The second wave of the COVID-19 pandemic hit India severely. The Delta variant (also call the Indian variant) of the coronavirus, which is believed to be behind the rise of second wave of COVID-19 in India, spreads much faster and can have a very drastic effect on the infected patients. As a result, the positivity rate of coronavirus as well as the mortality rate is much higher this time around. Buy health insurance policy that provides coverage against all hospitalization-related expenses, including coronavirus and black fungus treatment.

Even as India continue to struggle with the impact of COVID-19’s second wave, rising cases of black fungus infection among those recovering from the virus brought fresh concerns for the Government and citizens alike. As per the Central Government’s data, there were about 8,848 cases of black fungus infection in India on 22^nd May, 2021. And these figures were spiraling at a rapid rate.

Experts are calling this infection “A Pandemic within Covid-19 Pandemic”. As per the reports, number of people dying due to black fungus infection in India is steadily increasing. From black fungus symptoms, to causes, to its treatment, we have discussed everything you need to know about this disease in this article. Continue reading.

What is Black Fungus?

Also known as Mucormycosis, black fungus disease is a fungal infection which is presently seen in patients who are suffering from COVID-19 with co-morbidities such as HIV/AIDS, uncontrolled diabetes, and Mellitus cancer. If not controlled during its initial stages, black fungus infection can prove to be fatal for the patients.

What causes Black Fungus?

Black fungus or Mucormycosis is basically a rare fungal infection which is caused by a group of moulds or fungus known as Mucormycetes. These moulds are considered separate from plants and animals kingdom, and are found in plants, soil, water, decaying organic matter, and sometimes in animals and humans.

As per the doctors, the primary reason behind the development of fungal infection in a COVID-positive patient is prolonged exposure to moisture during oxygen therapy. Use of ordinary tap water in flow meters of oxygen cylinders are also believed to cause black fungus infection. This can also be triggered due to the use of mould-tainted oxygen pipes and humidifiers.

Who all are at risk?

As per the Ministry of Health, black fungus infection in India is mostly detected amongst people who are recovering or have recovered from the COVID-19 disease. This infection can occur anytime to a coronavirus patient i.e. either during his/her hospital stay or several days to few weeks after discharge.

People who have sinus problems or those who are on medications for lung problems are most susceptible to catch black fungus infection during the treatment of COVID-19. Besides, those who are suffering from diabetes, cancer, blood malignancies, and iron deficiency are prone to this fungal infection.

In the world of sky-high medical expenditures and sudden health problems, health insurance is undoubtedly necessary. A well-formulated health insurance cover gives you access to competent and quality healthcare facilities at all times. It helps you tide over medical expenses in a planned manner without creating a financial burden.

However, they entail a considerable premium amount that deters many individuals from taking an insurance cover, thereby isolating themselves from the host of benefits offered by the health insurance policies.

Insurance companies provide the health insurance co-pay feature as a part of their policy that you can use to reduce the premium payable amount. In this article, we shall discuss what is co-pay, its features, and benefits for insurance holders.

What is co-pay in health insurance?

The co-pay feature is an optional clause offered by health insurance companies in their policy. It is an arrangement between the policyholder and the insurance company wherein they share the medical expenses based on a mutually decided co-pay percentage. 

This co-pay percentage is the share of medical expenses that shall be borne by the policyholder in the event of a medical eventuality covered by the policy. For example, Ananya takes a health insurance cover with a co-pay feature of 15%. She incurs a medical bill amounting to Rs. 1 lakh. With the co-pay feature, Ananya will have to pay Rs.15,000 (1,00,000 x 15%), and the insurance company shall cover the balance. 

You may wonder, why would one take a policy where he/she has to pay out of their pockets? And why would the company offer such a feature?

Benefits to the Insured

• Reduced premium

The insured pays a specific portion of his/her medical expenses under the health insurance co-pay scheme. This feature provides the insured person with a direct benefit in the form of a reduced premium amount which is otherwise quite significant. Higher the co-pay percentage, lower the premium amount.

• Direct savings

Health insurance policies are of a pre-determined tenure, and you have to pay the same premium amount irrespective of whether you file a claim or not. With a co-pay health insurance cover, you pay a relatively lower premium amount. If you do not have any claim during the policy period, you have direct savings in the form of a lower premium amount.

Benefits to the insurer

• Promotes honest customer behaviour

Co-pay health insurance brings about a sense of ownership among the policyholders. It is common for policyholders to avail the services of expensive, luxury medical facilities unnecessarily and cover the expenses by filing claims with the insurance company.

In co-pay health insurance covers, policyholders realise that they will have to bear a portion of the medical expenditure, even if nominal. The clause encourages them to opt for services that are necessary and reasonable. 

• Reduction in misuse and fraudulent claims 

Insurance companies are often faced with inflated medical bills and fraudulent claims due to a nexus between healthcare facilities, insurance agents, and scammers disguised as policy holders. In such situations, insurance companies have no choice but to pay claims for medical services that were, in reality, not rendered to patients. It creates a dent in the insurance companies’ profitability and operations. 

With co-pay health insurance policies, patients know that they have to pay a certain sum of the expenses from their own pockets, which naturally keeps frauds at bay.  

India, went through a tough time during the second wave of coronavirus. The symptoms experienced by the infected patients were much more severe this time around. In fact, during the second wave of coronavirus in India, a greater number of middle-aged people (those who are aged between 30 to 50 years) and pregnant ladies got infected.

As per a recent study by Oxford University, pregnant ladies who are COVID-19 positive and their unborn babies might face a higher risk of complications than what was known previously. Women with co-morbidities are at an even higher risk. In many cases, the virus affects the unborn baby by reducing the amniotic fluid around it.

However, that doesn’t mean there is a need for panic. Not every pregnant woman, who is infected with the coronavirus, faces the same symptoms. Though, there could be some complications during the advanced stages of pregnancy as the immunity of a mother becomes weak during this time, mild cases of COVID-19 during pregnancy can be tackled at home with proper diet, rest, and exercise. Securing yourself with Health Insurance that covers covid-19 will be the best solution you have.

In case you’re pregnant and have tested positive for COVID-19, here’s what you should do to keep yourself and your baby safe.

1. Take all necessary precautions and follow Covid-safety protocols

We all know that prevention is better than cure. Make sure you are following all COVID-safety protocols laid down by the Government. It includes practicing social distancing, staying away from public places, and avoiding meeting anyone who has possible COVID-19 symptoms. Also, wash hands frequently or use hand sanitizers whenever you touch any high-contact surface.

It’s understandable that as a pregnant lady, you can’t avoid going out completely. You might have to visit your gynecologist or go out for antenatal activities. However, whenever you step out of your home, don’t forget to wear your mask, and take hand sanitizer with you.

2. Don’t panic and stay positive

Even if you’ve tested positive for coronavirus during your pregnancy, there is no need to panic. Don’t run immediately for hospitalisation as mild cases of COVID-19 can easily be cured at home with a few precautions and medications. Take proper rest and have a healthy diet.

Another thing is you should stay as happy and positive as possible. This will not only provide you the strength to fight with the disease but also keep your child in a good shape.

3. Isolate yourself. Get teleconsultation with your doctor

It’s obvious that you would never want someone else in your family to get infected with the virus and suffer. The first thing you need to do when you notice the coronavirus symptoms in yourself is to get isolated. Do not let anyone enter your room except if there’s an emergency.

Take regular teleconsultations with your doctor. Follow his/her advice strictly while taking your medicines. Keep checking your body temperature and blood’s oxygen saturation level every three to four hours. In case you notice anything adverse, inform your doctor immediately. Do not self-medicate in any case.

Premium is an essential factor that you must take into consideration before buying health insurance. This is because only if you pay it on time can you avail the benefits of your policy. It’s interesting to note that premiums for the same plan may differ across policyholders. While you can easily get a quote from your insurer, keeping in mind these factors can help you calculate health insurance premiums.

Factors Affecting Health Insurance Premiums

• Age

It is a vital factor affecting health insurance premiums. Premiums increase with age. This is because the body is more susceptible to diseases and ailments as and when you age. The insurer thus covers a greater risk and hence charges you more.

Therefore, it’s is advisable to buy health insurance when you are young and healthy. It will help you make significant savings.

• Lifestyle Habits

The lifestyle you lead has a direct bearing on health insurance premiums. If you are addicted to smoking or drinking, it will push up the premium amount. On the other hand, if you don’t, the insurer charges you less for the same policy offering the same coverage.

Smoking and drinking increase the chances of falling ill, leading to subsequent hospitalization. With a higher risk element involved with these habits, you need to pay more to your insurer.

• Coverage Amount

Health insurance premiums are directly proportional to the coverage amount. It means higher the amount, higher the premium. To put it numerically, you need to pay more for ₹ 10 lakh coverage than ₹ 5 lakh.

• Co-pay and Sub-limit Clauses

Co-pay refers to the amount you need to pay from your pocket towards hospitalization bill(s), while sub-limit is the cap on expenses such as room rent, doctor’s consultation fee, etc.

