Preventive Care – Health Insurance

Preventive care should be the first step in managing health related finances. Preventive care includes, initial medical evaluation and minimum laboratory investigations, based on age, gender and clinical risk factors, to identify and stratify health risk status and offer suitable advice on preventive strategies in the form of lifestyle changes, diet, exercise, health supplements, need for therapy, further consultations, hospitalization, etc.

Frequently, people visit their health care provider only when they are sick or injured. People also need to visit their doctor when they are well, for a preventive health care check-up.

A preventive health care check-up involves a complete physical examination i.e. tests to make sure that your health is in good condition. The doctor will suggest what risk factors are likely to result in a diseases or health conditions in the future and will run tests to check for early warning signs of these as well. The doctor also takes time to talk about health concerns or questions you may have. If the doctor discovers any concerns during the exam, he or she will develop a treatment plan and help you treat and monitor the condition.

Lifestyle diseases which have become the bane of urban India are preventable and manageable. Most heart attacks come without any warning signals. There is no chest pain or fatigue to forewarn the patient.

Lifestyle diseases are catching their victims younger and unaware. It has become common place for person in his 30s to have a heart attack. The problem is that the damage is done by then. One needs to put early warning systems in place so that they can be prevented and large expenses can be avoided.

A preventive cardiac care program will cost Rs. 4,000 – 5,000 per month even in an up-market hospital like Asian Heart Institute. Whereas a bypass surgery will set back the patient by at least Rs. 2 lakh.

Check-ups should not wait until symptoms appear. It may be noted that almost half of all patients of hypertension and diabetes show no outward symptoms.

The average claim amount in metro cities is Rs. 18,000 to Rs. 20,000 and is increasing every year. We feel that in future the market needs to have comprehensive packages or products that will have more focus on preventive aspects of healthcare. It is possible that there could be a penalty clause for people neglecting their health. We estimate that these measures could lead to a reduction of approximately 15-20% in claim ratios.

What does a preventive program entail? : A typical master health check up will entail tests for Cholesterol and Serum content, Pulmonary Function test (PFT), Stress Test or ECG, PSA or Pap Smear, Gynecology Consultation, Physician Consultation, Dental consultation, Ophthalmology Consultation, Dietary recommendation, etc. such a package would cost you Rs. 3,500 . If a healthy individual below the age of 35 purchases a medical insurance policy for its Rs.300.000, it will cost Rs. 3,850.

Preventive health care plans are mainly offered by hospitals or larger diagnostic centers.

Hospitals offer you several packages that facilitate good economies as well as diseases specific plans such as cardiac care testing or diabetes testing. The cost of these plans can range from Rs. 700 up to Rs. 3,500. Apollo offers a Health Edge card which provides discounts on treatments and repeat testing. Max Hospitals also offers a similar Wellness card.

Besides hospitals, there are specialized diagnostic centers which off preventive health check-ups. These centers use high-tech diagnostic equipment like digital X-ray, bone densitometry, 3-D and 4-D ultra-sonography and other facilities which are not available with preventive healthcare centers per se. Their customers are made to undergo lifestyle and stress management workshops.