critical illness policy that one could purchase for less money.

For better coverage, policyholders frequently need to purchase a comprehensive plan before adding a specialised disease plan. Buying a new policy can always raise the amount covered by the comprehensive plan. Needless to say, every person needs to be covered by insurance to live a happy and healthy life.

Conclusion

According to specialists, a customer with a family history of a particular condition might benefit from disease-specific coverage. Otherwise, a comprehensive health plan makes more sense, particularly in today's society, when the prevalence of numerous illnesses, such as heart disease, hypertension, and other severe conditions, is rising. As more people select a plan that meets their needs each day, the expanding nation realises the value of medical insurance. Now is the moment for you to purchase a health insurance policy. 

FAQs

1. Given that I do not live in a metro, is a disease-specific plan sufficient?

This insurance is not regarded as sufficient because it won't protect you from hospitalisation in the case of a variety of circumstances. Since you do not live in a metro, you can choose coverage based on typical medical expenses.

 

2. Why is a specialised plan often referred to as a disease-specific strategy?

Due to its focus on a single ailment or illness, this plan is sometimes called a niche plan.
 

3. How are the premiums for plans that are disease-specific determined?

This plan's premium is considerably lower because it only provides coverage for one ailment.

4. Which insurance plan should I choose if I have a seasonal sickness like a cough or cold? A policy that is all-inclusive or disease-specific?

A seasonal ailment is not a disease that a health plan would cover for diseases. It counts under a comprehensive plan. It depends on the plan that you have opted for.

5. What conditions must be met for a disease-specific plan?

The disease-specific plan is additional insurance that only kicks in when the insured member is found to have one of the policy-covered diseases.

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