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HEALTH INSURANCE

Wellness Benefits in Health Insurance - A Complete Guide

Shristi Nigam 06 May 2022

Health insurance benefits are enormous. To clearly understand the health benefits of health insurance, we need to focus on some details.

wellness perks in your health insurance

To cope with the rising costs of modern-day treatment, the best and the wisest answer is to maintain befitting health insurance. The benefits of health insurance are quite enormous. Until quite recently, most health insurance plans offered wellness perks as a standard inclusive feature. However, with the revision of the IRDAI norms, such facilities stand mandatory in the case of general wellness and preventative healthcare plans. To get a clear idea about the wellness perks of a health insurance plan, we need to focus on a few details.

What Is Meant by Wellness Perks or Programs For Health Insurance?

Health insurance packages are designed to include wellness perks offering several benefits like a sports club membership, gym membership, yoga class membership, or awards promised depending on an active and healthy lifestyle or quitting smoking, and the like. Apart from these, any insurance provider may also include preventive healthcare facilities like free of cost standard health check-ups, availing of second opinions from network hospitals, etc. IRDAI has improvised and implemented a new set of rules directing all the insurance companies to alter their current incentive packages.

Based on these revised norms, the insurance companies need to:

  • Offer an overview of all the benefits of health insurance, depending on the chosen plan, to all their policyholders at least once every year.
  • The concerned policy paper will explicitly mention without any ambiguity the exact manner in which the concerned awards are supposed to be communicated to the policyholder.
  • Clearly mention how the policyholders are supposed to enjoy money-back benefits.
  • Remain prepared and accountable in case of any omissions or errors in the administration of the concerned award and resolve the issues within the internal grievance cell, without letting it go any further.

Evidently, such improvisations on the standard health insurance plan offer an affirmative strategy towards incentivizing common men to adopt healthy lifestyles, while the insurance companies get benefitted from settling fewer claims, resulting from the improved health status of the policyholders.

How do Wellness Programs in Health Insurance Work?

As per the standard IRDAI norms, wellness perks might be offered in the form of membership subscriptions or vouchers for multiple health supplements. The insurance companies might also reward their policyholders with renewal perks. While this can be an encouraging step towards popularising a healthy lifestyle, however, certain economic consequences might develop because of the rising costs.

In the case of family floater health insurance plans, the insurance providers are now eligible to set wellness benefit terms like varied applicability of the concerned family members. They can also easily determine who is eligible for the wellness perks and what the eligibility requirements to avail of them are.

They possess the freedom to include these benefits as features of standard plans or as additional add-on options, depending on the interest of the concerned company. The insurance companies will also need to prepare clear-cut rules and regulations regarding the accumulation of the rewards, carry over terms, its validity after the expiration of the concerned health plan, and the yearly redemption terms, without any ambiguity.

What are the Benefits of These Wellness Perks for the Policyholders?

The standard policyholders may enjoy additional options. Currently, several benefits of health insurance like subscriptions and premium memberships are available at reasonable costs, allowing you to avail of the benefits without loading your pocket significantly. Under the improvised norms, the terms of the wellness perks will become clearer to the policyholders, ensuring enhanced transparency. They will also enjoy the advantages of the improved insurance policies along with the preventive healthcare alternatives and expanded wellness. They will enjoy the precious reward of a healthy lifestyle and well-being with an enhanced insured sum or a comparatively lower premium deduction.

The perks of maintaining a healthy lifestyle need no introduction. Under the current circumstances, it has become financially more profitable, too. Because of the overall well-being and the health benefits it offers, it has become a win-win situation for the people. You have to follow the standard practices for redemption from the enlisted network of hospitals and healthcare providers, offering hassle-free mutual benefits for both the insured and the insurer.

Also Read: How can health insurance assist in pre-and post-natal costs?

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