The health insurance policies help in controlling the mortality rate occurring from different diseases as well as allergic conditions. It has been constituted that at least 20% of the total Indian population suffer from different allergic conditions. On the other hand, 30% of the allergic population die due to lack of accessibility to medications and treatments. Thus, health insurance policies play a major role in the management of allergic burden as well as provide better management capabilities. The guidelines of health and medical insurance in India is constituted by the Insurance Regulatory and Development Authority (IRDAI).
Importance of health insurance policies
Health insurance provides the financial aid in the case where the allergy or any other disease condition become worse and need immediate hospitalization (Senthilkumar et al., 2017). Since it provides the coverage of the expenses for the 30- 60 days pre and post-hospital visits, it also helps the patients or families with immediate financial help. This help provides better access to healthcare facilities, treatment procedures, and medications. This, in turn, helps the affected individual with better management of allergic diseases.
With the help of health insurance, one can easily avail the healthcare benefit and will not rely on homecare (Meinhofer and Witman, 2018). Furthermore, the expenditures lower down as the charges of hospitalization and pre-post visits to the doctors remain covered by the health insurance. Apart from the advantages offered by the health insurance in case of decreasing the mortality rate of allergy disease, very less number of individuals are insured from allergic diseases (Rudra et al., 2017).
Types of health insurance policies in India
There are mainly three types of insurance in India that covers the allergic disease. The allergies covered by these health insurance, target audience and the loopholes associated with these health insurance policies as discussed in the table.
Type of Insurance
|1.||Health Gain Insurance||Severe allergies (only in case of hospitalization)||The adult age group mainly the working class people who can afford the health insurance policies for themselves and their dependent family members i.e. their children and old parents.||The health insurance only covers the hospitalization charges and the 30-60 days pre and post-hospital visits only.|
The medication required before and after that period for the control of the allergic disease not covered.
All types of allergic diseases not covered.
|(Reliance General Insurance, 2018)|
|2.||Senior citizen mediclaim policy||Severe allergies and pre-existing conditions like asthma||The people with the age group of 65- 80 years.||The premium rates for the health insurance for the pre-existing conditions are much higher.|
The people above the age of 80 do not get health insurance.
|(Policy Bazaar, 2017)|
|3.||Travel insurance with medical coverage||Only pre-existing allergic conditions||The target audience for such health insurance policies is the people who travel frequently for professional or personal reasons.||The pre-existing condition must be stable from past 3 months, and then only you will get this health insurance.|
Only hospitalization charges are provided under this, no daily medications remain covered.
Health insurance is much more prevalent in the USA and other European countries as compared to India (Tseng, 2011). Furthermore, lack of knowledge and awareness for the importance of health insurance in India makes a major differentiation between India and Western countries. Likewise, another reason is that health insurance in the USA and other European countries is much more customer oriented and are focused on giving the benefits to the customers (Goel, 2016).
The difference in policies between USA and India
The table below summarizes the difference between the health insurance policies in the USA and India that reveals the reason behind the less prevalence of health insurance in India.
|1.||Coverage||The insurance policies in the USA cover everything from a doctor’s visit for flu to hospitalization for critical illness.||The health insurance in India only covers the charges of hospitalization and 30-60 days pre-post visits to the doctors.|
|2.||Degree of compliance||It is compulsory for every individual to be covered with health insurance and also for the employers it is necessary to make sure that each of his employees is covered under medical insurance.||The insurance in India is optional. Only the people who can afford the premium of the insurance are having the benefits of it. It is also not mandatory for employers to provide health insurance for their employees.|
|3.||Rates of premium||The premium rates for the health insurance in USA are more because more people are covered under it and standard of living is much better.||Premium rates are lower in India because less number of people is covered in it and if the premium rates will become higher it will discourage people from taking health insurance.|
|4.||Health benefits provided to employees||It is mandatory to provide health insurance to every employee during their period of employment and in some cases, it gets extended till they get a new job after resignation.||In India, there is no rule that the employers must provide the health insurance to their employers and even if they do so it is only restricted to their duration of job period and after resignation either they have to buy the health insurance privately or get another job where the insurance is provided by the company.|
|5.||The state-wise difference in a health insurance policy||The health insurance policies differ in each state of USA as there are different sets of rules and regulation of the health insurance policy, that are best suited for that particular state.||There is no such customization of the health insurance policy for each state. The entire country follows the same set of rules and regulations of health insurance.|
Impact of health insurance policies in managing allergic diseases
The USA has personalized health insurance for people with allergic conditions and has therefore helped in better management of the disease. Moreover, there is a decrease in the rate of mortality caused by allergic disease due to health insurance policies but there are also many challenges attached to it (Policy Bazaar, 2017). However, severe allergy conditions that lead to the hospitalization of the affected individual are covered in some health insurance policy. This leads to a decrease in the mortality rate from allergic conditions. Nevertheless, there are many loopholes in the health insurance system of India. The health insurance companies do not cover the cost of medication for the allergy diseases.
Allergic disease coverage by insurance only provisioned for below poverty level population. However, IRDAI advises the provision of insurance against therapies like immunotherapy and similar medication. Immunotherapy advised for acute allergy conditions. The existing policies are also not very affordable by every individual in India because of the higher premium rates for the policies that cover the pre-existing conditions like asthma. On the other hand, IRDAI has provisioned guidelines for health insurance to AYUSH treatments, yet no mention of allergic conditions. Therefore, not every individual suffering from the allergy diseases can benefit from the health insurance policies. Thus, the insurance policies in India must update in order to avoid the rising allergic burden in India.
- Icicilombard (2016) Pre-existing diseases and how they Affect Your Travel Insurance. Available at: https://www.icicilombard.com/insurance-information/travel-insurance-info/article/check-pre-existing-diseases-when-buying-travel-insurance (Accessed: 26 October 2018).
- Meinhofer, A. and Witman, A.E., 2018. The role of health insurance on treatment for opioid use disorders: Evidence from the Affordable Care Act Medicaid expansion. Journal of health economics, 60, pp.177-197.
- Goel, N., 2016. Insurance in India and the West: A comparative study. Available at: https://www.businesstoday.in/opinion/columns/money-today/naval-goel-ceo-policyx-com/story/231861.html (Accessed: 29 October 2018).
- Policy Bazaar (2017) Senior Citizen Health Insurance: Mediclaim Policy for Senior Citizens. Available at: https://www.policybazaar.com/health-insurance/senior-citizen-health-insurance/?utm_source=organic&utm_medium=articles&utm_campaign=withintextlink (Accessed: 26 October 2018).
- Reliance General Insurance (2018) Health Insurance: HealthGain Medical Insurance. Available at: https://www.reliancegeneral.co.in/Insurance/Health-Insurance/Health-Gain-Insurance.aspx (Accessed: 26 October 2018).
- Rudra, S., Kalra, A. and Joe, W., 2018. Utilization of alternative systems of medicine as health care services in India: Evidence on AYUSH care from NSS 2014. PloS One, 12(5), p.e0176916.
- Senthilkumar, S.A., Rai, B.K., Gunasekaran, A. and Forker, L., 2017. Role of development officers in the marketing of public sector health insurance policies in India. International Journal of Business Innovation and Research, 14(1), pp.39-58.
- Tseng, C.H., 2011. Diabetes and risk of bladder cancer: a study using the National Health Insurance database in Taiwan. Diabetologia, 54(8), pp.2009-2015.