Health insurance an important ‘atmasvasth’ component of healthy ageing - Times of India

One important part of healthful ageing, the atmasvasth way, is health insurance. You may never need it, but as you grow older and the uncertainty around major illnesses increases, it is important to cover your expenses and costs by having adequate health insurance.

Even if you think you have enough money to cover your expenses if and when you fall sick, money can just disappear during serious illnesses and lead to a catastrophic loss of wealth and sometimes even a slide into poverty. In turn, the next time you then fall sick, you may not even be able to afford the level of care you had received the last time.

You should do your own research to find the best product that suits your needs, but good insurance agents can make a big difference, not only by helping you with the process of choosing the correct product but also guiding you later with the paperwork, if and when you fall sick and need to claim.

There are however some simple truths.

1. Buy the maximum health insurance you can afford.

2. The day you think of health insurance is the best day to buy.

3. Start buying health insurance at the earliest age you can.

4. Go with a group insurance plan…invariably, the coverage is better.

For example, most specialist doctors in Mumbai, if they choose to, can get excellent group insurance coverage through the Association of Medical Consultants (AMC). For Jains, there is a Jain group health insurance available through one of the Jain foundations and many other communities have similar plans. Many corporates and even small and medium sized businesses have group insurance plans that offer much more to their employees than individual insurance plans.

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It is sad to see patients above the age of 65 running pillar to post to gather money for their treatment, just because they forgot or consciously decided not to get health insurance when young and when they finally did decide to apply for the first time after the age of 60 years, found themselves largely ineligible.

I can understand people who are uneducated and/or do not have the means, not having health insurance (and even they have the PM-JAY to fall back upon), but educated people with money being without health insurance is nothing but sheer stupidity.

The rule is that if you have uninterrupted health insurance from a young age, then you will be able to continue to have health insurance till you die, even if you become a centenarian. However, if you haven’t had continuous health insurance earlier, then you may never be able to get one if the first time you apply is when you are over 60 years of age.

The health insurance industry is still a baby. The insurance policies we have today are crude, blunt tools, where you need to get sick to be paid money to cover your expenses.

There is currently no reward for being healthy and not getting sick, apart from the fact that your premiums don’t increase as much as of those who have fallen sick and claimed.

In the future, insurance companies will need to work with actuaries to develop risk models that reward those who make the effort to live healthy and penalize those who don’t. This cannot be difficult and we are already seeing some efforts in that direction.

For example, those who show evidence of some form of physical activity for at least 30 minutes, 5 days a week, have a blood pressure below 120/70, an LDL not more than 70 mg/dl, an Hba1c less than 5.6, who don’t smoke or drink or drink very mildly if at all, keep calories in check, eat a plant-based diet with adequate fruits, vegetables and nuts (yes, all of these can be tracked) should have to pay much less insurance premium than those who don’t follow these basic health rules.

In fact those who demonstrate healthy behavior should be reimbursed anywhere from 20-50% of their insurance premium for staying healthy, while those with unhealthy behavior patterns should be asked to cough up more, both at the end of the year and when they have to pay for the next year’s premium, even if there is no claim.

Similarly, where screening for diseases makes a difference or saves lives, as with mammography for breast cancer, not only should the costs of the tests be reimbursed, but those who don’t get them done, should be penalized.

Healthy behavior must be rewarded and unhealthy behavior must be penalized…this will go a long way in motivating people to adopt measures, like the atmasvasth guide, to live long, healthy.

Employers should also do the same and give bonuses or extra money to those who make an effort to be healthy and penalize those who don’t. It is in the interest of the company to have healthy employees who work harder and better and who would cost the company eventually less in medical expenses.

So the bottom line is this…get health insurance today, if you don’t have one, get the maximum cover you can afford, for yourself and for those around you and if possible, get into a group insurance. And since you are reading this, point 2 now applies…get one today, if you don’t have health insurance.

Footnote

With help from Dr. Sandeep Dadia and Mr. Nayanesh Mehta

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