Global health cover comes as a lifesaver for high-flyers: Experts

But examine countries covered and claim settlement mode

Many affluent Indians prefer to go abroad for treatment, especially when afflicted by a critical ailment. Given the high cost of medical treatment in developed countries, they should buy a health insurance policy that covers treatments abroad. Several general and health insurers now offer these plans.

A global health cover proves handy in many situations.

Says Apaar Kasliwal, executive director, PolicyBoss.com: “Some medical procedures and medications are available only in specific facilities outside India. Some doctors recommend seeking a second opinion from a renowned medical facility outside India, such as Mayo Clinic, Johns Hopkins, and so on. Also, doctors in India refer patients with critical illnesses that have reached an advanced stage to international specialists or medical facilities.”

Growing affluence has also contributed to this trend of seeking treatment abroad.

“Many high networth individuals from India like to avail of treatment at a facility in the US, Europe or the UK,” says Bhaskar Nerurkar, head–health administration team, Bajaj Allianz General Insurance.

Varied levels of coverage  

Broadly three types of global policies are available.

One, there are policies that offer global coverage only if the diagnosis has been done in India. Two, there are policies that cover only a specified number of critical illnesses. And three, there are full-blown global policies that cover all types of illnesses and diseases.

The premium is lower for a plan that covers critical illnesses only and higher for a comprehensive global cover.

Be aware of exclusions

These policies usually don’t cover travel expenses to the foreign country where the patient wants to avail of treatment.

Other things they may not cover are admission, primarily for diagnostics and evaluation purposes only (except outpatient treatment); admission for enforced bed rest and not for receiving treatment; surgical treatment related to obesity, gender reassignment; treatment of alcoholism, drug or substance abuse; cosmetic or plastic surgery; and unproven treatments.

Buy adequate sum insured

Those who buy this policy must make sure they purchase an adequate sum insured.

“Given the cost of overseas treatment and the rate of medical inflation, it is advisable to opt for a higher sum insured between Rs 1 crore and Rs 5 crore,” says Kasliwal.

Before buying this policy, the patient must look at the network of hospitals where cashless treatment can be obtained. It should cover some of the major hospitals abroad that one is likely to visit.

In some policies, there may be no country-wise restrictions. But some policies may exclude the US.

Says Ruchika Varma, chief marketing officer, Future Generali India Insurance: “The pricing of such products will differ if the cover includes treatments in the US and Canada, compared to the rest of the world.”

Policies that cover treatment in the US and Canada cost more.

With age, the premium of a global health insurance plan will increase. Long-term affordability is one factor that must be considered before purchase of these plans.   

Varma advises buyers to declare pre-existing illnesses to avoid problems at the time of claim.

Buy an individual policy rather than a group cover.

“Many of the benefits of individual policies are not there in a group cover. For instance, an individual policy offers lifelong renewability. In the case of a group policy, the entity offering the cover can at any point in time decide not to continue with the policy, in which case you could be left without a cover,” says Kapil Mehta, co-founder and chief executive officer, SecureNow Insurance Broker.

Patients must understand the claim settlement model offered by a policy.

“In some cases, the settlement is cashless. You have to inform the insurer in advance and it pays the hospital directly. In others, you have to pay the bill and get it reimbursed when you return,” adds Mehta. The former should be preferred.

A person who travels abroad frequently, or wants to be able to avail of the best medical facilities in the world, should opt for this policy.
 

Insurer

Plan

Annual Premium (Rs)

Future Generali India Insurance

FG Health Elite

Rs. 84,740