These clauses are there in health insurance plans to prevent misuse. A low co-pay and high sub-limit entail paying a higher premium.

• Age of the Eldest Member in Case of a Family Floater Plan

In case you are willing to buy a family floater plan which provides coverage to all family members, the premium amount depends on the age of the eldest member. More the age, higher the premium.

• Pre-existing Ailments

If you have any pre-existing ailments or diseases, premium increases. For example, if you are suffering from diabetes or hypertension, you need to pay more towards your health insurance plan.

• Riders Opted For

Health insurance riders are add-ons that you add to your base policy. Adding riders to your policy increases the premium amount to some extent. With riders, you can further fortify your coverage.

Using Health Insurance Premium Calculator

While the above steps can help you get an estimate of the premium you need to pay, a health insurance premium calculator makes the job extremely easy and fast. Today, almost all insurers have this calculator on their website, with the help of which you can get premium quotes effortlessly.

A health insurance policy has become a necessity in today’s times. It protects the policyholder against the skyrocketing medical costs he/she may incur during a medical emergency. A standard health plan covers a range of expenses, including hospital’s room rent, doctor’s consultation fees, costs for medicines and diagnostic tests, etc. But, do you think having only regular health insurance is enough?

Sedentary lifestyle and increasing complexities in our living standards have made us more prone to serious illnesses and diseases. In India, more than 5 lakhs people are diagnosed with cancer every year and approximately 24 lakhs people suffer from cardiovascular diseases. The treatment of such diseases is usually very expensive, and a normal health insurance plan may not cover it by default.

It means that in case you contract a critical illness, your regular health insurance policy may fail to cover you adequately and you might end up losing all your life-savings. That is why, you must procure a separate critical illness insurance policy or attach a critical illness rider to your regular health insurance plan.

It will keep you financially protected against some life-threatening diseases such as cancer, heart attack, stroke, kidney failure, and paralysis.

Below are the five vital reasons to include critical illness rider in your health insurance plan:

1. Coverage against several chronic ailments

As mentioned above, the critical illness rider will provide you financial protection against several chronic ailments which generally include cancer, heart attack, stroke, kidney failure, organ transplant, liver diseases, and paralysis, among many others.

Though the number of ailments which is covered by the policy varies from insurer to insurer, usually a critical illness insurance rider helps covering all major life-threatening diseases.

2. Fixed sum assured upon diagnosis

Critical illness insurance plans are fixed benefit plans. It means that by attaching a critical illness rider to your regular health plan, you will become eligible to receive a fixed amount of money in case you get diagnosed with any critical ailment mentioned in the policy document. This sum assured will be paid to you irrespective of the actual amount you incur for your treatment.

Also, this sum assured will be paid directly to you which means that you can use it in whatever way you need. For example, you can use it to pay for the treatment costs, medicines, diagnostic tests, and also for paying your EMIs and meeting daily living expenses of yourself and your family members when you’re not able to earn a livelihood.

3. Tackle the huge medical expenses

As mentioned above, critical illnesses such as cancer, heart attack, and kidney failure are usually very expensive to treat and care for. For example, average cost of treatment for cancer is estimated at ₹ 10 lakhs, whereas certain lung diseases can take up to ₹ 20 lakhs for treatment.

In the absence of a critical illness cover, tackling such huge medical expenses can become next to impossible for a common person. Also, the critical illness insurance will ensure that you get the best possible treatment for covered diseases at the best healthcare facility around the world.

How To Choose Right Health Insurance At Different Stages Of Life?

Today, a health insurance policy has become imperative for everyone. Rising cases of lifestyle diseases and constantly increasing cost of healthcare facilities have made health insurance a necessity for everyone. Apart from covering almost all healthcare expenses a policyholder may incur during a medical emergency, a health insurance plan also helps him/her avail regular health check-ups and income tax benefits.

But, have you ever wondered if a specific health insurance policy is enough to provide you sufficient coverage for your entire life? The answer is “No”. As your health condition keeps on changing throughout your life, your health insurance needs also change accordingly. For example, a young person who is usually fit and healthy require a relatively smaller health insurance cover than an elderly person who is more prone to diseases and infections.

In this article, we’ve tried to explain the health insurance needs of a person during the different phases of his/her life and how should he/she choose the right health insurance cover for himself/herself at every stage. Read on.

When you’re young and single (in early 20s)

During this phase of a person’s life, he/she is pretty healthy and barely has any responsibilities. That is why, a large health insurance cover is not required at this stage. Hence, you can take a standard health insurance policy with a coverage amount of around ₹ 2 to 5 lakhs. Additionally, you should also consider the points mentioned below:

• Opt for a health insurance plan which fits your budget. As, at this stage of life, you are either not earning or have just started your career, paying high premiums for a health plan makes no sense.
• If you can, go for a health insurance policy with higher co-pay or deductibles.
• Consider your health condition and pre-existing diseases. If you have some pre-existing diseases or if you pay frequent visits to doctors, you should opt for a health insurance plan with higher coverage.
• Also, consider your profession while choosing a health plan. If you’re in a profession which involves working in conditions which are hazardous for your health, opt for a plan with high coverage.

When you are in your 30s or late 20s

When you enter this phase of life, you will suddenly find a plethora of responsibilities on your head. During this stage of your life, you could either be already married or have started planning for your marriage. You might have even started thinking about having a child in future.

Keeping in mind the number of dependents and responsibilities on you, you will need to increase your health insurance cover during this phase. Also, this is the time when you could be facing a lot of stress while managing your professional and personal life. Ideally, you should opt for a health insurance cover of ₹ 10 to 15 lakhs during this stage. You should also keep in mind the points mentioned below:

• You should get regular medical check-ups to find out if you have any pre-existing diseases. It’s common to develop certain lifestyle diseases such as Type II diabetes, hypertension etc. in this stage of life.
• You can opt for a family floater health insurance policy. It will provide comprehensive medical coverage to you, your spouse, and your children (if any).
• If you’re planning for a kid, you should go for a health insurance plan which comes with maternity benefits and new-born cover. In case your health insurance policy doesn’t provide maternity cover by default, you can add it as a rider.

The spread of coronavirus during the start of 2020 wreaked havoc in the entire world. More than a 100 million people got infected with the virus, resulting in the death of more than 2 million people. India was no different with more than 10 million cases and around 1 lakh deaths due to coronavirus. In fact, India ranked third among the worst affected countries after the USA and Brazil.

When the coronavirus vaccine in India was launched on 16^th January 2021, we all thought the pandemic days are gone and started to breathe freely. However, the joy was short-lived. The disease hit the country even harder in the form of the second wave of coronavirus. As a result, the number of coronavirus cases in India started going up rapidly and this time, the symptoms were even more severe.

As per the official records, as much as 2,16,828 new COVID-19 cases were recorded in India on 15^th April 2021. This was the highest number of cases recorded in our country in a single day till date. As a result, many state Governments including Maharashtra, Uttar Pradesh, Gujarat, Punjab, Delhi, and West Bengal announced either complete lockdowns or night curfews.

A negative COVID-19 report obtained within 72 hours was also made mandatory by many state Governments for air travellers from other states of India. In this article, we have explained how this second wave of coronavirus in India has been different and more severe than the first wave. Continue reading.

First wave vs Second wave

The surge in COVID-19 cases during the second wave in India has been more rapid than the first wave during August to October last year. The cases rose at double the pace in the second wave of coronavirus in India. While it took 32 days for cases to rise from 18,000 to 50,000 during the first wave, it took only 17 days for the cases to rise from 18,377 to 50,000 during March 2021.

The total number of cases being recorded in a single day was also much higher during the second wave. During the first wave, the highest number of cases recorded in a single day stood a little over 1 lakh. However, the number of cases in a single day during the second wave had touched the figure of 4 lakh.

India becomes second worst-hit country in the world

After the onset of the second wave of coronavirus, India overtook Brazil to become the second worst-hit country in the world. So, far the country has recorded around 3 crore COVID-19 cases, which keeps it only behind the USA (3.27 crore cases). India surpassed Brazil in terms of total number of COVID-19 cases only in April 2021 after staying at third position for several months.

When it comes to the total caseload, Maharashtra remains the worst-hit state during the second wave as well, followed by Uttar Pradesh, Punjab, Chhattisgarh, and Kerala. Along with the number of active cases, the fatality rate has also gone up during the second wave of coronavirus in India. The death count on 14^th April stood at 4.22 lakh.

A health insurance policy has become imperative for everyone today. Not only does it provide thorough coverage against the healthcare expenses the policyholder may incur during a medical emergency, but also it allows the insured person to avail free health check-ups and timely treatment for illnesses.

However, you should remember that most health insurance plans come with lots of terms and conditions. You should know these terms and conditions before buying the policy to avoid any rude shocks during the time of claim settlement. One such term associated with health insurance plans is “room rent limit”.

