Health Insurance For Asthma Patients: A Quick Look

Globally India ranks first in Chronic Obstructive Pulmonary Disease (COPD) cases and second in asthma cases. As per Global Burden Disease Study 2016, there are more than 93.5 crore patients in India suffering from asthma and COPD.  

Several reasons have been attributed for the same. Increasing urbanisation, poor infrastructure and worsening pollution levels only contribute further to this conundrum. According to a WHO report, in a test unit of not so well-managed asthma patients, 42% patients had to be given emergency treatment at least 5 times a year and 18% had to be hospitalised twice or thrice. Asthmatic patients are at a high risk of developing conditions such as stroke, pneumonia, gastro esophageal influx and several other medical complications. 

Hence, on-going and timely management is absolutely critical and, if the condition is managed properly, the patient can live a healthy life without any barriers. In this context, it becomes imperative to buy health insurance coverage for the unforeseen burden of medical costs imminent with asthma and COPD.

Points to Evaluate Before Buying Health Insurance for Respiratory Diseases

1. Know the coverage: As an asthma sufferer, one would need a health cover that funds the OPD spends, offer services of an experienced coach who can engage with the customer continuously to keep the condition well managed and just in case there is hospitalisation also cover that. There are such condition-specific health insurance policies which offer comprehensive coverage. Thus, before purchasing health insurance, you need to know which type of plan best suits you and your budget.

2. Consider out-of-take pocket costs: Health insurance does not cover certain elements of medical costs.  There could be co-payments, deductibles, sub-limits and non-payable items. Co-payment is a specified percentage of admissible claim cost that customer bears each time during a claim.  Deductibles are the amount one pays for covered services in a given year before the insurer pays, and non-payable costs are those which the insurance won’t pay. Sub-limits are caps on amounts payable for specified items in the policy coverage. Therefore, it becomes vital to understand these costs before buying a health insurance policy.

3. Check if drugs and OPD consultations are covered: When choosing between options, the information provided may not be necessarily sufficient to know which one covers asthma best. After narrowing down your choices of plans, it is recommended to call the insurance company to ensure if the doctor’s fees, medications, and hospital charges are comprehensively covered under the plan. A good health insurance plan covers the expenses of the numerous tests along with doctor’s consultation fee and the cost of medication even if the patient is not hospitalised.

4. Hassle-free treatment and recovery: Illnesses not only affect your financial state but also impact you emotionally. Asthma can make an individual go through the worst transitions while the financial stress can cause depression. This depression usually hampers the recovery process. A good health insurance cover meets all the aforementioned asthma-related costs and aspects so that a patient can focus on her health and be comfortable that he is backed up by a financial safety net.  Please check that you are comfortable with the brand of the insurance company, and their past record of claims payment and turnaround times.

5. Check for other covers and services: There are products that offer services of a qualified Health Coach who guides an asthma patient to manage her condition well and ensures that she adheres to the treatment protocol.  Relationship with a ‘health coach’ is like that with a family doctor as personalized attention is given. The health coach instills discipline in life of asthma patient to take care of her condition. 

To sum up, it is important to take smart decisions while investing in a health insurance plan.  Invest in a policy that can be a partner with you in your health and ill-health and ensure that your health is well-managed to minimise hospitalisation.  This will not only provide comprehensive financial protection but also give peace of mind to you and more importantly to your family.

The author is the Chief Actuary at Aditya Birla Health Insurance