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Health Insurance Coverage for Cancer Survivors or Cardiac and Diabetes Patients in India

Introduction:

India’s basic health indicators have improved significantly since our independence in 1947, life expectancy has risen, infant and child mortality rates have improved significantly. the mother but we still have a long way to go before reaching progress or European Standards.

These improvements have occurred due to improvements in education, sanitation, health facilities and increased disposable income resulting in a general improvement in living standards across the board.

Today we produce more cereals, grains, fruits, poultry, fish and eat more so the presence of protein in our diet has improved a lot making Indians taller and healthier. more.

But with an increase in disposable income and an increase in the standard of living, there is an increase in the consumption of alcohol, tobacco, red meat and fatty foods.

The growth of wealth and the possibilities of new technological gizmos have made us sedentary and dependent on even the smallest and easiest tasks; Today we often use mobile phones from the comfort of home to communicate with salespeople, pharmacists, assistants, electricians, mechanics, etc.

And instead of going to the nearest shopping center, we tend to use a car and instead of walking or cycling to get around our neighborhood, we drive.

Many of us would be hard pressed to remember the times when we used to travel far to hail an auto-rickshaw or taxi now we tend to book taxis which pick us up from our doorsteps.

Which together with unresponsive or apathetic citizen management has resulted in unplanned development in most cities where drinking water, sanitation services and the growth of vehicles, industry, land, noise pollution.

In 2012, the GOI along with the Indian Council of Medical Research released a revised definition of overweight and revised the figures to:

If the BMI (Body Mass Index) is between 18-22.9kg/m2, it is a normal weight.

If the BMI is 23-24.9kg/m2, the person is obese.

If the BMI is more than 25 kg/m2, the person is obese.

In the 21st century obesity has become an epidemic in India with more than 5% of the population being labeled as OBESE.

When analyzing 22 SNPs (single nucleotide polymorphisms) near the MC4-R-gene, scientists found 12970134 SNPs associated with waist circumference. In this study, almost 2000 people of Indian origin participated and this SNP was found to be the most popular among this group.

Therefore, genetics predisposes to abdominal obesity and this is one of the main causes behind type 2 diabetes and heart disease.

Worldwide 3-5 million deaths due to obesity, 3.9% of years lost and 3.9% of years lost due to disability.

All of the above have increased the number of Indians suffering from non-communicable lifestyle diseases like Cancer, Vascular Cardiac Disease, Diabetes, Hypertension, Mental Disorders, Respiratory Diseases like Asthma etc.

What is the disease burden of non-communicable diseases such as cancer, diabetes and heart disease in India? (Reference: Paper on Burden of Disease in India by National Commission on Macroeconomics and Health)

The figures for Diabetes, CVD (vascular disease) and cancer are alarming and the highest percentage of new cases are reported from urban areas and young men. and women are as fragile as old men.

Diabetes:

India is expected to become the diabetes capital of the world, it is estimated that in 2015 around 4.6 million Indians are suffering from diabetes.

The prevalence is estimated to be:

In the 30-39 age group around 6% of the population is estimated to have diabetes.

In the 40-49 age group around 13% of the population is estimated to have diabetes.

In the 70+ age group, approximately 20% of the population is estimated to have diabetes.

Diabetes has been recognized as one of the main reasons for the increasing number of Cardio Vascular Disease (CVD) patients in India.

Cardiovascular Disease (CVD):

It is estimated that around 6.4 crore Indians have one or the other disease which can be classified as CVD.

Cardiovascular disease is a combination of conditions including Acute Myocardial Infarction, Angina Pectoris, Congestive Heart Failure (CHF) and Heart Disease.

This increases in rural areas where it is estimated that 13.5% of the rural population is in the age group of 60-69 years.

The incidence of CVD is increasing among young people in the age group of 40 years and above.

Cancer:

It is estimated that nearly 10 Lakh new cancer cases were diagnosed in 2016 and 670,000 died from cancer in 2016.