Room rent limit is a common sub-limit found in many Mediclaim policies. Before knowing more about health insurance room rent limit, let us first discuss what room rent is in health insurance.

What is Room Rent in Health Insurance?

When a person gets admitted to a hospital, he/she has to pay daily rent or per day room charges to occupy a room or bed in that hospital. Room rent in health insurance refers to the coverage for these boarding charges or per day room charges that the policyholder may have to pay while he/she remains admitted to a hospital.

Room rent largely depends upon the type of room and hospital a policyholder opts for. For example, room rent for a single or double occupancy room is more than a ward or a multiple-occupancy room. Similarly, room rent for private hospitals is much higher as compared to the same type of rooms at government hospitals.

Understanding Hospital Room Rent Costs in India

Hospital room rent costs in India differ based on the city, type of hospital, and room category. For instance:

• General wards in urban hospitals typically cost ₹1,000–₹2,500 per day.
• Semi-private rooms range from ₹3,000–₹7,000 per day.
• Private rooms can cost ₹5,000–₹15,000 per day.
• Deluxe or suite rooms in high-end hospitals may charge ₹20,000 or more per day.

These costs can quickly add up during extended hospital stays, making it critical to understand how your medical insurance handles room rent.

How is Room Rent Limit Specified in the Health Insurance Policy?

Now that you know about the room rent, it would be fairly easy for you to understand the concept of room rent limit in health insurance. It is the capping or limit imposed on the coverage of room rent of a hospital by a health insurance policy. The room rent limit can either be expressed as an absolute amount or as a fixed percentage of the sum insured.

In other words, the room rent limit in medical insurance policy is the maximum amount of per day room charges a policyholder can claim when he/she gets admitted to a hospital. Any amount above this sub-limit will have to be borne by the policyholder himself/herself.

For example, if your health insurance room rent limit is ₹ 5,000, then the maximum room rent you can claim under the policy is ₹ 5,000. In case the limit is expressed as “2% of the Sum Insured”, and you have chosen ₹ 5 lakhs as the sum insured, your room rent limit will be ₹ 10,000.

Types of Room Rent Limits in Health Insurance Coverage

Room rent limits in health insurance can be classified as follows:

1. Capped Room Rent:

Policies with capped room rent specify a fixed amount or percentage of the sum insured. For example:

• Fixed cap: ₹3,000 per day.
• Percentage cap: 1% of the sum insured per day.

2. Category-based Restrictions:

These policies cover specific room categories, such as semi-private rooms. Choosing a private or deluxe room may result in a higher co-payment by the policyholder.

3. No Room Rent Limit:

Some comprehensive plans do not impose any restrictions on room rent, allowing policyholders to choose any room type.

How Does Room Rent Limit Impact Your Overall Health Insurance Claim?

Room rent limit in health insurance is a very important concept. Your entire claim for health insurance coverage will depend on this room rent limit. Not only does it cap the maximum per day room charges you can claim on a policy, but it also limits other expenditures such as doctor’s fees, treatment costs, etc. Let’s understand this with the help of an example.

Suppose, you purchased a health insurance plan with a Sum Insured of ₹ 5 lakhs where the room rent is 1 percent of the Sum Insured. This means that the actual room rent limit for your policy will be ₹ 5,000. Now, if you get hospitalised and choose a room whose rent is below ₹ 5,000 per day, you will be able to claim for all expenses incurred on hospitalisation, without any deductions.

It means that if you incur ₹ 3 lakhs during the hospitalisation, you will get the entire ₹ 3 lakhs amount from the insurer upon filing a claim.

However, if you choose a room whose rent is more than ₹ 5,000 per day, your claim amount will be deducted in equal proportion by which the room rent exceeds the room rent limit of your policy. It means that if your room rent is ₹ 7,500, then you will get only 5000/7500 i.e. only 67 percent of the total expenses incurred by you during hospitalisation.

It means that if you incur ₹ 3 lakhs during hospitalisation, you will get ₹ 2.01 lakhs only (3,00,000 * 0.67) from the insurance provider. This is because hospitals charge differently for the same services for different room types. It means that the fee for a doctor’s visit in a shared room can be ₹ 1,000, whereas the fee for a visit by the same doctor in a private room can be ₹ 2,000. Hence, insurance companies pay a proportionate claim if the policyholders opt for expensive rooms.

Benefits of Health Insurance Plans Without Room Rent Charge Caps

Choosing medical insurance without room rent limits offers several advantages:

1. Flexibility in Room Selection:
   Policyholders can choose any room type, including private or deluxe rooms, without worrying about additional costs.
2. No Proportionate Deductions:
   Since there’s no cap, there are no proportionate deductions on the overall hospital bill.
3. Comfort and Privacy:
   Patients can opt for more comfortable and private rooms, which can positively impact recovery.
4. Hassle-free Claims:
   With no room rent restrictions, the claim process becomes simpler and less stressful for the policyholder.

While such health insurance plans may come with higher premiums, they offer more benefits and comprehensive coverage, proving useful in times of critical illnesses and hospitalisations. 

FAQs

1. What is the room rent limit in insurance?

The limit on the cost of a hospital room covered by a health insurance policy is called the room rent limit. It can be between 1% to 2% of the total insured amount, but it varies for each insurance provider.

2. What happens if I exceed the room rent limit specified in my policy?

If you choose a room with rent higher than your policy’s cap, the insurer may apply proportionate deductions to the entire bill. Additionally, you’ll need to pay the excess rent out of pocket.

3. Are ICU charges included in the room rent limit?

ICU charges are typically higher and may have separate limits in the policy. It’s essential to read your policy documents for specific details.

4. Can I upgrade my policy to remove the room rent limit?

Yes, most insurers allow policy upgrades to include features like no room rent cap. Contact your insurer for details on premium adjustments.

5. Is it worth paying higher premiums for a policy without a room rent limit?

Policies without room rent limits offer greater flexibility and reduce the risk of out-of-pocket expenses during hospitalisation, making them worth considering for those who prioritise comfort and convenience.

6. Do corporate health insurance plans have room rent limits?

Many corporate health insurance plans impose room rent limits. It’s advisable to review the terms and consider additional personal health insurance if needed.

Conclusion

The concept of room rent limit in health insurance is beneficial only till you are choosing a room whose rent is below the capping. Otherwise, it can significantly affect the claim amount that you will get. Hence, the best option is to go for a Mediclaim policy with no room rent limit. By opting for such a policy, you will be able to avail treatment in the room of your choice, without worrying about the capping.

For instance, you can purchase ICICI Lombard’s Complete Health Insurance Policy which has no capping on room rent. Additionally, this policy is easy to purchase and comes with an option of lifetime renewability.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis or treatment. Please consult a certified medical and/or nutrition professional for any questions. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.

Time and again, the Government of India has taken steps to ensure optimum care and protection of its citizens. From bringing about developmental and infrastructural changes in the healthcare industry to providing social security through various subsidised health insurance policy schemes, the Indian Government has left no stone unturned in showing concern for its citizens.

Back in the year 2015, the then Finance Minister of India – Late Mr. Arun Jaitley – launched three social security schemes during the Budget Speech. All these schemes were aimed to provide social security to those working in the unorganised sector in India. One of these three schemes was Pradhan Mantri Suraksha Bima Yojana (PMSBY).

Through this article, we have tried to throw some light on the PMSBY scheme and what it is all about. Continue reading to know more.

What is Pradhan Mantri Suraksha Bima Yojana (PMSBY)?

As mentioned above, the Pradhan Mantri Suraksha Bima Yojana (PMSBY) is one of the social security schemes which was launched by the Government of India during the 2015 Budget Speech in the Parliament. The PMSBY scheme is a Government-backed accident insurance scheme which provides protection against accidental death and disability to individuals between 18 to 70 years of age.

This scheme is highly helpful in preparing an individual for unexpected emergencies by providing an accident insurance coverage of up to ₹2 lakhs at a highly affordable premium of ₹20 per annum.

PMSBY scheme details

The primary features of the PMSBY insurance scheme include:

• Coverage for a year and is renewable on annual basis
• Indians as well as NRIs can avail the benefits of this scheme
• Provides coverage of up to ₹2 lakhs against death and full or partial disability caused due to an accident
• The annual cover will remain valid from 1st June till 31st May
• To avail the benefits under this scheme, each member will have to pay an annual premium of ₹20
• Annual premium of ₹20 will be auto-debited from the beneficiary’s bank account

Inclusions & exclusions under the PMSBY scheme

Here is what will be covered and what won’t, under the PMSBY insurance scheme:

• Accidental death of the applicant will be covered by the scheme.
• If the applicant dies by suicide, it won’t be covered by the scheme.
• If the applicant dies because of murder, it will be covered by the scheme.
• Permanent total disability, i.e. loss of both eyes, hands, or feet will be covered.
• Permanent partial disability, i.e. loss of one of the eyes, hands, or legs will also be covered.
• A compensation of ₹2 lakh will be paid in case of accidental death or permanent total disability. Whereas, in case of partial disability, a compensation of ₹1 lakh will be paid.

