Articles
A Look into the Indian Health Insurance Sector
by Alton Duke Health InsuranceHealth is an asset that is unpredictable and therefore we must make the necessary arrangements beforehand to deal with health issues when they arise. This can be done by getting a health insurance policy. Health insurance is a type of risk management which prepares us for all the financial risks that might occur when health fails. It protects one from sudden financial loss and helps to maintain a balance in life.
Why do you need a Health Insurance Plan?
Healthcare has always been an issue in India as the country is burdened with a large rural population that lives in slums and villages. Thus, it has forced the government to explore various health financing options to manage this problem. The Indian health insurance market is gradually growing with new firms entering the market. The annual report of IRDA states that the Indian health insurance industry is worth Rs. 96,000 crores and is expected to grow by Rs. 10,000 annually.
The various types of health coverages in India are based on the type of ownership. They are broadly categorized as Government based systems, voluntary or private health insurance schemes, and employer provided insurance schemes and NGO or cooperative based systems.
Government based systems include some of the best health insurance plans in India such as Central Government Health Scheme (CGHS) and Employee State Insurance Scheme (ESIS). About 20-30 million of the population is covered under this system. ESIS scheme apply to those employed in factories and other non-power establishments. It covers the employees and their dependents against loss of salary which may be due to sickness, maternity, disability and death due to the job. It also covers the expenditure for arranging funerals and rehabilitation allowances. Medical care will include expenses for outpatient care, hospitalization, medicines and specialist care. The CGHS established in 1954 cover employees and retirees who have worked under the central government and certain autonomous and semi-government organizations. Members of Parliament, Governors and qualified journalists are also included. The expenditure for medical care, home visits, medicines and diagnostic services are met by the Government and 12% is contributed by the state employees.
There are varied best health insurance plans in India under private insurance policies. Some of the schemes are Asha deep plan II, Jan Arogya Policy, Raja Rajeswari Policy, Cancer Insurance Policy, Jeevan Asha Plan II, Overseas Mediclaim Policy and Bhavishya Arogya Policy. Mediclaim is another policy introduced in 1986 which covers hospitalization expenses due to illness or injury suffered by the insured but does not cover outpatient treatments. Community or NGO based health schemes are usually for covering the poorer population and offers preventive care, ambulatory and inpatient services. They are run by patient collection, government grants and charity donations. Some of the popular schemes under his are Self-Employed Women’s Association, Voluntary Health Services, Action for Community Organization, Rehabilitation and Development and Sewagram. Employer based schemes are provided by owners of various organizations and covers both group health insurance schemes and individual healthcare expenses.
The Indian health insurance scene is marred by several issues as some insurance schemes do not spell out conditions clearly and often includes hidden clauses which are non-negotiable. Thus, the health insurance industry has to go a long way still to improve itself.
Author Bio: The author is a sociologist studying social dynamics and has penned several books on the senior citizen health insurance India.
Why do you need a Health Insurance Plan?
- Swelling of prices in health treatments.
- Growing burden of new disease and health risks.
- High financial burden on the lower income groups of society leading to erosion of their savings.
- Government’s continuing negligence of funding preventive and primary healthcare functions.
Healthcare has always been an issue in India as the country is burdened with a large rural population that lives in slums and villages. Thus, it has forced the government to explore various health financing options to manage this problem. The Indian health insurance market is gradually growing with new firms entering the market. The annual report of IRDA states that the Indian health insurance industry is worth Rs. 96,000 crores and is expected to grow by Rs. 10,000 annually.
The various types of health coverages in India are based on the type of ownership. They are broadly categorized as Government based systems, voluntary or private health insurance schemes, and employer provided insurance schemes and NGO or cooperative based systems.
Government based systems include some of the best health insurance plans in India such as Central Government Health Scheme (CGHS) and Employee State Insurance Scheme (ESIS). About 20-30 million of the population is covered under this system. ESIS scheme apply to those employed in factories and other non-power establishments. It covers the employees and their dependents against loss of salary which may be due to sickness, maternity, disability and death due to the job. It also covers the expenditure for arranging funerals and rehabilitation allowances. Medical care will include expenses for outpatient care, hospitalization, medicines and specialist care. The CGHS established in 1954 cover employees and retirees who have worked under the central government and certain autonomous and semi-government organizations. Members of Parliament, Governors and qualified journalists are also included. The expenditure for medical care, home visits, medicines and diagnostic services are met by the Government and 12% is contributed by the state employees.
There are varied best health insurance plans in India under private insurance policies. Some of the schemes are Asha deep plan II, Jan Arogya Policy, Raja Rajeswari Policy, Cancer Insurance Policy, Jeevan Asha Plan II, Overseas Mediclaim Policy and Bhavishya Arogya Policy. Mediclaim is another policy introduced in 1986 which covers hospitalization expenses due to illness or injury suffered by the insured but does not cover outpatient treatments. Community or NGO based health schemes are usually for covering the poorer population and offers preventive care, ambulatory and inpatient services. They are run by patient collection, government grants and charity donations. Some of the popular schemes under his are Self-Employed Women’s Association, Voluntary Health Services, Action for Community Organization, Rehabilitation and Development and Sewagram. Employer based schemes are provided by owners of various organizations and covers both group health insurance schemes and individual healthcare expenses.
The Indian health insurance scene is marred by several issues as some insurance schemes do not spell out conditions clearly and often includes hidden clauses which are non-negotiable. Thus, the health insurance industry has to go a long way still to improve itself.
Author Bio: The author is a sociologist studying social dynamics and has penned several books on the senior citizen health insurance India.
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About Alton Duke 
Health Insurance
56 connections, 1 recommendations, 200 honor points.Joined APSense since, November 26th, 2012, From Kolkata, India.
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