We all work hard throughout our lives to feed and clothe ourselves well, educate our children, and save for the future, right? But while we are saving this money, have we ever thought about whether we are preparing ourselves for the illnesses that come with old age? Imagine, if you suddenly develop a serious illness, all your hard-earned savings can be gone in one day. In such an unexpected situation, health insurance coverage is something that will come to your aid without putting a heavy burden on your wallet.
Simply put, what is health insurance?
This is a very simple concept. Think of it like a bereavement society in the village. We all come together and collect small amounts of money. If someone gets into trouble, we use the money we collect to help that person. Health insurance is the same.
You pay a small amount of money to an insurance company every month or every year. We call it a ``premium`` . In return, if you get sick and have to be hospitalized, the insurance company will pay for the expenses - that is, doctor's fees, medicines, tests, room charges, etc. This is called a claim .
Simply put, health insurance is like saving a little today for a big hospital bill that may come in the future.
Is this really important for us in Sri Lanka?
Some may think, "When government hospitals are free in our country, why pay for insurance?" Yes, free healthcare in our country is one of the greatest blessings we receive. There is no argument about that. However, we all know about the overcrowding in government hospitals, the sometimes long queues for surgeries, and the fact that some expensive medicines or tests have to be done outside.
On the other hand, if you seek treatment at a private hospital, you probably know how expensive it is. Imagine if you suddenly need lakhs for an emergency bypass surgery, cancer treatment, or a kidney transplant? In such a case, having a good health insurance cover will give you the opportunity to get the best treatment without worrying about that money. Especially after retirement, when you do not have a stable income, something like this is a big help.
Who can get health insurance?
Actually, anyone can get health insurance. But the most important thing to remember is your age and health condition at the time you get the insurance .
- Young and healthy: If you buy insurance when you are young and free of major illnesses, the premium you will pay will be much lower. You will also be able to get insurance coverage without any problems.
- Seniors and retirees: You can get insurance as you get older, but the premiums may be a little higher. Some companies have introduced insurance plans specifically for retirees.
- People with pre-existing conditions: If you have a pre-existing condition like diabetes or hypertension, some insurance companies will accept you. However, you may not be covered for the first few years, or your premiums may be higher. The most important thing is to be honest about your health conditions when applying for insurance.
How to choose good insurance? Be careful about these things!
There are many health insurance companies in Sri Lanka now. Before choosing one, it is very important to research these factors carefully.
| Things to be aware of | Simply meaning |
|---|---|
| Coverage Amount | What is the maximum amount the insurance company will pay you if you get sick? (e.g. 5, 10, 20 lakhs per year?) |
| Premium | The amount you need to pay per month or year to get that coverage. |
| Network Hospitals | Which private hospitals can you get treatment at? Some insurance plans pay the bill directly to the hospital (Cashless). |
| Covered Illnesses | What types of illnesses are covered? Be sure to check the exclusions. |
| Age Limit | What is the maximum age to enroll in insurance? Also, what is the maximum age to renew insurance? |
| 'No Claim Bonus' | If you don't make any claims for a year, will the coverage amount increase the following year or will the premium decrease? |
What happens if I'm late in getting insurance?
This is also a mistake that many of us make. Postponing, saying, "Oh... let's wait a little longer." But in the case of health insurance, postponing results in a loss.
1. Premiums increase: As you get older, the premiums charged by insurance companies also increase due to the increased risk of developing diseases.
2. Disease coverage is limited: If you go to get insurance after developing a new disease (e.g. diabetes) as you get older, you may not receive coverage for that disease or the insurance may be denied.
3. Waiting Periods: Some insurance policies do not cover certain conditions for the first few months or years after you take out coverage. This period can be a problem if you take out coverage late and have an emergency.
Therefore, the best thing to do is to start insurance while you are young and healthy, paying a small premium. It is the biggest investment you can make in your own future health.
Also consider the insurance provided by your job.
Many private companies offer group insurance coverage to their employees. That's a great thing. But remember, that coverage often ends when you retire or leave the company . Also, there are insurance plans for government employees like 'Agrahara'. Ask your company about these as well. But it's safest to think about retirement and have your own personal insurance in addition to this.
If you have any further questions about this, talk to a trusted insurance advisor. However, if you have medical concerns about whether or not you can get insurance due to your health condition, it's best to talk to your family doctor about it.
Take-Home Message
- Health insurance is not an expense, but an investment in the future. It can protect your savings in the event of an emergency.
- Start insurance when you are young and healthy. That way, you can get more benefits for a lower premium.
- Before choosing an insurance policy, get details from several companies and compare the amount covered, premiums, covered illnesses, and hospitals.
- Don't hide anything about your health condition when filling out the insurance application. Being honest about everything can help prevent problems when making a claim in the future.
- Even if you receive insurance through your job, it's still worth considering private insurance for retirement.
- Talk to your doctor about any medical problems.
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