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Terms and conditions related to wellness benefits differ from insurer to insurer depending on the services covered by the health insurance plans

Health insurance is one of the essential financial commitments today especially following the pandemic. But while you opt for a new health insurance you should remember there are several things written between the lines of a health insurance policy. As per the recent guidelines by the IRDAI on preventive and wellness feature, the insurers have been instructed to incentivise the insured who are eligible for the reward points. These are known as wellness benefits. Whenever you go to buy a health insurance you should check whether there are any wellness benefits included in the policy. If not, ask your provider to furnish the policy details. Money9 gives you a brief idea about this facility of health insurance policy.

Wellness benefits

Health Insurers reward policyholders with a range of services that are a value-addition to the health insurance coverage. These are offered at no additional expense and are referred to as wellness benefits. This is a type of rider but with no extra cost. It might be a free health check-up if you do not avail any claim for three-four consecutive years.

Multiple health insurance companies such as Care health insurance, Bajaj Allianz, Aditya Birla Health and some others offer these facilities to their clients. IRDA issued guidelines on wellness and preventive features under a health insurance policy in September 2020. According to the guideline, these features shall be designed with the objective of maintaining and improving good health.

Points to remember

There are some points to keep in your mind while having wellness benefits along with a health insurance policy.

Reward points

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 a tab of how well a person manages his/her well-being with various applications that come with the tracking feature. This is basically done to award reward points and promote a healthy lifestyle.

The insured can use these reward points by redeeming this into various ways like gym, marathon, cyclotron, yoga centres, daily workout training etc.

Wellness mentor

There are some insurers that provide a wellness mentor under the wellness program. This is done to provide guidance to the policyholder regarding the appropriate diet, having proper exercise, providing the right nutritional advice, giving up smoking, managing the correct body weight and many more.

On achieving the target set by the insured, the policyholders are rewarded with points or other special benefits. The insured can later redeem these points or use the benefits for various health-related services.

Second 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 insurers would not be responsible for any mistakes or omissions resulting from e-opinions under the insurance plans.

Exciting discounts

This kind of wellness benefits acts as a motivating factor for policyholders to take care of their health and monitor it. This drives the insurers to provide discounts during the renewal period.

Keep a close tab

The type of wellness benefits offered depends on the insurer, so it is recommended that one should closely read all information pertaining to the health insurance plan and its value additions to prevent any potential misconceptions.

Not all insurance plans will provide you the same benefits. Terms and conditions related to wellness benefits differ from insurer to insurer depending on the services covered by the health insurance plans. Before taking a final call, one should take advice from a professional.

Published: September 19, 2021, 13:48 IST
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