Worldwide, cancer accounts for 5.1% of the burden of disease and 9% of all deaths, in India cancer accounts for 3.3% of the burden of disease and 9% of all death.

Health insurance companies’ response to rising disease burden:

Considering the number of people infected and suffering from the growing burden of disease, it is a fact that all these diseases or conditions are rejected because the existing conditions and risks are not accepted by insurance companies.

The best answer is a benefit policy from a Life insurance company that offers a term plan for cancer or heart disease, but by paying the benefit, it must be done during the policy period. the disease.

A survivor benefit plan known as a critical illness benefit policy pays out only when the illness worsens especially in the case of cancer today. once the disease reaches the 3rd or 4th stage of the appearance.

Currently, plans for people who have or survive these diseases are minimal, some insurance companies have tried to launch products for people with pre-existing diseases or survivors but the effort seems futile.

New India Assurance has developed a cancer treatment policy with the Indian Cancer Society and CPAA but these policies exclude existing cancer patients or those diagnosed with cancer and enroll people who have no symptoms. only cancer disease.

Health Insurance Policy for Heart Disease Patients:

Start Health and Allied insurance companies have launched the Star Cardiac care policy for people who have undergone PTCA, CABG within 7 years prior to the commencement of coverage under this policy.

Some features of Cardiac Care insurance policy:

There are 2 sections in the policy section 1 is standard health insurance with PED covered for 48 months, 2% limit on room, medical charges and nursing charges subject to Rs.5000 per day and liability if the package price is limited. 80% of the package price.

But section 2 covering the coverage of known heart disease is not limited to SI.

There is a 91 day waiting period before anyone can claim any complications due to pre-existing heart disease under this policy.

Health insurance for people with diabetes:

In the Diabetes space, there are two insurance products for Diabetes from insurance companies Star Health and Allied and an Energy Health insurance plan from health insurance company Apollo Munich:

A comparison of the two products is as follows:

Insurance company: Star Health Insurance

product: Affordable diabetes insurance plan

Who is covered?

Patients with type 1 and type 2 diabetes

Number of plans:

2 plans in plan A pre-approval medical test is mandatory, in plan B no pre-approval medical test

Waiting period: In plan A no waiting period, in plan B 15 months waiting period for coverage of diseases related to CV system, eye disease and peripheral diabetes disease, ulcer the legs.

Family floater options: available, each section has a 2 section plan

Benefits under the floater lens and part 2 are specific to diabetes care.

Guaranteed money Rs. 300,000, up to Rs. 10,00,000

meTax Benefits: Less than 80 (D)

limitations:

For cataract the limit is defined as :

For SI 3-500,000 liable for Rs.20,000 per eye person and Rs. 30,000 per policy term

For SI Rs. 10,00000 liability limited to Rs. 30,000 per eye person and Rs.40,000 for policy period

For diseases of the cardiovascular system, the limits are defined as follows:

For liability of SI 300,000 limited to Rs.200,000

For SI 400,000 Liability limited to Rs.250,000

For SI 500,000 liability limited to Rs. 300,000

For SI 10,000,00 liability limited to Rs.400,000

The cost of artificial limbs is limited to 10% of SI if the amputation is related to diabetes.

Insurance companies: Apollo Munich Health Insurance Co. Ltd

product : Energy Health Insurance Plan

Who is covered?

Covers patients with Type 2 diabetes, impaired fasting glucose, impaired glucose tolerance and or Hypertension.

Number of plans: Single plan

Waiting period : No waiting, 1 hospital day due to diabetes and high blood pressure

Family floater options: No, there are individual policies

Guaranteed money : Rs. 200,000 to Rs. 10,000,000

Income tax benefits : Less than 80(D)

prevent: There is no limit

VAS (value added services): Health coach, phone consultation, health line, discounts, access to health portal leading HRA, maintaining medical records

Optional VAS service: diagnostic monitoring program to monitor and manage health).

Reward: Premium discounts and additional benefits for good health management

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