Benefits of PMSBY

Here are some benefits of the Pradhan Mantri Suraksha Bima Yojana:

• Affordable Premium: Just ₹20 per annum, ensuring cost-effective coverage.
• Financial Security: Helps families cope with financial stress in case of accidents.
• Easy Enrolment: Can be linked to any bank account with minimal paperwork.
• Nationwide Availability: Open to all eligible individuals across India.
• Supplement to Family Health Insurance: Complements existing family health insurance plans by covering accidental risks.

How to apply for PMSBY?

The PMSBY scheme will be administered through public sector general insurance companies and private insurance companies such as ICICI Lombard. You can apply with any of these insurance companies through SMS or Net Banking to become a beneficiary under this scheme.

All you need to do is download the PMSBY form the Government website and approach a bank or insurance company with the duly filled form.

Steps to enrol for PMSBY through SMS

• Step 1 – Send a message on the onboarding organisation’s toll-free number
• Step 2 – You will receive an activation message
• Step 3 – Reply to the activation message with “PMSBY Y”
• Step 4 – You will receive an acknowledgement message
• Step 5 – The bank will process your request as per the information in your savings account

Steps to enrol for PMSBY through Net Banking

• Step 1 – Log in to your net banking account
• Step 2 – Click on “Insurance”
• Step 3 – Select the bank account to be used for premium payment
• Step 4 – Verify the details and click on “Confirm”
• Step 5 – Download and save the acknowledgement receipt for future reference

Documents required under PMSBY Scheme

Give below is a list of documents needed for PMSBY scheme-

• Aadhaar Card (linked to the bank account).
• Bank Account Details (for auto-debit of premium).
• Application Form (available at banks and online portals).
• Nominee Details (to ensure smooth claim settlement).

How to file a claim under PMSBY?

In case of accidental death or disability of the beneficiary, he/she or his/her nominee can file a claim under the PMSBY insurance scheme. Here’s what needs to be done:

• Step 1 – Reach out to the bank or insurance company from where the scheme was purchased.
• Step 2 – Obtain a claim form and fill it. It may ask for your name, address, contact details, and accident details. You can download the PMSBY claim form Jansuraksha
• Step 3 – Submit the duly filled claim form with relevant supporting documents, including the death certificate or disability certificate.
• Step 4 – After verifying the documents submitted by you, the insurer will transfer the claim amount to the specified bank account.
  

FAQs

1. Does PMSBY cover hospitalisation costs for accidents leading to death or disability?

No, PMSBY does not reimburse hospitalisation expenses. The scheme only provides financial assistance in case of accidental death or permanent disability.

2. Who can receive the insurance payout if the insured person passes away?

The nominee mentioned in the enrolment form will receive the insurance amount. If no nominee is registered, the legal heir can apply for the claim.

3. How is the insurance claim amount paid?

For disability claims, the insured person receives the amount in their bank account. In case of death, the payout is transferred to the nominee’s or legal heir’s account.

4. Will the insurance cover apply if the policyholder dies by suicide?

No, PMSBY does not provide benefits in case of suicide.

5. Is a police report necessary to file an insurance claim for an accident?

Yes, for accidents such as road mishaps, drowning, or criminal incidents, an FIR is required. However, in cases like snake bites or falls, hospital records can serve as proof.

6. If a person goes missing, will their family receive the insurance payout?

No, the claim is approved only when death is confirmed with valid documentation proving it was due to an accident.

7. What compensation is given for partial disability?

The scheme only covers complete and irrecoverable loss of sight in one eye or total loss of function in a hand or foot. Partial disabilities that do not meet these criteria are not covered.

8. Can someone claim benefits from multiple banks if they have enrolled in PMSBY through different accounts?

No, even if an individual has registered through multiple banks, they can claim the benefit only once.

9. Is it possible to enrol in PMSBY through multiple bank accounts?

No, a person can enrol only once, even if they hold multiple bank accounts.

10. What is the eligible age range for joining PMSBY?

People aged between 18 to 70 years can enrol in the scheme.

11. How is the insurance premium paid?

The premium is automatically deducted from the insured person’s bank account every year.

12. If I missed enrolling in the first year, can I join later?

Yes, if you didn’t enrol initially, you can join in later by providing consent and ensuring your bank account has sufficient funds for premium deduction.

13. Can someone rejoin the scheme after leaving it?

Yes, individuals who exit the scheme can re-enrol in the following years by paying the premium again.

14. Can PMSBY benefits be claimed along with other insurance policies?

Yes, PMSBY benefits are independent of other insurance plans and can be claimed even if you have additional coverage.

15. Does PMSBY cover accidents due to natural disasters? What about cases of murder or suicide?

Yes, PMSBY covers accidental death or disability caused by natural disasters like floods and earthquakes. It also covers murder cases, but it leaves out suicide cases from ts coverage.

16. Can all members of a joint bank account enrol in PMSBY separately?

Yes, all joint account holders can individually register for the scheme, provided they pay the premium separately.

17. What types of bank accounts qualify for PMSBY enrolment?

Any savings bank account with an auto-debit facility is eligible for enrolment.

18. Can NRIs enrol in PMSBY?

Yes, NRIs can join the scheme, but claims are payable only in Indian currency and will be given to a nominee or legal heir residing in India.

Conclusion

The essence of the PMSBY scheme is to provide social security to the citizens through personal accidental cover at a much lower price than the prevalent market rate. It is a yearly scheme that needs to be renewed every year through auto-debit of the premium amount of ₹20. The policyholder or his/her nominee will get a fixed sum of ₹1 lakh or ₹2 lakhs upon filing a claim. With its affordable premium, easy enrolment and significant benefits, it is a valuable addition to your health insurancepolicy. Enrolling in PMSBY is a simple yet effective step toward securing your family’s financial future against accidental risks.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It may contain outdated data and information regarding the Insurance industry and products. It is advised to verify the currency and relevance of the data and information before taking any major steps. ICICI Lombard is not liable for any inaccuracies or consequences resulting from the use of this outdated information. 

Leprosy, also known as Hansen disease, is a bacterial infection affecting a person's skin, nasal lining, and peripheral nerves. This disease has prevailed across the globe but commonly affects the residents of warm tropical and subtropical regions. According to the World Health Organization (WHO), there are around 2,08,000 leprosy patients worldwide, mostly from Asia and Africa.

One of the oldest diseases existing since biblical times, leprosy was always considered a highly infectious and dangerous condition. Till date, many leprosy patients across the world are forced to live in isolation and suffer social stigma. This article will talk about the causes and symptoms of leprosy, its treatment, and eliminate misconceptions surrounding the disease.

What causes leprosy?

Leprosy is caused by Mycobacterium leprae (M. leprae) or Mycobacterium lepromatosis (M. lepromatosis) which affects the skin, eyes, respiratory tract and peripheral nerves of the infected person. Skin lesions appear mainly in the colder areas of the body. The disease can spread through cough or sneeze droplets from an infected person or direct contact with an untreated leprosy patient.

A person with a weaker immunity can get infected with the disease quickly. Children may be more susceptible to this disease than adults.

What are the types of leprosy?

There are several classifications of leprosy. The two main categories are the Ridley-Jopling classification and the World Health Organization (WHO) classification.

Ridley-Jopling classification identifies the following five gradations of the disease:

• Tuberculoid leprosy: Fewer lesions; some are large and numb with nerve enlargement
• Borderline tuberculoid leprosy: More but smaller lesions with more nerve enlargement
• Mid-borderline leprosy: Reddish plaques with moderate numbness and swollen lymph nodes
• Borderline lepromatous leprosy: Many lesions with raised bumps, plaques and more numbness
• Lepromatous leprosy: Several lesions, disfigurement, limb weakness and hair loss

The number of skin lesions defines world Health Organization (WHO) classification:

• The first form is paucibacillary; wherein there are fewer skin lesions with no bacterium seen on the skin smear.
• The second form is multibacillary; wherein there are multiple skin lesions with bacterium seen on the skin smear.

What are the symptoms of leprosy?

Leprosy doesn't show immediate symptoms. The infection gradually develops into the disease, and it may take between one to 20 years for the infected person to show the first signs of leprosy, which include:

• Skin lesions paler than the person's normal skin tone
• Skin lesions with reduced sensation
• Foot ulcers
• Dry and cracked skin
• Muscle weakness
• Numbness in the hands and feet
• Curled fingers
• Facial disfigurement
• Hair loss
• Dry eyes, ulcers and maybe blindness

Diagnosis of leprosy

The doctor will first examine the patient for physical signs of symptoms of leprosy. Based on this, the doctor will conduct a biopsy on a small skin sample. This may be followed by a skin smear test to identify paucibacillary or multibacillary leprosy.

The doctor may also conduct a lepromin skin test to diagnose the type of leprosy further. In this process, the patient is injected with a small dose of inactive leprosy-causing bacterium on the forearm. The skin patch will be observed after a few days. A patient infected with tuberculoid or borderline tuberculoid leprosy will show a reaction to the injection.

