Are women-specific health covers a good idea?

Last Updated: Mon, Aug 12, 2013 05:03 hrs

Health insurance penetration is just about three per cent in India. Of the total women workforce in the country, only 10 per cent have some kind of a health care insurance plan.

On the back of low insurance penetration, insurers launch products catering to a specific segment in the society. For example, insurers market women-specific plans where the sum assured is payable for important life events like marriage, maternity, child's education and so on, in case you are diagnosed with a critical illness. However, experts say one shouldn't fall for such gimmicks and should compare them with those not gender-specific before buying a policy.

Apart from health plans, life insurers also offer health-cum-investment-based covers, again women-specific. But the thumb rule is to keep insurance and investments separate.

While it is necessary for women to get themselves adequately covered, it's equally important to see how wide is the plan's coverage. "This is because women are prone to pregnancy-related and bone-related illnesses and breast/ovarian cancer at a younger age. Hence, while you should buy insurance at an early age, they need not be women-centric as long as they serve the purpose of insurance," says Yashish Dahiya, chief executive, Policybazaar.

Critical illness (CI) plans: There are 25 illnesses defined as CI by the insurance regulator. However, when an insurer sells a CI policy, the product may cover a maximum of eight to 10 of those CI and not all.

Divya Gandhi, head, general insurance, and principal officer of Emkay Insurance Brokers, says: "In the case of critical illness cover, it makes sense to buy women-centric plans because these will cover illnesses which women are likely to have."

Usually, CI plans cover paralysis, cancer, stroke, coronary artery disease, multiple sclerosis, heart valve disease, renal failure and so on. Bajaj Allianz's CI plan covers breast/ovarian/vaginal cancer, burns and congenital diseases. For a Rs 10-lakh CI cover, Bajaj Allianz will charge a 30-year-old woman a premium of Rs 5,500. Since a health plan doesn't usually cover these ailments, it's best to have a CI policy. For CI covers, a medical test is not required until the age of 45 years. But after 45 years, it is mandatory. That is why it is better to take a CI cover early.

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

Health insurance: Experts say before you buy a CI plan, one needs to have a comprehensive health insurance plan in place, which will pay for hospitalisation and permanent disability due to accident. Some insurers make it comprehensive to an extent that even critical illness will also be covered under these policies. These policies would cost anywhere between Rs 3,000 and Rs 4,500 annually for a Rs 10-lakh cover.

Bharti AXA and Tata AIG General Insurance offer health insurance plans which cover hospitalisation as well as critical illness. Whereas, stand-alone health policies will have a waiting period of at least two to four years, depending on the insurer. The premiums in group plans offered by banks are cheaper and can be individually negotiated with the bank for wider coverage. However, group policies can have problems of renewability and weak claim settlement ratios. Such policies don't offer cashless facility and come with sub-limits (on sum assured).

Group policies: If you are looking for a cover against maternity complications, experts advise getting covered under group policies offered by banks or employers. Pre-existing diseases and maternity is covered from the day the policy is issued.

Some individual polices offer in-built pregnancy-related covers, which you could consider. But you get limited cover. For instance, Max Bupa's Heartbeat Gold Policy provides a sum assured of Rs 10 lakh but the maternity cover is only Rs 50,000. The premium of the policy is Rs 19,042. Also, the waiting period to cover maternity ranges from two to four years in individual policies.

Hence, opt for a group policy if the plan suits your needs. "Unemployed and unmarried women who are not covered under any group policy should opt for individual plans that can cater to their needs," adds Gandhi of Emkay.

Insurers like HDFC Life and Aviva Life offer women-centric investment plans. These plans offered by private insurers are cheaper than the ones offered by LIC. For instance, HDFC Life's Smart Women Plan would charge Rs 1 lakh for a Rs 40-lakh cover, compared with LIC's Jeevan Bharti, which costs nearly Rs 2 lakh for a Rs 25 lakh cover. However, financial planners warn against buying such plans.

Hence, opt for pure protection plans on the life side, with health and critical illness plans on the health side.

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