What should women look for in health insurance?

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While healthcare is an important concern for both men and women, the health of women and young girls is of particular concern. According to data from the World Health Organisation (WHO), as many as 810 females die every day from preventable causes related to pregnancy and childbirth worldwide. The financial cost of quality health in middle-income countries like India has become a key factor while addressing the issue of medical access to the last mile.

Thus, it becomes rather crucial for females to have good health insurance to cover the expense of an unexpected health emergency in life. But medical concerns that are often unique to women may not be covered in regular insurance policies. So, how should women select an effective health insurance policy for themselves? Let us look at few key pointers that must be revisited before buying health insurance for women.

Adequate coverage

The most important aspect of insurance lies in its adequacy. It should be huge enough to cover illnesses that the insured is prone to. While it’s impossible to predict health emergencies, you can take into account your age, family medical history, and lifestyle to get a fair idea. It’s also advisable to check with your gynaecologist to understand your health temperament.

In case your father suffered from blood pressure, your mother has thyroid, or your grandmother was diagnosed with breast cancer – you can factor these details into the amount of medical cover you are planning and disclose it to the health insurance provider.

“Women should look for specific things that can be covered like cancer (breast, cervical) to prenatal and postnatal expenses and even a job loss cover. I think it would be good for companies to extend this to preventive health check ups as studies have shown preventive measures to be most effective,” said Shweta Jain, CFP and founder at Investography.

In fact, Jain also pointed that mammograms, pap tests, etc. should also be a part of women’s health cover, breastfeeding support is something that is also not seen in too many policies in India, be it breast pumps or lactation consultants expenses, Indian policies have to evolve to cover the needs of women today.

Family floater plans and your age?

The thumb rule for buying insurance policies is to get one while you’re still young. It applies to women-specific healthcare plans as well. The only benefit to this rule is the cost-effectiveness provided to the policyholder. Imagine if you’re 33 and three years into marriage when you decide to get a health cover compared to buying it in your early 20s? The insurer will be more confident of your health in the latter situation, of course. This gives you the leverage to opt for a wider cover at a relatively low cost.

After marriage, one usually opts for a family floater policy that covers both spouses. The kind of family floater you opt for can very well change as the family expands. However, as your children grow older, it will make more sense to get an individual policy for yourself as the premium will depend on the age of the oldest family member and the sum assured gets divided between each member of the family.

Even if you overlook these limitations of a floater policy, a woman must have individual insurance under her name. Otherwise, something like a troubled marriage could end up brewing further financial troubles for the wife during a health crisis.

Understand policy features

As a policyholder, you wouldn’t want to remain oblivious to the exact features and benefits of your insurance cover. Another thumb rule of insurance – never assume. You are advised to not just read the policy document but understand its features such as room-rent limits, co-payments (what you will have to pay out of pocket), and OPD costs. You do not want to be left with high co-payments or low room rent limits simply due to a lack of sincerity or carelessness.

As women, one may not be really comfortable sharing hospital rooms. Thus your room rent should aim to cover for private wards as well. Room rentals are usually a percentage of your total sum insured (typically 1%). Now, if you buy a Rs 5 lakh cover, your room rental will be Rs 5,000 which is low for metro cities.

It means – you either compromise on twin-sharing rooms or pay the rent from your personal pocket. Thus, it’s important to read the sub-limit clause and fine print from a women’s point of view. Remember, a higher sum insured hints at larger chances of additional costs being covered in the policy.