Treatment of leprosy

Leprosy can be cured if detected early. In 1995, the World Health Organization (WHO) introduced Multi-drug Therapy (MDT) to combat it. And this treatment is available for free across the world. Depending on the type of leprosy, the doctor may prescribe treatment for six months or longer, in case of severe leprosy. A combination of the following antibiotics is used for leprosy treatment:

• Dapsone (Aczone)
• Minocycline (Minocin)
• Ofloxacin (Ocuflux)
• Rifampin (Rifadin)
• Clofazimine (Lamprene)

For nerve damage, the doctor may prescribe anti-inflammatory medication such as prednisone (Rayos), aspirin (Bayer), or thalidomide (Thalomid). However, since thalidomide leads to a congenital disability, it should be avoided by pregnant women or women who plan to have a child soon.

Breaking the stigma

For decades, leprosy has been considered a highly contagious disease and the patients are banned from society. Many are denied employment opportunities and thus lead a life in financial struggles and emotional turmoil. The social stigma associated with the disease prevents patients from getting treatment at the right time.

In 1954, French humanitarian Raoul Follereau started the World Leprosy Day to honour Mahatma Gandhi's compassion towards leprosy patients. Across the world, the last Sunday of every January is observed as the World Leprosy Day to create awareness of leprosy. Besides, WHO has been working towards public awareness about leprosy and removing this social stigma.

However, leprosy is not highly contagious. The disease is transmitted through direct physical contact with an infected person. Sitting next to an infected person or shaking hands doesn't spread the disease. Also, the condition isn't transmitted from pregnant lady to her unborn child. Contrary to the misconception, animals like armadillos, chimpanzees and mangabey monkeys may rarely transmit the bacteria to humans.

According to Census 2011 there are 26.8 million specially-abled persons residing in India. This essentially means that 2 percent of the population of the country suffers from some kind of disability, be it mental or physical.

The government of India has taken several steps to ensure that disabled persons have health insurance covers available to fall back upon and to give an equal opportunity for benefits to all. Here is what you need to know about health insurance for differently-abled and mentally challenged individuals.

Health Insurance Schemes

If you or your family member suffers from a disability, the medical condition does not necessarily need to be an impediment towards obtaining a health insurance policy. The Niramaya and the Swavlamban Health insurance schemes are here to ameliorate your burden to a great extent. Read on to find out what the schemes are about.

Niramaya Health Insurance Scheme

The Niramaya health insurance plan has been introduced by the National Trust to help persons afflicted by diseases such as autism, mental retardation, cerebral palsy, multiple sclerosis and related illnesses. The application fee for the Niramaya health insurance scheme is ₹250.

When you want to claim benefits under this plan, your reimbursement will be made after the process of review of your application. You will be entitled to get treatment in the hospital of your choice and claim benefits of up to ₹1 Lakh in total.

Swavlamban Health Insurance Plan

This plan is a group mediclaim policy meant for differently-abled persons. The objective of the health insurance plan is to provide affordable plans to persons suffering from blindness, hearing disability, loss of motor functions, mental disabilities, leprosy and related severe illnesses.

The COVID-19 pandemic has made the entire world realise that medical exigencies can arrive anytime and cause a substantial financial setback that is often tough to handle. The continually rising medical inflation in our country and skyrocketing costs of availing healthcare facilities means that a single instance of hospitalisation can burn a large hole in your pocket and ruin your entire financial planning.

However, you can prevent all this by investing in a reliable health insurance policy. In case of a medical emergency, it would cover most of the healthcare expenses you may incur, including hospital room rent, doctor's consultation fees, costs towards diagnostic tests, medicines, ambulance charges, and even post hospitalisation expenses to a certain extent.

Though there is no shortage of health insurance offerings in India from different insurance providers, one plan stands out in the market - Family Health Insurance. True to its name, it can be the complete solution for yourself and your family members' health insurance requirements. Read on to know more about some significant features and benefits of this plan.

What is ICICI Lombard Complete Health Insurance Plan?

The Complete Health Insurance Plan by ICICI Lombard is a comprehensive medical insurance policy that can secure you and your entire family against unforeseen healthcare expenses. You can either purchase this plan only for yourself or include your family members under the family floater option. This plan comes with an option of lifelong renewability, and you can add your spouse, kids and parents under the floater benefit.

You will also have the flexibility to optimise the coverage based on your precise healthcare needs by selecting add-ons such as maternity cover, OPD cover, critical illness cover, donor expenses cover, etc.

Some other noteworthy features of this plan include:

When you get hospitalised, you must pay room rent for staying in the hospital room with all medical facilities. Room rent of a private hospital can quickly run into several thousand rupees for each day. Standard health insurance plans usually put a cap on the coverage of room rent. In case your hospital's room rent is above that capping, you will have to pay the difference out of your pocket.

However, with ICICI Lombard Complete Health Insurance Policy, there will be no capping or limit on hospital room rent. It means that in case of sudden hospitalisation, you can choose to stay in the room of your choice and avail the best possible treatment without worrying about the finances.

Under the co-pay clause of a health insurance policy, the insured person or policyholder is liable to bear a particular portion of the medical expenses incurred by him/her during a medical emergency. Usually, health insurance plans come with a co-pay clause, and the co-pay percentage is fixed at the time of policy inception.

However, ICICI Lombard Complete Health Insurance Plan comes with zero or no co-pay clause. It means that in case of a medical emergency, the entire expenses incurred by the policyholder will be borne by the insurance company (except for non-medical costs).

Many health policies exclude pre-existing diseases from the ambit of their coverage. However, ICICI Lombard Complete Health Insurance Plan covers pre-existing conditions, albeit after a waiting period of two years. By choosing a sum insured of ₹3 lakhs or more, you will be able to get the coverage for your pre-existing diseases after two years of continuous coverage under the policy.

Tips to Boost Your Oxygen Saturation Level at Home

Until the dreaded COVID-19 entered our lives, we did not pay much attention to blood oxygen level/saturation. In fact, many of us were also not aware of what the normal oxygen level is and what to do if oxygen dropped below normal. Let's understand what oxygen saturation means and how to improve blood oxygen levels naturally at home.

What does blood oxygen level mean?

Blood oxygen level, also known as oxygen saturation or SpO2 refers to the amount of oxygen present in your blood. When we breathe in oxygen, it enters the bloodstream through our lungs and then goes to all the cells for the proper functioning of our body. SpO2 indicates whether our body is getting the right amount of oxygen. The normal blood oxygen level ranges between 95% and 100%. If the level goes below 90%, it is a concern and needs immediate medical attention.

When to get your blood oxygen level tested?

If you experience or have any of the following symptoms, it's crucial to get your blood oxygen level tested -

• Rapid breathing or shortness of breath
• Chronic cough or wheezing
• Chest pain or discomfort due to any underlying heart or lung conditions that might affect oxygen levels.
• Multiple episodes of nausea and vomiting
• Chronic fatigue, dizziness, or weakness

It's also advisable for people who have asthma, COPD, cystic fibrosis, sleep apnoea, or heart disease to monitor their oxygen levels regularly.

Tips to improve your blood oxygen level at home

Some tips to improve blood oxygen level naturally at home include -

1. Practice breathing exercises

Your breathing pattern can have a vast effect on your blood's oxygen saturation level. By changing your breathing style, you can provide a significant boost to your blood's SpO2 level. Recently, doctors and scientists have discovered that those who breathe using their upper chest and inhale less air experience reduced oxygen levels in their bodies.

Therefore, the correct breathing method involves slow and deep inhaling, using your diaphragm and not your chest. This will allow you to inhale as much air as possible, and hence, your body will be able to get more oxygen. Also, it's better to breathe from your nose rather than the mouth.

Simple breathing exercises such as pursed-lip breathing and diaphragmatic breathing can help open your airways and increase oxygen intake. These exercises will help improve the lung capacity.

2. Drinking Lots of Water & Fluids

Keeping yourself hydrated is another important method to improve your blood's oxygen saturation level. When you drink lots of water, your lungs remain properly hydrated, which improves their ability to oxygenate and expel carbon dioxide. Therefore, the oxygen saturation level of your body gets improved.

Also, drinking 2-3 litres of water may improve your blood's oxygen saturation level by up to 5 per cent. Drinking lots of water also helps in regulating body temperature and boosting the immunity of your body.

3. Quit smoking

Lungs get damaged with smoking; hence the ability of the lungs to absorb oxygen efficiently decreases. Passive smoking or getting exposed to second-hand smoke, pollutants, and toxic gases are also harmful to the lungs.

4. Grow Houseplants

Houseplants, like spider plants and peace lilies, help to purify the air indoors and improve air quality.

5. Breathing in fresh air

One of the best and simplest ways to improve your oxygen level is by breathing in fresh air. Open your windows or go out for a walk and feel the difference when fresh air enters your lungs.

