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Wednesday 4 March 2015

This women's day opt for special health plans

Politics, work places, education or manufacturing units, women are breaking the glass ceiling and seeking equality in all walks of life. But differences exist, especially with regards to the health issues that women wrestle with. Illnesses such as cervical cancer, breast cancer, arthritis, burns and fallopian tube cancer are far different from what men face.

With the finance minister announcing enhancement of the medical insurance exemption limit to Rs 25,000 for general and Rs 30,000 for senior citizens, we decided to take a sneak peek at the health insurance options available for women in India.

Fewer women opt for health insurance in India as per the Irda Insurance Awareness Survey Report released in 2012, which states, "The male female ratio among those having health insurance are 70:30 for government, and 67:33 for private."

But the chances of women being hospitalised vis-à-vis men aren't too different. Somesh Chandra, chief operations officer & chief quality officer, Max Bupa, says, "We have registered a competitive number of claims filed by women and men… Changing lifestyle and increasing stress levels among other factors have exposed women to growing health issues including critical illnesses."

Going by the claims history witnessed by general insurers in the country women are prone to heart diseases, bone disorders, cancer of varying kinds and diabetes. If the Insurance Bureau numbers are to be believed medical inflation stands at 15-18%. Hence, getting a health cover is essential.

Though not many different women-specific health insurance plans are available, critical illness offerings catering to women are being offered by select players.

The good news is that insurers are no longer dreaded by the pregnancy related disorders, which come solely in women's share. Today certain general insurers are covering maternity-related medical expenses, which were hitherto excluded under health policies. Health plans such as ICICI Lombard's Health Advantage Plus, Royal Sundaram's Total Health Plus, Max Bupa's Heartbeat and Health Companion plan, Apollo Munich's Easy Health and Star Allied and Health Insurance's Star Wedding Gift Health accept maternity claims.

Apart from these plans, there are critical illness plans offered by Tata AIG General Insurance and Bajaj Allianz General Insurance and a critical illness rider offered with life insurance policies of Aegon Religare Life Insurance. These offer benefits upon detection of 8-11 women-specific diseases.

Unlike a hospitalisation or mediclaim cover, under a critical illness cover the insurer makes a lumpsum cash payment on diagnosis of any of the critical illnesses listed in the insurance policy. You do not have to get hospitalised or show medical bills to claim under this policy. The claim is payable the moment any critical illness is diagnosed and none of the exclusions under the policy apply.

Bajaj Allianz's Critical Illness Cover for Women pays a lumpsum benefit when a policyholder is detected with breast cancer, ovarian cancer, vaginal cancer, cervical cancer, burns, uterine/endometrial cancer, fallopian tube cancer, and paralysis/multitrauma.

There are other implications of a health problem such as loss of job, which too are covered under the plan. But there is a restrictive period of three months for availing this benefit. Additionally, congenital disability benefit and children's education bonus are provided under the policy. An amount equal to 50% of the sum assured will be payable under the plan on the birth of the child with any one or more of the congenital disabilities -- Down's syndrome, Congenital cyanotic heart disease, Tracheo-esophageal fistula, Cleft Palate with or without cleft lip, Spina bifida.

The benefit is paid only if the child survives 30 days after being diagnosed with the disorder. This benefit will be available for first two children only and will not be available if the birth of the child occurs after the proposer attains the age of 40 years.

The Tata AIG Wellsurance offers a higher benefit when it comes to cancer detections. The benefit offered for cancer is double of that offered for the other 10 illness. Apart from cancers, the Tata AIG Wellsurance Women policy covers total blindness, major organ transplant, major burns and even cosmetic reconstructive surgery recommended after accidents and burns.

The diseases common to men and women such as paralysis, first heart attack, kidney failure, multiple sclerosis, stroke, coronary artery bypass grafting are covered under the Tata AIG plan, but not under the Bajaj Allianz plan (except paralysis).

One must note the conditions under which the policy benefits would be nullified. For instance, Bajaj Allianz says that the "Loss of Job" benefit would not be paid if the policyholder opts for voluntary resignation from service.

Also, all the critical illness policies have a survival clause, wherein the policyholder is paid the benefit upon detection of a disease only if she survives for 30 days after discovery of the illness. The company excludes diseases detected during the first 90 days of the policy period. This three-month waiting period is not applicable when it comes to accident cases.

If you have a family history of the diseases covered by women-centric plans, be ready to pay a higher premium of 20-25% and serve a longer waiting period.

Chandra suggests, "To protect and guard against rising medical inflation, women should buy a health insurance policy early in life, preferably before they turn 30. This is beneficial as they can serve the waiting period at a much younger age and utilize their health cover when they need it." He adds that women should review the coverage needed every 3-4 years especially after events such as marriage, children increasing dependency of aging parents and the likes.

Women opting for these covers also gain access to value added benefits such as free health helpline, discounts at health and wellness centers and health check-ups.

So this Women's Day stop ignoring your health and get an optimum health cover to be ready if the need arises.

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