Should You Consider Wellness Programs When Buying a Health Insurance Policy?

What is a Health Insurance Wellness Program?

Earlier, wellness programs, also called wellness benefits, were offered only under the premium health insurance plans, but nowadays most plans offer at least some wellness programs. These programs are activities to help you improve health, maintain an active lifestyle, and prevent chronic and terminal illnesses. It includes activities like yoga classes, gym, sports club, etc. membership subscriptions or redeemable vouchers. There could also be preventive healthcare benefits like free heath check-ups, a second opinion in the network hospitals, etc. Apart from these benefits, there are 'wellness points' or 'reward points' attached to the health insurance plan renewal. In other words, the insurance company rewards the insured for staying fit and healthy.

The Health Insurance Wellness Programs typically include;

• Smoking cessation programs

• Weight-loss programs

• Fitness activities

• Vaccination drives

• Mental health care programs

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As per the Insurance Regulatory and Development Authority of India (IRDAI) guidelines, the wellness and preventive features under the policy can be offered either as optional or add-on cover. The regulator says, "As part of promoting wellness and preventive regime, insurers may offer reward points to those policyholders who comply with or meet the set criteria of wellness and preventive features.".

The IRDAI mandates the insurers to;

• Provide the rewards summary to the policyholders at least once a year

• Mention the mode of communication of rewards in the policy document

• Mention how the policyholders can redeem their rewards

• Be responsible for any errors in the administration of the rewards and maintain an in-house grievance redressal mechanism to resolve any issues

• Allow the policyholders to choose the service provider of their choice if the insurer has tie-ups with multiple service providers

The insurers can offer reward points to the policyholders for staying healthy and fit as they stand to gain with the lesser claims because of the improved health of the policyholders. Therefore, it is a win-win for both; the policyholders and insurance providers.

What are the benefits of the Wellness Programs?

• Membership subscriptions or redeemable vouchers for yoga classes, gyms, fitness centres, sports clubs, etc.

• Discounted or free medical consultations, second opinions at network hospitals

• Free health check-ups

• Discount in the premium on policy renewal or increased sum assured upon policy renewal

• Choice to use rewards as per your needs, in case you earn more than one reward

How do Health insurance Wellness Programs work?

As mentioned in the IRDAI guidelines, wellness benefits can be in the form of membership subscriptions or redeemable vouchers for health supplements. The insurers can also reward policyholders in terms of renewal benefits. As discussed earlier, the insurer offers you reward points that you can redeem as per the terms and conditions of the policy. The insurance company needs to clearly convey to the policyholders regarding rewards accumulation, carry forward, the validity or expiry of points, and redemption. Upon participation in a wellness program, some insurers provide you with a fitness tracking device that can be synced to the insurer's mobile app. You will earn points based on your physical activities and can exchange these points for curated rewards/benefits. While this helps in increasing the awareness of healthy living, it could add up to the cost of insurance.

Insurers can define wellness benefits criteria and set eligibility, which especially helps the policyholders who have a family floater health insurance plan as there could be different applicability for family members.

Should you consider Wellness Benefits when buying a Health insurance Policy?

Health Insurance Wellness Benefits can serve the individual's specific health insurance needs with its numerous offerings. Financial rewards for staying healthy could be the biggest motivation for many individuals. Health Insurance Wellness Benefits can turn a basic health insurance policy into a customised health insurance policy that offers the best health-related benefits. However, you should know that these benefits vary across insurers. What one insurer offers, might not be offered by another insurer. Hence, it is crucial to check with multiple insurers, compare them, and choose the health insurance plan that offers the most suitable benefits to you. Furthermore, it is necessary to check the premium before and after adding these benefits as it does not make sense if the integration cost between the insurer and service provider is passed on to the policyholders. More importantly, the health insurance buying decision should not be solely based on Wellness Benefits. You should also consider different aspects, such as coverage provided, network hospitals, sum assured offered, add-ons and riders, policy premium, customer service, customer reviews, list of inclusions and exclusions, policy exemptions, etc. Here's a complete guide to buy a Health Insurance Policy in India that elucidates everything; right from the important terms used in health insurance to things to consider when buying a health insurance policy

Warm Regards,
Ketki Jadhav
Content Writer