Which one to choose: Comprehensive Health Insurance or Disease-Specific Insurance?

Should I opt for a comprehensive health insurance that covers a host of diseases or go with a policy tailor-made to covera specific ailment? This is the most pertinent question that needs to be answered.

As health insurance companies in India are offering niche covers for a host of ailments like cancer, diabetes, dengue, etc.; it is difficult to decide whether one should opt for a comprehensive health insurance policy or go with a disease-specific insurance policy.

Benefits of niche plans, i.e.; disease-specific insurance

Niche plans like those covering critical ailments are a better option than comprehensive health insurance plans. The main benefit of such plans is that they cover the disease at all stages i.e.; early to advanced. For instance, a cancer specific insurance policy will cover cancer of all stages, whereas a comprehensive health insurance, like a critical insurance policy will cover only late stage cancer.

Comprehensive health insurance Vs Disease specific insurance

Usually, most of the individuals go with a comprehensive health insurance policy that covers all types of ailments. However, the coverage opted by them, i.e., Rs 2 lakh or Rs 5 lakh is not sufficient for the treatment of major critical ailments, like cancer, hypertension, kidney failure, etc. Those who already have a comprehensive health insurance cover of minimum Rs 10 lakh should not go for a disease specific insurance. In fact, they can enhance their cover with the help of top-up and super top-up plans. Such top-up plans give more coverage than a dedicated health insurance policy at easy premium rates.

Premium Factor

Usually, disease specific health insurance policies are much expensive than comprehensive health insurance plans. For instance, a 30-year old would have to pay around Rs 13,679/year to get Rs 10 lakh coverage under a diabetes specific health insurance policy. As against this, a comprehensive health insurance policy offering Rs 10 lakh coverage and covering more ailments and offering benefits like in-patient treatment, day care treatment, AYUSH cover, pre & post hospitalisation expenses, etc.; will cost around Rs 7,243/year.

Further, standalone health insurance policies do not cover adisease other than the covered one, so before taking a decision, make sure to weigh the extra premium loading vis-a-vis the available benefits carefully.

Do you need it?

Every person should buy a comprehensive health insurance policy that addresses one’s current health state and lifestyle. However, there is a need to go with additional covers as per the situation. For instance, if heart issues and diabetes are running in your family, you should go with a niche cover to stave off hefty medical expenses.

Also, these disease-specific plans should be considered by those are already covered under their corporate health insurance policy.

However, in case you already have a basic health insurance policy and don’t want to go with a disease-specific insurance plan, you can opt for super top-up plans which score above top-up policies when it comes to benefits. To cover the claim or not, a super top-up policy considers the total medical expenses incurred in a year as against top-up plans which consider the individual medical expenses in a policy tenure.

Comprehensive Health Insurance Vs. Disease-Specific Health Insurance

 

Parameters Comprehensive Health Insurance Disease-Specific Health Insurance
Type of Coverage All types of ailments are covered, including critical. Only a particular ailmentis covered like cancer, diabetes, etc.
Waiting Period Usually, 3 or 4 years for critical ailments No waiting period
Premium waiver No waiver of future premium Future premiums are waived in certain cases

 

In any case, disease-specific insurance policies should be consideredonly if the comprehensive health cover you have chosen doesn’t cover that particular ailment and you have a family history of such diseases. Moreover, people holding comprehensive health insurance policy can also benefit from various wellness programs initiated by health insurance companies and avail discounts on premium. Various health insurance companies have tied up with doctors, dieticians, gymnastics, and fitness consultants to ensure that policyholders tread on a fitness regime. If you adopt any healthy habit, you become entitled to enjoy discounts and incentives doled out by insurers.

A comprehensive health insurance policy covers multiple health ailments and conditions under a single plan and removes the worry of managing multiple insurance plans. Also, when one can get the treatment under one plan, the need for going with specific covers also reduced. Further, if the policyholder develops the ailment, say diabetes, many years after buying the policy, it would still be covered by the insurer as it was not pre-existing, so the disease specific cover would be relevant only in the case where the insurance policy is purchased after the diseaseis covered.

Though, disease specific insurance plans, like dengue policy cover out-patient treatment as well, one should remember that the inherent costs of tests are not very high and thus, they are manageable. So instead of spending money on buying a standalone insurance policy, go with a comprehensive health insurance, or increase your sum insured by that amount. You may have to pay an extra premium, but it will cover all the hospitalisation expenses, including specific ailments.

A word of caution

Irrespective of the health insurance policy you have—comprehensive or disease specific, it is always better to stay healthy, exercise daily, eat a healthy diet, make good lifestyle changes, and have regular health checkups. After all, health insurance is just to back insurance claims and therefore, should not be considered as a substitute for good health.