Health Insurance for Women- 5 Things to Look For

As times are changing, so are the women of the world. From voicing their opinions to fighting for an equal stance in society and becoming financially and socially independent, women are breaking the societal hierarchy for good. However, as women hustle toward their goals, they often forget to care for themselves.

According to the National Family Health Survey India report, only 30% of women aged 15-49 had health insurance between 2019 and 2021. The concerning part is that this includes all socio-economic backgrounds, meaning even women from well-to-do families do not secure their lives with health insurance.

With the increasing stress in life, it is only sensible for women to buy health insurance policies catering to specific needs. But why do women need a health insurance policy, and what qualifies as a good policy? Let us find out.

What does a women's health insurance policy include?

Women have unique health needs that may differ from those of men. Women's health insurance plans provide coverage for conditions and medical procedures specific to women, such as maternity care, reproductive health services, and preventive screenings. This not only makes life secure, but it also saves you from unforeseen hospital bills that might dent your finances.

Why is health insurance important for women?

According to a report from the National Institute of Child Health and Human Development, women face a higher susceptibility to health issues such as STDs, heart attacks, osteoarthritis, diabetes, blood pressure problems, depression, and UTIs. Additionally, these diseases have different effects on women compared to men.

As you get older, conditions like PCOD, hormonal imbalances, and other reproductive issues might affect your life. Hence, it is important to consider getting a health insurance policy, whether you are a working woman or not. 

But how do you choose the right plan? Here is how.

5 things women should consider before buying a health insurance policy

Bigger coverage (Sum assured)

You never know what expense might befall you in the form of a hospital bill. Hence, choose a plan that avoids financial struggles in a medical emergency. Seek a policy that offers extensive coverage to address your medical expenses, ensuring financial stability.

The minimum coverage should be at least 35% to 50% of your annual income. So, if your annual income is Rs 6 lakh, you can go for health insurance with Rs 3 lakh coverage. However, with medical inflation in India being among the highest in Asia, reaching 14% in 2023, even 50% might not always be helpful. To be on the safer side, it is advisable to get health insurance coverage of Rs 5 lakh or more. 

You can also get a top-up plan in addition to your existing base plan to ensure more security. Top-up plans provide additional coverage when the limit insured on your base plan is exhausted. However, they come with a mandatory deductible amount for each claim that you need to pay before the plan takes effect. So, check the deductible amount for affordability before adding a top-up plan.

Sub-limits and Co-Pay

When you buy insurance, you must check for co-pay and disease-wise sub-limits, if applicable. Health insurance sub-limits are predetermined limits on specific medical expenses, often a percentage of the sum insured or a fixed value. A plan with sub-limits might be affordable, but it also restricts your insured amount. 

Hence, it is advisable to avoid any kind of sub-limit on specific diseases. For example, if your plan mentions 80% coverage for cancer treatment and you have a bill of Rs 10 lakh, the insurance will only cover Rs 8 lakh, and the difference of Rs 2 lakh then needs to be paid from your pocket. These sub-limits apply to various other expenses, like hospital rent and post-hospitalisation expenses. So, ensure that you are aware of what limits your insurance has and make decisions accordingly.

Another factor that might affect your insured amount is co-payment, where you pay a pre-decided amount or percentage of the medical bills. So, if the co-pay on your insurance is 10%, every time you claim your health insurance, you pay 10% of the bill out of your pocket. It is better to avoid co-pays because even though they might cost you less premium at present, handling the charges later might strain your finances.

Waiting period for pre-existing diseases

If you have a pre-existing condition that runs in your family, it is important to consider it while choosing your health insurance plan. Issues like heart conditions, asthma, diabetes, and even cancer can be inherited from family genes. Hence, it is better to be prepared beforehand and get coverage that provides better security and a reasonable waiting period. 

Several pre-existing illnesses come with a waiting period that can be a maximum of 4 years or you can also claim immediately, depending on the insurer. However, smaller waiting periods call for higher premiums. So, choose a plan with the lowest waiting period and fits your budget to avail of better benefits.

Maternity benefits

Maternity benefits usually cover pre- and post-natal expenses, childbirth hospitalisation, infant cover, and even vaccination coverage. You enjoy cashless facilities, access to skilled professionals, receive tax benefits, and minimise childbirth-related costs for a budget-friendly experience. A child born with congenital disabilities such as Down syndrome can also be treated by your insurance.

India does not currently have any insurance policies with a zero waiting period for maternity coverage, and most of them range from 9 to 24 months. If you plan to have a child in 2-3 years, consider getting a policy with a minimum waiting period to enjoy the most benefits. If your health insurance does not provide maternity coverage, you also have the option to get an add-on maternity plan.

Maternity covers usually have a sub-limit of Rs 15,000 to Rs 25,000 for normal deliveries and between Rs 25,000 and Rs 50,000 for C-section deliveries.

Sum assured restore option

The restoration benefit allows you to restore your complete insured sum after it has been partially or fully exhausted in a policy year. This helps if you have a lower sum insured and saves you from paying for further expenses out of your pocket. 

A restoration option is beneficial for anyone with recurring illnesses since it automatically reinstates your insured money for future claims. However, restoration benefits only apply to future claims and not to the first claim of the policy year.

What other factors should you consider?

When you get health insurance, it's important to look at the claim settlement ratio and the incurred claim ratio. Ideally, a good claim settlement ratio is above 90%, meaning that 90 out of 100 claims were approved by the insurer in the past fiscal year. 

It is also advisable for a woman to get a health insurance plan before their 30s to enjoy cheaper premiums and enhance the sum insured due to the bonus awarded for each claim-free year. Ensure to also check for waiting periods that range from 9 months to 3 years or more.

Lastly, consider the exclusions and compare all potential plans before you choose the one for you.

What tax benefits do you get with a women's health insurance plan?

Individuals and Hindu Undivided Families (HUFs) covered with health insurance are eligible for tax deductions under Section 80D of the Income Tax Act. These deductions include your medical insurance premiums and expenses incurred for senior citizens with payments made in any mode other than cash. Remember, that cash payments are not covered under tax deductions.

As an individual, you can claim tax benefits of up to Rs 25,000 per year if the insurance covers yourself, your spouse, dependent children and parents under 60 years of age. However, if you have dependent parents or family above the age of 60 years, you are eligible for a tax deduction of Rs 50,000 per year.

Conclusion

Let us be honest, nobody likes hospital bills exhausting their life savings. Although a healthier lifestyle can help your fitness, health insurance is still a must for your financial protection. A health condition can be mentally stressful as it is, and good health insurance can ease some of it by taking care of the financial aspect of it.

Still confused about which plan might be for you? Floatr, your WealthCare Partner, can help you. Talk to our experts, who will provide you with the guidance you need. You can also give us a call if you need any guidance or information on your journey ahead.

Whether you are a working woman or not, your health is important, and it is never too late to start attending to your health requirements and living your best life. So, start now.