6. Prone Exercise

Proning is the best position to increase the oxygen level of your body. It is scientifically proven and recommended by most doctors as well as the Health Ministry of India. In this method, the person has to lie down on his/her belly with his/her chest raised using the support of pillows. You can place one pillow beneath your neck and two pillows beneath your shins and lie down on your stomach or belly.

You can also lie on your right or left side or sit at a 90-degree angle in the "fowler" position and practice rapid breathing. When you notice a drop in your SpO2 level, we recommend remaining in the prone position for at least two to three hours. This will improve ventilation in your lungs, and hence, your oxygen saturation level should begin improving.

7. Include more antioxidants in your diet

Antioxidants allow your body to use oxygen more efficiently, thereby helping your blood's oxygen saturation level. Hence, you can include more antioxidants such as blueberries, cranberries, strawberries, blackberries, kidney beans, plums, and artichoke hearts in your daily diet to maintain your SpO2 level.

You can also consider having foods rich in fatty acids and Vitamin F. These foods work to increase the capacity of the haemoglobin in your bloodstream to carry oxygen. Iron-rich foods such as green vegetables, apples, legumes, fish, poultry etc. also help by strengthening the red blood cells of your body.

What to do if your Blood Oxygen Level is Low?

If your blood oxygen level is below 90%, it is considered low. Here are some ways to improve it naturally -

• Practice deep breathing exercises.
• Get fresh air by keeping your windows open or going outside. Avoid pollution.
• Stay hydrated by drinking 2-3 litres of water every day.
• Maintain a healthy diet rich in iron and antioxidants.
• Manage stress and anxiety.
• Quit smoking.
• Keep yourself active by engaging in regular physical activity.

However, if the oxygen levels don't improve, you must seek medical attention.

Conclusion

Learning how to maintain your blood oxygen saturation at home is essential. In case your SpO2 level drops down severely, get immediate medical help. However, you can avoid hospitalisation if your symptoms are mild and your doctor does not recommend getting admitted.

FAQs

1. What is the fastest way to increase oxygen saturation?

Lying in the prone position is one of the fastest ways to increase oxygen saturation. Practising breathing exercises regularly will also help to maintain your blood oxygen levels.  You have to focus on taking deep breaths for some time or till your breathing becomes normal and easier. It’s important to be aware of the simple breathing exercises to improve lung capacity.

2. What can I drink to increase my oxygen level?

Drinking lots of water (i.e., 2-3 litres a day) will keep your lungs properly hydrated and improve your ability to take in oxygen. It may improve your oxygen saturation level by up to 5%. There is no particular drink to increase oxygen level.

3. Which food gives more oxygen?

Foods rich in iron, nitrate, and antioxidants give more oxygen. Some superfoods you must incorporate into your diet to increase blood oxygen levels are leafy greens, fatty fish, beetroots, berries, citrus fruits, avocados, nuts, and seeds.

Medical costs have been increasing at an alarming rate in India. As per reports, healthcare inflation in our country is rising at double the overall retail inflation rate. At such times, not having adequate medical insurance cover for yourself and your family members can prove to be a significant financial drawback for you.

In the absence of health insurance, even a single medical emergency in the family has the potential to wipe years' worth of savings. Health insurance policies provide a protective shield against the hefty medical expenses you may incur if you or your family member needs hospitalisation.

However, with many insurance companies offering a wide array of mediclaim policies in India, selecting the right health insurance plan can sometimes become difficult. To tell you how to buy health insurance for yourself, we've collated some critical factors regarding health policies in this article.

By being aware of these factors, you can make an informed decision while purchasing a medical insurance policy. Let's get started.

Types of health insurance plans

The first thing you need to know before buying a mediclaim policy is the types of health insurance plans available in the market. Typically, there are two types of health insurance policies:

1. Individual health policy

As the name suggests, this type of health insurance policy caters to an individual. The premium amount for these health plans is calculated based on an individual's age, medical history, present health condition and inherent risks. You can choose to purchase a standalone individual health policy for yourself or buy separate individual health policies for different family members.

2. Family floater policy

Also known as a group health insurance plan, this policy is designed to cover the entire family under a single medical insurance plan. The sum insured of a family floater policy is shared by all family members covered under the policy. A family floater plan usually covers the policyholder, his/her spouse, dependent children and parents.

The sum insured

The sum insured is the maximum amount of money the insurance company is liable to pay to the policyholder in a year. It means that if a health insurance policy offers a sum insured of Rs. 5 lakhs, it's the maximum claim amount that you'll get in a year. In case your claim amount exceeds the sum insured of the policy, you will have to bear the extra expenses out of your pocket.

It would be best to opt for the right combination of premium and sum insured while buying a health insurance policy. A policy with a lesser sum insured can prove inadequate during a medical exigency whereas, a policy with a very high sum insured may lead to a higher premium.

The waiting period clause

Being aware of the waiting period clause can help you make the right decision while purchasing a health insurance policy. The waiting period refers to the period you have to wait for before the insurer can cover your existing health conditions. Usually, the waiting period ranges between two to four years, depending upon the insurer and policy type.

This waiting period applies to all pre-existing illnesses, including thyroid, diabetes, blood pressure, etc., that the policyholder may have before buying the policy. Some policies may also extend the waiting period clause to certain specific treatments and illnesses such as cataract, arthritis, varicose veins, etc.

Hence, you must check the policy document's waiting period clause while buying a health insurance plan. It's best to choose the policy with a minimum waiting period.

Cashless treatment facility

Generally, all health insurance plans offer cashless treatment facility to the policyholders. The policyholder is not required to pay anything out of his/her pocket during hospitalisation at a cashless facility. All he/she needs to do is show the policy document at the hospital, and the bills are settled directly between the insurance provider and the hospital.

However, this facility may not always be available at a hospital of your choice. Health insurance companies have tie-ups with the network hospitals where the policyholders can avail this facility. Thus, while buying a health insurance policy with a cashless treatment facility, you should always check for the network hospitals in your vicinity.

It goes without saying that you should opt for the insurer which has partnered with the maximum number of hospitals and all major hospitals in your city. For instance, you can go for health insurance, which offers cashless treatment at more than 6500 network hospitals across the country.

By taking good care of your health and body, you can avoid serious ailments during the winters

It's that time of the year when you sip hot cups of coffee or ginger tea while enjoying the foggy mornings and chilly evenings. While you look forward to being bundled up in your favourite winter outfits and relishing cosy nights under the blanket, you cannot ignore the fact that this season has a downside to it as well.

If you fail to take proper care of your health and body, you can end up with severe ailments during the frigid winter months. A sudden drop in temperature can cause significant health issues such as bronchitis, pneumonia etc. What seems like a common cold or flu, in the beginning, can progress into a more severe illness if not taken care of properly.

Read on to know about a few common winter ailments, their symptoms and prevention tips.

Common cold

This is one of the most common winter diseases, and most of us often ignore it, thinking it's due to the changing season. Though we are right to an extent, if this common cold or viral infection doesn't subside in two to four days, we need immediate medical help. Common cold can affect anyone, but children and senior citizens are more vulnerable to severe disease symptoms.

The common cold symptoms include headache, sore throat, runny nose, sneezing, and coughing. However, if the condition worsens, you may also experience high fever, chest congestion and breathing difficulties.

• Drink plenty of water and other fluids
• Get adequate rest and sleep
• Wash your hands frequently to avoid infection
• Avoid outside food as much as possible
• Wear multiple layers of clothing
• Gargle with hot water or inhale steam

Flu

Flu is often mistaken for the common cold by most people. However, that may not be the case every time. Flu, also known as influenza, is an infectious health disease that mainly affects the infected person's respiratory tract. The leading cause of flu is the contamination of the body with the influenza virus. It can last from 2 to 7 days, depending upon the severity.

Most of the symptoms of flu are similar to that of the common cold. A person suffering from flu may experience mild to high fever, sore throat, body ache, headache, nasal congestion, runny nose, cough, and cold. In some cases, patients may also experience pain in their ears and redness or itchiness in their eyes.

• Cover your nose and mouth while sneezing or coughing
• Maintain a safe distance from people showing flu symptoms
• Wash your hands frequently
• Maintain respiratory hygiene
• Exercise daily and consume immunity-boosting food

Bronchitis

Bronchitis is an infection in the person's respiratory tract, caused by Respiratory Syncytial Virus (RSV). Children or toddlers below the age of two and people with weak immunity are mainly affected by this disease. Bronchitis causes inflammation of the small airways in the lungs, causing breathing difficulties. If the symptoms persist for more than ten days, medical intervention is required.

As mentioned above, the person suffering from bronchitis experience difficulty breathing due to the inflammation of airway passage in the lungs. Other symptoms of bronchitis include mild fever, wheezing, coughing, nasal congestion and dehydration.

• Get adequate rest and sleep
• Drink lots of fluids to keep yourself hydrated
• Wash your hands frequently
• Avoid smoking and exposure to smoke, firecrackers etc.

