Overview
The innovative health care segment has seen the emergence of several new concepts. It is including primary care as an integrated part of the health scheme offerings. Root India Healthcare, one of the youngest players in the domain. They bet on the philosophy of keeping the customer healthy and rewarding physically active customers with a 100% benefits payback. The basic idea is to move customers from ‘insurance’ to ‘primary care’, says its CEO Sunita Singh Chhabriyal. Health insurance still ranks low on priority in the overall financial planning for most. What is the deterrent?
Low Demand
The health insurance industry is experiencing robust growth over the past few years. As per IRDAI annual reports, health insurance market continues to grow over 20 percent year-on-year during the past three financial years. Yet, India still has a low non-life insurance penetration (ratio of premium to GDP) of 0.93 percent.
Less Awareness
However, with increasing medical inflation and financial distress due to hospitalization. Also awareness of health insurance has increased significantly over the last few years. Customers have started asking for adequate coverage in the urban areas. IRDAI’s standardization guidelines have also made the scope and coverages under insurance policies easy to understand for the end customer.
Moreover, with the introduction of schemes like Ayushman Bharat, both accessibility and affordability of health insurance. This would be greatly increase in the coming years to a segment of the population.Whereas, health insurance had still not become a major focus point of overall financial planning. Health insurance is still looked up as covering hospitalization. How do you change that with your plan that is targeting primary care o OPD care?
OPD Coverage Scope
Health insurance in India and worldwide has predominantly evolved as a product for indemnification against hospitalization expenses. This is the primary intent of any indemnification-based health insurance product. We have been a pioneer in bringing in the concept of OPD Healthcare as an integrated part of primary care offerings.
We have incentivized the customer in forming such healthy habits to take care of their health and, in turn, use such incentives to reduce premium payments and make other medical payments. Such kind of a structure also motivates the youth to buy insurance as generally, younger population view health insurance as an unnecessary expenditure.
What can be done about providing OPD expenses with their unwanted visits?
OPD (Out Patient Department) expenses as part of out of pocket savings are at a nascent stage of development in India. There are only players offering such cover in some of their products.
The market is slowly evolving, and the industry is coming up with innovative products covering OPD expenses including coverage for doctor visits, pharmacy bills, and medical tests.
Standardization of medical diagnostic expenses and pharmacy expenses, increase of distribution network by insurance firms to cover a large number of doctors and making the fragmented OPD ecosystem into a well regulated and standardized entity across each city and town would go a long way to ensure uptake of OPD products by the customers.
How does play Root India OPD plans?
First of all, All opd plans are applicable to their existing doctor or specialist hence there is no rule to follow a lengthy process to book an appointment with new or unknown doctors. Root India products are providing coverage through its opd plan with single philosophy “any Doctor, Any disease”, there are many benefits like pre-existing without waiting period.
For salaried people covered under an employer corporate group health insurance plan, they may go for additional OPD health plan to cover their such expense which generally insurance policy never does. We are also open for the corporate plan to initiate as group OPD plans.
OPD Gateway
For instance, These opd healthcare plans can seem little comparative with an insurance premium, but very much cost effective for their any disease. You may call it the platform of planet fitness.
One should note that claims under OPD Healthcare are payable on doctor visits only. Hence it’s not applicable on a non-covering class and or hospitalization basis. Hence, it is advisable for everyone to have a clear picture before placing the claim request.
What is the kind of tax incentive available for OPD Healthcare products and how beneficial is that?
OPD Health plans should not be looked only through the lens of tax savings. Protection from unwanted doctor visits expense, which leads out of the pocket expense. Adequacy of coverage should be the primary deciding factor for health. However, tax incentives should only be of secondary consideration. However, the government is trying to popularise healthcare penetration in India through such tax incentives.
Below is the current structure for deductions applicable under Section 80D of the Income Tax Act.
Depending on the tax rates applicable to the individual, substantial savings can be made via deductions on healthcare premium.