Why Just Health Insurance Isn’t Enough in the Age of Lifestyle Diseases?

The increasing number of lifestyle-related diseases has severely affected the healthcare conditions in India and worldwide. While health insurance remains a crucial financial safety net, the evolving nature of health risks means that relying solely on traditional health insurance may leave significant gaps in protection.

Keep reading to know why a comprehensive approach, including additional financial tools like term insurance and critical illness covers, is essential today.

What are Lifestyle Diseases?

Lifestyle diseases—such as diabetes, hypertension, heart disease, obesity, and certain cancers—are primarily caused by unhealthy habits, sedentary routines, poor diet, and stress. Unlike infectious diseases, these are non-communicable and develop gradually, often requiring lifelong management and leading to substantial medical expenses. 

The National Family Health Survey highlights a worrying rise in such conditions, especially among younger adults, making them a pressing public health concern.

What are the Limitations of Health Insurance in Covering Lifestyle Diseases?

You can get coverage for the expenses related to medical treatments, hospitalisation, surgeries, etc., under a health insurance policy. However, despite its importance, health insurance has notable limitations:

• Waiting Periods

You have to deal with long waiting periods while claiming for a lifestyle disease. It means you cannot claim benefits immediately after purchasing a health insurance policy for lifestyle disease.

• Exclusions

Some policies exclude diseases linked to unhealthy habits, such as those caused by smoking, alcohol, or drug abuse.

• Higher Premiums

If you already have a lifestyle disease, you may face higher premiums or coverage restrictions.

• Co-Payments and Sub-Limits

Many policies require you to bear a portion of the costs, especially for chronic conditions, through co-payments or sub-limits on specific treatments.

Pre-Existing Conditions: Insurers may impose waiting periods or even deny coverage for pre-existing lifestyle diseases, making it harder to get adequate protection.

How to Choose the Right Health Insurance Policy for Lifestyle Diseases?

Here are some of the factors to consider while buying a health insurance policy for lifestyle diseases:

• Sum Insured

Prioritise a policy with a sufficiently high sum insured to cover expensive treatments and hospitalisations associated with chronic conditions like diabetes, hypertension, and heart disease. Since lifestyle diseases often require long-term management, a higher sum insured provides a financial cushion for ongoing care.

• Waiting Period

Check the waiting period for lifestyle disease coverage. Most health insurance plans impose a waiting period of 2 to 4 years before you can claim benefits for pre-existing lifestyle diseases, so understanding this timeline is crucial. Also, verify if the policy covers outpatient expenses, as lifestyle diseases often involve regular doctor visits and medication.

• Types of Health Insurance Policy

You must have a complete understanding of the health insurance types while selecting one for lifestyle diseases. Here are the different types of health insurance policies for your reference :

1. Individual Health Insurance

It covers the policyholder's medical and hospitalisation expenses. No other beneficiaries are eligible for health insurance coverage under this plan.

2. Family Floater Plans 

As the name suggests, a family floater plan insures the whole family of the policyholder under a single insurance. It saves on your overall insurance premium costs since a single plan covers all. 

3. Senior Citizen Plans 

These are specially designed for older adults but usually come with higher premiums. This is because older individuals are high-risk profile policyholders and are likely to make frequent insurance claims due to poor health conditions.  

4. Group Health Insurance

Employers provide it for their staff. These plans generally have limited insurance benefits and end with employment. 

5. Critical Illness Cover

Consider adding a critical illness cover as an add-on or rider to your health insurance. This provides a lump sum payout for diagnosing serious illnesses such as heart attacks, cancer, or common lifestyle diseases, helping cover non-medical costs and income loss.

• Wide Network Hospitals

Additionally, choose a plan with a wide network of hospitals offering cashless treatment to reduce out-of-pocket expenses. Finally, disclose all pre-existing conditions honestly to avoid claim rejections and review your policy regularly to keep pace with changing health needs. 

This holistic approach ensures your health insurance adequately supports you through lifestyle disease challenges.

Why is Health Insurance Not Enough to Protect Against Lifestyle Diseases?

Health insurance is essential for covering hospitalisation and treatment costs of lifestyle diseases, but it often falls short when it comes to long-term and indirect expenses. Many health insurance plans have waiting periods, exclusions, or co-payments for pre-existing or chronic conditions, limiting immediate financial support. 

Additionally, lifestyle diseases can result in loss of income if you’re unable to work during recovery, and health insurance typically does not cover this gap. Critical illness riders or separate policies offer a lump sum payout on diagnosis, which can be used for non-medical costs, rehabilitation, or income replacement. 

Moreover, term insurance policies also add an extra layer of protection. It ensures that you and your family are financially secure when health insurance alone isn’t enough to manage the impact of lifestyle diseases. It is a life insurance product that offers financial protection to your family in case of your untimely demise. 

While health insurance covers medical expenses, term insurance ensures your family’s financial stability if a lifestyle disease leads to premature death or long-term disability. This is especially important for families where the primary earner is at risk due to a lifestyle disease.

Disclaimer: This content is sponsored and does not reflect the views or opinions of Ground Report. No journalist is involved in creating sponsored material and it does not imply any endorsement by the editorial team. Ground Report Digital LLP. takes no responsibility for the content that appears in sponsored articles and the consequences thereof, directly, indirectly or in any manner. Viewer discretion is advised.

Follow Ground Report on X, Instagramand Facebookfor environmental and underreported stories from the margins. Give us feedback on our email id[email protected]. 

Don't forget to Subscribe to our weekly newsletter,Join our community on WhatsApp, Follow ourYoutube Channel for video stories.