What if anyone said you would be rewarded for staying fit, consuming nutritious and fresh food, and adopting a healthy lifestyle? Isn’t that amazing?
As per the recent guidelines by the IRDAI on preventive and wellness feature, the insurers are asked to incentivize the insured who is eligible for the reward points and fits well with the wellness criteria.
Insurers are rewarding the policyholders with a range of services that are simply a value-addition to the health insurance coverage offered at no additional expense, referred to as wellness benefits.
Even though there are several other applications or software tools that can keep track of one’s health status, however, it becomes quite challenging with the busy work schedule to keep up to maintaining a proper routine. That is where this wellness benefit ensures optimum utilization as policyholders are motivated to take their health seriously and in return offered some exciting rewards or benefits.
Here are some of the wellness benefits in health insurance offered by the insurers:
Reward Points that incentivizes Health Behavior
These reward points can provide discounts or concessions on different medical check-up programs like diagnostic centres, network hospitals for healthcare facilities, pharmacy bills, etc. Insurers keep track of how well you manage your well-being with various smartphone applications that come with the tracking feature. This is basically done to incentivize health behaviour and promote a healthy lifestyle.
The insured can use these reward points by redeeming this into various fitness activities like gym, marathon, cyclotron, yoga centres, daily workout training etc.
A Wellness Coach that helps you do it right
There are some insurers that provide a wellness coach/mentor under the wellness program. This is done to provide guidance to the policyholder regarding the appropriate intake of diet, acquainting with the proper exercise routine, providing the right nutritional advice, ceasing smoking habits, managing the correct body weight, and many more.
These wellness mentors associated with the insurers offer extended support to the policyholder to help them live a healthy and better lifestyle.
On achieving the target set for the insured during this mentoring process, the policyholders are rewarded with points or other benefits. The insured can later redeem these points or use the benefits for various health-related services.
Second Medical Opinion
There are certain health insurance plans that provide you with specialist guidance and second medical opinion benefits for specified diseases or surgeries that have already been scheduled. However, the insured must notify the insurer that he is seeking the second medical opinion’s benefit.
The normal practice is first to request a properly filed claim form, including a copy of all medical records and the investigation report or the current medications (if any). However, the insurers would not be responsible for any mistakes or omissions resulting from e-opinions under the insurance plans.
Exciting Discounts on Renewal
This kind of wellness benefits acts as a motivating factor for the policyholders to take care of their health and monitor it. This drives the insurers to provide discounts during the renewal period. However, as per the recent guidelines by IRDAI, the insurance providers should not offer any payments on any third-party services other than the monetized value of the reward points. The discount price can be centred on the premium amount of the insurance, pharmaceuticals or consultation services.
The type of well-being benefits offered depends on the insurer, so it is recommended that you closely read all information pertaining to the health insurance plan and its value additions to prevent any potential misconceptions.
It is essential never to get swept up with the reward systems and benefits available by your insurance coverage under the wellness services. Not all insurance plans will provide you with relatively homogenous benefits.
Wellness benefits related terms and conditions differ from insurer-to-insurer depending on the wellness services covered by the health insurance plans. Before taking a final call, it is highly suggested to review the insurer’s policy wordings and check the online reviews well in advance to avoid any unpleasant surprises during the claim process.
by Rakesh Goyal, Director, Probus Insurance