Pneumonia

Pneumonia is another common lung disease which can occur during the winter season. Unlike other winter diseases, pneumonia is caused by a bacterial infection. You can usually treat it at home, but hospitalisation is necessary if symptoms get severe. Pneumonia can prove to be a life-threatening disease for children below five years of age and senior citizens.

A person suffering from pneumonia experiences constant cold and high fever for several days. Other pneumonia symptoms include excessive coughing, difficulty in breathing, chest pain, fatigue, loss of appetite, heavy sweating, and shortness of breath. Though pneumonia symptoms can vanish in one or two weeks, weakness and fatigue can last for a month or so.

• Wash your hands frequently
• Eat lots of fruits and leafy vegetables
• Avoid smoking and exposure to smoke
• Exercise daily to boost your immunity
• Visit your physician if the symptoms persist

Norovirus

Among the several bottlenecks that have slowed the adoption of health insurance, complexity of products deserves a special mention. This is because the common man, more often than not, is not aware of the jargons used in health insurance or understands their implications in the working of a plan.

To bridge this knowledge gap, the Insurance Regulatory and Development Authority (IRDAI) has issued a fresh instruction to insurers, asking them to colour code policies based on their level of complexity. The diktat is aimed to aid consumers to know how easy or difficult it is to understand the policy.

What is the Colour Code?

The colour code of health insurance plans will be akin to traffic signals – red, orange and green. While a green colour implies that the policy is easy to understand, orange represents moderate complexity. Red, on the other hand, reflects that the policy is complex. The colours are based on a score ranging from 0 to 6.

Health insurance plans with a score of 2 or less will have green colour, while those having a score of more than 2 but less than 4 will be coloured orange. A health insurance policy with a score of more than 4 and up to 6 will be red.

How do Insurers Calculate the Score?

To calculate the score, insurers take into account seven parameters:

• Number of optional covers
• Waiting period
• Percentage of co-pay
• Number of treatments where sub-limits are applicable
• Simplicity of terms
• Deductibles
• Number of permanent exclusions

All the seven parameters mentioned above would get an equal weightage of 14.28%.

Score for Optional Cover and Co-pay

A score of 0.6 would be allocated to one optional cover. So, if a health insurance policy has 6 optional covers, this parameter would get a score of 3.6. For co-pay, which represents the percentage of payment that the policyholder has to pay from his pocket, a score of 0.3 is given for every 1% rise in co-payment beyond 5%.

Score for Waiting Period

Every one-month waiting period would get a score of 0.15%. So, if the maximum waiting period is 24 months, then the score on this parameter would be 3.6. Waiting period refers to the time where the insurer doesn’t entertain claims for pre-existing ailments.

Sub-limit Score

When it comes to sub-limit, a score of 0.6 is allotted for every disease under sub-limit. So, in case a health insurance policy has 8 diseases under sub-limit, then the score allotted for this parameter would be 4.8.

Scores for Deductibles and Permanent Exclusions

For deductibles, which is the amount a policyholder needs to pay before the insurer starts paying, a score of 0.3 is given for every 1% of deductible in a policy. Hence, if a health plan has a 5% deductible, this parameter's score would be 1.5.

A score of 0.6 is given for every permanent exclusion. Therefore, if a policy has 10 exclusions, the score for this parameter would be 6.

For the final of the score towards a policy, the weighted average score of all the seven parameters would be added.

The insurance regulator has also said that health insurance companies need to indicate the colour code on their websites for products they are selling and do the same while advertising so that customers can make an informed choice.

A comprehensive health insurance plan will help cover your parents’ medical expenses as they age.

As your parents grow older, they become more prone to illnesses and infections, and hence health insurance becomes a necessity.

Your parents strive hard throughout their lives to provide a comfortable lifestyle and quality education to you. However, in their quest to provide for the family, they may end up ignoring their own needs. As a result, they may be left with minimal savings during the golden years of their lives.

Therefore, as a responsible son/daughter, it becomes your duty to purchase a reliable health insurance policy for your parents. Many insurance companies in India offer dedicated health insurance plans for senior citizens, keeping in mind the unique medical needs of older people.

So, if you haven't yet purchased health insurance for your parents, you should do so without any delay. Let's have a look at some of the benefits of procuring health insurance for parents.

Tackle the increasing healthcare costs

As the medical inflation rate goes up globally, healthcare costs are rising every year in India too. It means that in case your mother or father falls ill in the near future, you may incur greater expenses for their treatment that what you would assume as per today's treatment rates.

However, a health insurance policy for your parents may help you tackle these costs. It typically covers healthcare expenses such as hospital room-rent, doctor's consultation fees, costs for buying medicines and other medical supplies, ambulance charges, etc.

Medical coverage for elderly people

Most standard health insurance policies provide medical coverage for people only up to the age of 65. It means that after this age, your elderly parents may be left without any medical coverage, which can be very risky.

By buying a senior citizen health insurance policy, which offers coverage for senior citizens even after the age of 65, you can ensure optimal health coverage for your elderly parents. Some insurers even provide health insurance for senior citizens with an option of lifetime renewability.

A high sum insured

The healthcare needs of your parents might be very different from yours. They usually require some extra medical care since their bodies are more prone to infections and illnesses. Therefore, a sum insured sufficient for younger people might not be enough for their older counterparts.

A senior citizen health insurance policy generally comes with a high sum insured, keeping in mind the additional healthcare needs of older adults. It allows the policyholders to get coverage of up to ₹25 to 30 lakhs. Some insurers even allow their customers to top-up their sum insured to ensure adequate coverage all the time.

You must take your family size into consideration, to get a health insurance plan that suits best.

Hectic professional schedules, lifestyle, pollution and accidents are few of the several grim factors that can affect your family's health. The continually rising medical inflation and skyrocketing healthcare prices have made health insurance a must-have for everyone.

Family health insurance plans protect you from high medical expenses you may incur due to unforeseen hospitalisation of any of your covered family members. Such plans typically take care of hospital bills during medical emergencies or planned medical procedures.

However, before buying a health insurance plan for your family, you must know the impact of a family's size on the cost of the medical insurance policy. Although a larger family size may escalate the health insurance cost, it does not necessarily mean you will spend more to secure your loved ones.

How to secure your family's health

Below are the ways through which you can get your family's health secured:

The first option is to buy separate individual health plans for different family members. Below are the features of such plans:

• The medical coverage is steady and well-defined. It will not be affected by the claims made by other family members.
• Coverage is based on the age, health and habits of each member of the family.
• You can avail medical coverage for anyone in your family with individual policies.

However, having a separate health insurance plan for each family member can break your bank. Here, your family size directly impacts the premium amount as the number of policies you need to buy increase.

The other and more prudent option is to buy a family floater plan for your entire family. Below are the features of a family floater plan:

• The medical coverage of other members can change in a particular policy term if one member claims expenses.
• Children above a certain age cannot be included in family floater plans.
• The premium is based on all the members covered in the plan.
• New members can be added to a floater plan with at the time of renewal.

Impact of family size on the cost of health insurance

Larger family size does not necessarily mean higher medical expenses. A family of six people may incur lesser medical costs than a family of two, depending on the individual's current health condition. It means a healthy family of six people may utilise its health insurance only once during a year, whereas, a family of two people with existing health issues may need to use their health insurance multiple times.

However, the size of a family does indeed impact its health insurance premium. The cost of a family health insurance policy goes up every time a new member is added.

For a better understanding of how family health insurance works, let's study an example.

Mr X wants to take a health insurance policy that gives coverage to himself, his spouse and two minor children. He gets an insurance coverage of ₹50 lakhs for the four family members combined. The insurance premium is based on Mr X's age since he is the oldest member of his family. It also factors in the other three members he is adding to the plan.

Suppose, during a policy term, Mr X's wife requires a gall bladder stone removal. She utilises the family medical insurance policy, and the insurance company pays the bill of ₹3 lakhs for it. For the rest of that particular policy term, all Mr X's family members will be eligible for medical claims of up to Rs. 47 lakhs.

During the same policy term, say Mr X experiences a cardiac event and has to undergo an operation. The insurance company pays the hospital bill of Rs. 7 lakhs for it. So, for the rest of that particular policy term, Mr X's entire family remains eligible for medical claims up to ₹40 lakh.

In this way, the remaining sum insured continues for the family on floater basis.

India has started its COVID-19 vaccination drive on 16th January, with healthcare workers getting the first jabs.

2021 started on a promising note with the Drugs Controller General of India (DCGI) approving two vaccines for coronavirus for restricted emergency use. This news brought a sigh of relief, given the virus's toll on all of us last year. With India starting one of the biggest vaccination drives globally, here are some of the finer aspects that you should know.

Who Will Get Priority in the COVID-19 Vaccination Drive?

Given our country's vast population, administering the Covid vaccine to all is undoubtedly a challenging task. However, the Government had set its priorities as per the following vaccination sequence:

As per the National Expert Group for Vaccine Administration on COVID-19, public and private healthcare workers will get the vaccine first. These workers have been further divided into several sub-categories such as frontline healthcare workers, nurses and supervisors, support staff, paramedical staff, medical officers and students.

