Health Insurance Portability in India - Things to Know
Meaning – Before we move on to Health Insurance Portability it is important for you to know what health insurance is. Health Insurance is a coverage that is given to you by the insurance company in order to meet out your future uncertain medical expenses. This may work in two ways. Either you get the reimbursement from the insurer and you, in turn, pay it to the care provider or insurer may directly settle the bill with the care provider which is also termed as cash less in some places. Moving on to Health Insurance Portability - it means that you may transfer your existing insurance policy to a new insurer keeping intact the benefits that your existing insurer is providing you.
If you wish to break free from your existing insurer and reach out to a policy that a new insurer is providing you then you may easily switch over to it without undergoing the formalities of a fresh policy issuance like waiting period and other formalities.
The benefits Sum Assured and waiting period for pre-existing diseases will be switched over to the new insurer automatically thus making your moving on to a new policy more easy and convenient. It is important to note that if there has been a break in the existing policy then you may face trouble in the process of portability.
Insurance Regulatory and Development Authority (IRDA) gave go ahead to health insurance portability on 1st July 2011. All the policies issued by health insurance companies and general insurance fall under this and portability are allowed for individual as well as family policies.
Advantages of Health Insurance Portability
- When you switch from the existing insurer to a new one you become entitled to Sum Assured and cumulative bonus also forms a part of health insurance portability and you will be entitled to the same.
- While you move on to a new insurer you will get a waiver on the thirty days of waiting period in which no cover is provided.
- There is portability available for waiting period of pre-existing diseases. This means that while you switch yourself to a new insurer, the time that you have spent with the old insurer would be taken into consideration.
- It is a customer centric initiative that is easy and convenient especially for those of you who are having a tough time with your existing insurer.
- While you plan to switch to a new insurer you are surely offered lower or competitive premiums.
- You can put your heart at ease if customer service is bothering your mind as you switch to another insurer.
- You can ensure better claim settlement from all the companies while you plan to change your insurer.
- You can not deny that when you change your insurer you will get access to new, better and upgraded health insurance products.
- It enables you to move towards better health insurance plans and products as per your changing requirements and needs. You are no more bound to stick to your existing user.
- Health insurance portability has triggered a strong will to retain existing customers in all competitors thus paving way for better customer service and more customer centric products at your disposal.
- It has come as a boon for all of you who fall under the head of group insurance policy of your organization. You can freely change your job and switch your existing policy that is under the banner of your current organization without much hassle and without losing on to the accrued benefits.
- As a lot of information is shared across the insurers there is a lot of transparency created with the onset of health insurance portability.
- You are not charged any thing extra when you opt for portability. All you need to pay is the premium.
Disadvantages of Health Insurance Portability
- You can opt for health insurance portability only when your policy is due for renewal.
- Different health insurance companies have different polices and features, so you need to opt for the new insurer very carefully.
- If you wish to switch your group medical claim then it becomes mandatory for you to first move it to the same company and then only after a span of one year will you be entitled to switch to some other company.
- You may be charged loading charges on the premiums for your pre-existing disease policy while you switch to a new insurer.
- In case of shifting your group insurance policies to individual policies you may lose on to maternity benefits which are not included in individual policy.
- It is important for you to do some research while you chose the new insurer as there are some companies which do not provide cumulative bonus or claim bonus while you switch your policy which may pose a loss to you.
- Your application of portability may be rejected by the new insurer keeping in view your medical history and claim. The insurers reserve this right.
- You can only switch over to similar or same type of polices like basic reimbursement to basic reimbursement when you opt for portability.
Things to Watch Out for While Opting for Health Insurance Portability
It is important for you to consider the following points before opting for health insurance portability
- Service that is offered and how the product will benefit you. Is it worth taking a call?
- Check out for limits, sub-limits or restrictions that may come handy on the claims that you make based on age, disease or hospital when you opt for portability.
- Look out for the age limits or age cut-offs. Always go in for policies having the maximum age limit.
- If you have Cashless claims and Reimbursement options in hand then give preference to Cashless claims.
- Check out the network of hospitals that the new company covers. You would surely want your nearest hospital to be covered as that is the most approachable place in case of emergencies.
- It may be so that while you opt for a new insurer the premium may change due to health conditions or age factor. So make sure you get this information in advance.
- You should not forget that while you switch from one insurer to the other you will be able to port only the waiting periods or credits of bonus or pre-existing diseases and not the features of your policy.
- Whenever you plan to go in for portability keep 15-45 days in hand as the entire procedure may take that amount of time.
- You can not ignore the fact that while you move towards a new insurer he will in no way abide by the terms and conditions of your existing insurer. He will have his own set of terms and conditions. Make sure you go through them.
Health insurance portability is undoubtedly a customer friendly move but it is important to understand that health insurance products and plans vary across different companies and all benefits of your existing policy do not get ported.
It is important for you to do a good research work before you move in the direction of portability. Do not haste in opting out for new product or plan unless they are really worth the effort.
Contributed By: Megha Sharma
Megha Sharma works as a guest lecturer in Delhi. She holds an MBA & Doctorate from the UPTU. With extensive knowledge and experience in various financial products, she also works as a consultant in banking & finance domains wherein she offers advice to her clients in managing personal finance.