What are wellness benefits in health insurance policies?

You may have always wondered what the benefits of a wellness program are? Well, insurers these days are sweetening the deal for you – with a wide array of services that are a value addition of sorts to the health coverage they are already offering. These are also known as wellness benefits. It is like saying that your insurer would reward you for staying fit, adopting a balanced lifestyle, and eating good foods for your health.

So, by now, you would have had a pretty clear idea of wellness benefits in health insurance. IRDAI (Insurance Regulatory Development Authority) has come out with some guidelines for wellness and preventive features in health plans. It has asked insurers to provide incentives to their clients who are fit to get reward points. It must be acknowledged that this suits the wellness criteria rather well. These services are pretty helpful even when you consider the plethora of fitness apps you have these days. Given our busy schedules, it has become rather challenging for people to lead healthy lives. This is where these wellness benefits in health insurance can play such a major role. 

You get reward points that lead you to be responsible for your health

These days, health insurance policies offer reward points as an incentive for proper behavior that takes the right care of your health. These reward points can be provided in the shape of concessions or discounts, depending on the provider. They are usually provided for various medical check-up programs such as diagnostic centers, pharmacy bills, and network hospitals for healthcare facilities, to name a few. In these cases, the insurers will monitor how well you are doing when it comes to taking care of your health and well-being. This is why they would have you install various apps with tracking features on your smartphone.  

This is done so that people behave responsibly about their health. It also promotes a healthy lifestyle among people. You – the insured – can use these reward points and redeem them for various fitness-related activities such as the following:

• gym
• yoga centers
• marathon
• daily training and workout
• cyclotron    

A wellness coach to help you get it right 

Some insurers that offer you health insurance also provide you wellness coaches so that you can live in the healthiest way possible. These professionals would offer you guidelines on several areas that are related to your health and, thus, critical for your eventual well-being. 

They have been enumerated as below:

• eating the most appropriate diet
• following the right exercise routine 
• having the correct nutritional suggestions 
• stopping bad habits such as smoking
• keeping body weight at the correct level

Also Read: Health Insurance Wellness Programs Guide

So, this is one more way in which the providers of health insurance plans can help you take proper care of your health. These insurers also work with wellness members. They would offer you additional support in this context so that you can enjoy a better lifestyle that is healthier for you as well. As part of the mentoring process, the insurers set certain targets for you.  

If you can achieve them, you stand to get benefits such as points from the insurers. This is a common feature of all the best health insurance policies in India. You can redeem these points later on or even use the benefits for availing of different health-related services.

You get a second medical opinion 

In certain health plans, you get specialized guidance and benefits such as second medical opinions. These benefits are provided for certain surgeries and diseases that are already being covered by the plan. However, in this case, you have to inform the insurer that you are going to take the benefit. 

This has become a prominent feature for health insurance in India, but you have to follow a definite process in these cases. You first have to ask for a claims form and fill it up properly. After that, you would have to attach copies of all your medical reports along with an investigation report of the medicines you are taking right now. Make sure that you do not make any mistakes or omit any detail from the claims form. The insurers would not be held accountable in those cases. 

You get great discounts for renewing the policies 

If you renew your health insurance policy with the same service provider, it will offer you some exceptional incentives for sure. The wellness benefits that we have mentioned so far act as a great motivator for you as far as taking care of your health and keeping tabs on it are concerned. This, in turn, encourages the insurers to offer discounts at the time when you renew the policy as well. IRDAI has, however, issued some guidelines in this regard. The insurers cannot make any payment for third-party services other than the financial value of the reward points.

In case they offer discounts, it is to be done based on the premium paid for the policy, consultation services, and pharmaceuticals.  

Conclusion:

You need to understand that these policies’ health insurance benefits would depend on the insurer. This is why we suggest that you read the policy document with complete attention. Check the value being added by the policy. Doing this would make sure that you do not have any misgiving regarding the policy in the future. You should also not get too excited about the benefits and reward points being provided by the insurers. 

As we have said already, the wellness benefits under the policy would depend on the insurer that you are buying the policy from – you would not get the same benefits from all the policies. A lot in this case also depends on the wellness services that your health plan is offering you. Before you make a final decision in this regard, always read the policy document very carefully. Also, check out what people are saying online about the insurers so that no unpleasant surprises are waiting for you in the future.