What is a Micro Health Insurance Plan?
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Medical emergencies can strain finances, especially for low-income families. That is where the importance of micro health insurance plans lies. It ensures access to timely care without incurring high costs. Let us understand what a micro health insurance plan is and how it benefits the policyholder.
What Does a Micro Health Insurance Plan Mean?
Micro health insurance is a type of plan designed to provide financial protection to low-income individuals and families during medical emergencies. As per the regulations of the Insurance Regulatory and Development Authority of India, the premium for micro variable insurance products must not exceed ₹6,000 per annum.
Most insurers offer the flexibility to customise these policies to align with the needs of the populations they serve (e.g., micro farmers).
What are the Benefits of Micro Health Insurance Plans in India?
1. High Affordability
Since they are designed for low-income individuals, premiums are very low. It makes them accessible to the communities that cannot afford expensive health insurance policies.
2. Good Coverage Range
It generally offers a sum insured between ₹1 lakh and ₹5 lakh. For individual purposes, it usually offers a sum insured of ₹1 lakh.
3. Coverage for Vulnerable Sections
Insurance companies specifically target informal-sector workers, such as farmers and rural populations. So they can avail financial security when medical emergencies arise.
4. No Pre-medical Screenings
Most plans do not require Pre-Acceptance Medical Screenings, and the application process is simple and easy to understand.
5. Instalment Options
Additionally, they come with a flexible premium payment structure: quarterly, half-yearly, or annually.
6. Family Floater Coverage
Policyholders can cover their entire family under a single policy, ensuring coverage for spouses, children, parents and in-laws.
What is Covered Under the Micro Health Insurance Plan?
1. Hospitalisation Expenses
It covers inpatient expenses, including room rent, boarding, ICU charges, operating theatre charges, nursing charges, medication, and the cost of blood transfusion and oxygen supply.
2. Pre- and Post-Hospitalisation Costs
It covers expenses incurred 30 days before and 60 days after hospitalisation.
3. Surgical Costs
Suppose a farmer needs to undergo surgery. That person does not need to pay any bill upfront. The surgeon's fee, medical practitioners' fees, and consultation are all covered.
4. AYUSH Treatments
Some plans offer coverage for Ayurveda, Unani, Siddha, and Homoeopathy treatments in network hospitals.
5. Cataract Treatment
Most insurers cover cataract surgery expenses, ranging between ₹10,000 and ₹15,000 per eye.
6. Day Care Procedures
Some plans provide coverage for treatment that requires less than 24 hours of hospitalisation.
7. Modern Treatments
Imagine a policyholder with a low bank balance who needs advanced treatment procedures, such as robotic surgeries and stem cell therapy for recovery. They are also covered with sub-limits.
Final Words
Micro health insurance plans are affordable, low-premium insurance products launched to provide basic healthcare coverage. Though some plans cover all hospital-related expenses, including modern treatment, PED covers with a certain waiting period and daycare procedures.
Also, its cashless feature and Hassle-Free Claims settlement procedure make it a popular choice among rural families.