One of the main pillars of contemporary healthcare access, health insurance, has changed dramatically throughout time. It is essential to comprehend this progression in order to design an effective, accessible, and long-lasting healthcare system, from its modest beginnings to the technologically advanced future it faces. Therefore, this blog will delve into the details of how health insurance has evolved over the years in India and how it has become useful in shaping the future of the healthcare system.
Relation Between Increasing Medical Costs and Health Insurance
The high inflation rate is affecting the majority percentage of Indian citizens. Researchers have stated that, unfortunately, only 15% of Indian citizens receive health insurance support from their employers. The remaining 75% of individuals are personally bearing their healthcare costs leading to excessive financial burden.
In the 90s, health insurance witnessed a massive boom due to increasing medical costs. For most people, spending money on healthcare services is quite expensive. So, to bridge the price gap, the GOI (Government of India) promoted buying health insurance plans among commoners.
In addition, varied changes and amendments were made to enhance the health insurance policies. After the privatisation of the healthcare sector, numerous sub-limits were extended, price caps were removed, and more critical illnesses and health conditions were included in health policies. This helped in providing comprehensive coverage to the commoners of India.
The Growth of the Health Insurance Sector in the 21st Century
The health insurance industry has seen significant growth from the 21st century onwards. In the early 2000s, numerous private insurance companies emerged and offered exceptional healthcare products at affordable price points. Most individuals opt for health insurance as it acts as a viable solution for rising medical costs.
In addition, due to advanced digital technologies, the health insurance sector has shaped itself to suit today's generation. Many insurance providers have shifted the mediums of purchase and communication to online. For instance, ACKO General Insurance is a trusted and digital-first insurance provider allowing their policyholders to raise claims, track real-time claim status, etc. in their mobile application.
The need for third-party insurance agents has also reduced which made insurance companies lower the premium rates, along with offering additional discounts. Moreover, the health insurance sector expanded to cover diverse health contingencies and the people who might need healthcare as mentioned below:
- First-time/second-time mothers
- Newborn babies
- Children
- Senior citizens
- Travellers
- Corporate employers and employees
Common Illnesses and Medical Treatments Get Covered in Health Insurance Plans
Unlike traditional days, there are some common disabilities or medical conditions and medical expenses fall under today’s health insurance plans.
Healthcare Costs and Treatments Covered in Health Insurance Plans
- Inpatient hospitalisation costs
- Daycare procedures and treatment costs
- Domiciliary hospitalisation costs
- Alternative treatment costs
- OPD expenses
- Pre-and post-hospitalization costs
- Advanced technology treatment costs
- Ambulance and transportation costs
- Costs of medicines and assistive equipment
Illnesses and Disabilities Covered in Health Insurance Plans
- Maternity complications
- Critical illnesses
- Accidental death
- All stages of cancer
- Mental ailments
- Vector-borne diseases
- Burns
- Fractures
- Broken bones
- Permanent or temporary physical disability (due to an accident)
Major Trends Currently Affecting the Future of Insurance
GOI (Government of India) has designed varied health insurance schemes to offer financial protection to individuals against medical emergencies.
Some of the famous government health insurance schemes are Rashtriya Swasthya Bima Yojana (RSBY), Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), Pradhan Mantri Suraksha Bima Yojana (PMSBY), etc. Below are some pointers which will affect the future of health insurance in India:
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Widening Health Protection Gap
The health protection gap refers to the financial stress faced by households, including uninsured medical costs and avoidance of expensive medical treatments or diagnoses.
This gap is expected to get worse with the trend of increasing longevity and an ageing population. Almost every healthcare stakeholder is working to bridge the gap by offering government health plans, micro-insurance and easy access to affordable healthcare products.
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Rapidly Evolving Customer Needs and Preferences
Surveys have shown that compared to the pre-COVID-19, the utilisation of health insurance increased by more than three times during the post-pandemic period, and further increasing day by day. Consumer willingness to invest in health insurance has also increased.
Also, value-added services included in health insurance plans expanded from providing support at the point of claim to providing lifestyle-related benefits like routine health check-ups, mental health support, etc.
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An Increasingly Digital and AI-driven World
People are also demanding hyper-personalised clinical interventions through precision medicine and personalised treatments. Thus, there has been a steady adoption of genomics among healthcare providers when adapting treatment plans and drug prescriptions.
In addition, by pairing artificial intelligence (AI) with this new source of data, advanced data analytics can provide deeper insights into the medical claim cost which employ these outcomes for management of provider networks, claims, pricing and risk management.
The Bottom Line
The story of the evolution of health insurance is one of constant adaptability. Finding a balance between price, accessibility, and innovation will be crucial going ahead. Incorporating value-based care models, addressing price and accessibility concerns, and embracing technology breakthroughs will help us create a future where health insurance really fulfils its intended function of guaranteeing that everyone has access to the healthcare they require when they require it.
Moreover, if you are looking for the best health insurance plan for you and your family, consider a few essential factors like inclusions, exclusions, co-payment clauses, etc., and ACKO Insurance can be the best choice to fulfil all such needs.
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