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Is it beneficial to have wellness perks in your insurance?

Updated On Apr 19, 2022

Until recently, premium health insurance policies included wellness benefits as a standard feature. Following the recent rules given by IRDAI, India's insurance regulator, in regard to preventative healthcare and wellness, these benefits may become routine. So, what are health insurance wellness programs?

What is a Wellness Program for Health Insurance?

Wellness programs are health insurance packages that include advantages such as gym membership, sports club membership, yoga class membership, or prizes based on healthy living such as keeping an active lifestyle or quitting smoking. Additionally, an insurance provider may provide preventative healthcare benefits such as free health check-ups, second opinions from in-network hospitals, and other such services. IRDAI has issued new rules directing insurance companies to make changes to their incentive packages. In layman's terms, insurance firms would now be required to:

  • At least once a year, provide policyholders an overview of their benefits.
  • In the policy paper, explicitly state the manner in which awards are communicated.
  • Mention the several ways in which policyholders can get their money back.
  • Be accountable for any errors or omissions in the award's administration, and resolve any issues through an internal grievance system.

Evidently, this is a positive step in incentivizing people to adopt healthy lifestyles, and insurance firms stand to benefit from fewer claims as a result of their members' improved health.

How Does a Wellness Program for Health Insurance Work?

According to the IRDAI rules, wellness benefits might take the shape of membership subscriptions or vouchers for health supplements. Policyholders might also be rewarded with renewal perks from insurance firms. While this may be a positive step toward the insurance regulator's goal of encouraging healthy living, there may be economic consequences that result in a cost rise. In the case of family floater plans, insurance providers can now set wellness benefit conditions, such as varied applicability for family members. They can also determine who is eligible for wellness programs and what the eligibility requirements are. They have the option of including such benefits as regular insurance features or as optional add-ons. They'd also have to make the rules for reward accumulation, carryover, validity after the policy expires, and redemption very clear.

What Are the Advantages of a Health Insurance Wellness Program for Policyholders?

Now, the regular policyholder has additional options. Premium memberships and subscriptions are now available at a reasonable price. The rewards scheme will be more transparent to policyholders. They will also benefit from improved insurance plans as well as expanded wellness and preventative care alternatives. A healthy lifestyle will be rewarded with a higher sum insured or a lower premium reduction. 

Take Away

Living a healthy lifestyle has many advantages. It is now also expected to be financially profitable. It's a win-win situation for everyone, since overall health benefits. Because integrating wellness providers and health supplement items increases insurance companies' upfront costs, it must be closely regulated to ensure that these costs are not passed on to the end consumer. Otherwise, the aim is defeated. It would alleviate the regret of a wasted health insurance benefit while also assisting the insured in meeting his or her true needs. For redemption, the insurer might choose from a list of hospitals on its panel. People who begin to use diagnostic test facilities will be able to discover health problems earlier. This implies that people can get prompt care if they have health insurance. It will also entail having a better understanding of how to guide patients in the event of hospitalization claims. Both the insured and the insurer benefit from this arrangement.

Also Read: Is COVID-19 Version Omicron More Dangerous Than COVID-19 Delta?

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This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

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