The Government has collected and fed data on all these workers on its CoWIN platform, which it seeks to scale up in the coronavirus vaccination drive.

Next in the vaccination line come the workers associated with armed forces, state and central police department, municipal workers, revenue officials, home guards, disaster management, and prison staff. Note that all these officials are associated with the containment of COVID-19 and its surveillance.

Vaccine for coronavirus will also be administered to workers associated with ministries of home, defence, housing and urban affairs.

Population Above 50 Years

Next in the line for COVID-19 vaccination comes people above 50 years of age. This group has also been sub-divided into two categories – above 50 and 50-60 years. The Government will use electoral rolls for identifying people in this age group.

High COVID-19 Infection Areas

States and union territories will have the flexibility to administer vaccines among identified priority groups in geographical areas with high COVID-19 infection prevalence.

Rest of the Population

After covering the above categories, the rest of the population will be inoculated. To avoid overcrowding, everyone will receive the vaccine in a staggered manner.

Registering for Coronavirus Vaccination

In the later phase of the vaccination drive, mainly while covering the rest of the population, a self-registration module will be available. To self-register, you need to:

• Register yourself on CoWIN app
• Authenticate using any Government ID proof or Aadhaar
• Once you register, you will get a time and date for vaccination

Note that there will be no spot registration. Only, if you are a pre-registered beneficiary, can you proceed for vaccination.

COVID-19 Vaccination Sites

Depending on the priority groups, sites have been identified where you will receive the COVID-19 vaccine. The sites are:

This is a health facility (Government or private) where a medical officer or doctor is present.

Session sites other than health facilities, such as community halls, schools, etc., fall under this category.

Several locations in India are remote and hard to reach. Special mobile teams, planned by the district administration, will reach out to such areas.

Three Rooms of Vaccination

There are three dedicated rooms for COVID-19 vaccination. They are:

You need to wait your turn in this room.

You will be given the vaccine in this room.

After receiving the vaccine, you will be kept under observation in this room for half an hour, post which you can go home.

5-Member COVID-19 Vaccination Team

A five-member vaccination team will conduct the vaccination process. The team includes:

• Officer 1: This officer will be in charge of pre-checking registration.
• Officer 2: This officer will be responsible for authentication.
• Officer 3: The third vaccination officer will be in charge of administering the vaccine.
• Officer 4 and 5: These two officers will be in charge of managing the crowd and observation.

With an aim to provide social security to the people belonging to the low-income groups, the Government of India launched AABY on 2nd October 2007.

As per the Ministry of Labour and Employment data, approximately 93% of India's total workforce is employed in the unorganised sector. Workers belonging to these occupational groups often shy away from buying health insurance coverage due to their poor financial state. However, in case of accidental injuries, illnesses, or death, their families may have to face the excessive financial brunt.

To provide social security to this section of the population, India launched "Aam Aadmi Bima Yojana (AABY)" on 2nd October 2007. The literal translation of the name is the common man's insurance scheme. It provides coverage against natural or accidental death and disability to the Below Poverty Line (BPL) families' breadwinners.

What is Aam Aadmi Bima Yojana (AABY)?

As specified above, the Aam Aadmi Bima Yojana (AABY) is a social security scheme, launched on 2nd October 2007. It provides health insurance coverage against contingencies such as death or disability. It is targeted towards the breadwinners of low-income families in India, and benefits those working in the unorganised sector, such as daily wage labourers, fishermen, cobblers, auto drivers, etc.

The AABY scheme started operating successfully from 2013 under the supervision of the Finance Ministry of India.

What is covered under Aam Aadmi Bima Yojana?

The AABY scheme covers the following:

• Natural death: ₹30,000 payable to the nominee.
• Accidental death: ₹75,000 payable to the nominee.
• Permanent total disability (due to accident): ₹75,000.
• Partial permanent disability (loss of one eye or one limb): ₹37,500.

These benefits ensure that a family's financial stability is not completely shaken in case of the death or disability of the breadwinner.

What is not covered under AABY scheme?

While the AABY provides financial aid in several circumstances, it does not cover:

• Hospitalization or medical expenses, unlike a health insurance policy.
• Death due to suicide within one year of enrolment.
• Death or disability arising from participation in hazardous activities or criminal acts.

This scheme is focused solely on life and accident insurance and is not a substitute for a health insurance policy for family.

Features of Aam Aadmi Bima Yojana

Key features of AABY include:

• The scheme covers family heads or lone earning members of the families belonging to the low-income groups.
• The coverage amount remains fixed throughout the policy period. The policyholder gets a lump sum in case of a claim.
• In case of the insured person's natural death during the coverage tenure, the nominee or surviving family members will be paid ₹30,000.
• In case of accidental death or total permanent disability (loss of both eyes or both limbs), the policyholder or his/her nominee gets ₹75,000.
• In case of partial permanent disability (loss of one eye or one limb), the policyholder or his/her nominee gets ₹37,500.

Benefits of AABY scheme

Here’s why the AABY is beneficial:

• The scheme is designed to cover the members of 48 occupational groups identified by the Government.
• The premium amount that's charged to provide the benefits of AABY scheme is ₹200 per annum. While 50% of this premium will be subsidised from the Social Security Fund, the State Government or Nodal Agency will bear the remaining 50% amount.
• The AABY scheme also offers a free scholarship of ₹100 every month to the eligible children (maximum of two children per person) to ensure that they receive uninterrupted education. The children must be studying between class 9th to class 12th to avail of this benefit.
• By availing the AABY scheme's benefits, the insured person will also be eligible to claim certain tax benefits under Section 80(D) and Section 10(10D) of The Income Tax Act, 1961.
• Insured members can approach their nearest Life Insurance Corporation (LIC) branch to solve their queries or issues regarding this scheme.

Occupations covered under Aam Aadmi Bima Yojana

The AABY scheme covers over 45 unorganised occupations, including:

• Beedi workers
• Fishermen
• Handloom weavers
• Brick kiln workers
• Auto drivers
• Rickshaw pullers
• Construction workers
• Agriculture labourers

This wide scope ensures that a vast segment of India’s workforce benefits from social security coverage.

Eligibility criteria for AABY

As mentioned above, the AABY scheme is meant to benefit the low-income families of India. Below is the basic eligibility requirements for an individual to avail the benefits of this scheme:

• The applicant should be between 18 to 59 years of age.
• The applicant should be the head of the family or its lone earning member belonging to the EWS, i.e., below the Poverty Line (BPL) or slightly above the poverty line.
• The individual must belong to a rural landless household.
• The individual must belong to one of the 48 vocational groups identified as beneficiaries under this scheme.
• Only one member per family can be covered under the scheme.

How to enrol in Aam Aadmi Bima Yojana?

The process to enrol for the AABY scheme is simple and hassle-free. No lengthy paperwork and documentation is required. However, since this is a Government-sponsored scheme, the process is slightly different from buying a regular insurance plan. Below are the steps one needs to follow:

• Step 1 – Download and fill in the Aam Aadmi Bima Yojana application form from the relevant Government website.
• Step 2 – Visit the Nodal Agency, an institution or NGO appointed by the Government, to carry out the enrolment process for this scheme.
• Step 3 – Submit a specific set of documents along with the application form to the Nodal Agency.

Documents required to apply for AABY

Below are the documents that need to be submitted by the applicant to become a beneficiary under the AABY scheme:

• Duly filled application form
• Proof of identity (voter ID, Aadhar card, ration card)
• Address proof
• Age proof, or extract of the applicant from his/her birth certificate or school certificate
• Income or BPL certificate

Once the documents are submitted to the Nodal Agency, the applicant would be enrolled to receive the scheme's benefits.

How to download AABY application form?

The AABY application form can be downloaded from:

• MyScheme Portal - AABY
• LIC India’s official website or local branch
• Nodal agency offices

The form includes personal, occupational, and nominee details and must be filled accurately to avoid delays in claim processing.

Aam Aadmi Bima Yojana premiums

Here are the details:

• The total premium is ₹200 per annum per member.
• Of this, 50% (₹100) is contributed by the Central Government.
• The remaining ₹100 is paid either by the state government, the nodal agency, or in some cases, by the beneficiary.

This ultra-low premium makes it accessible for families who may not afford even a basic health insurance policy.

How to claim under Aam Aadmi Bima Yojana?

The claim process for this scheme is relatively easy as compared to other health insurance products. In case of a contingency, the insured member or his/her nominee will have to approach the Nodal Agency's designated personnel. While filing a claim, the claimant will have to submit the relevant documents such as death certificate of the insured person, autopsy report (in case of accidental death), copy of FIR, medical proof of disability, etc.

After receiving the relevant documents, the Nodal Agency officer will begin the process to verify the claim's authenticity. Once the claim is verified, the beneficiary amount will be transferred to the targeted bank account through the National Electronic Fund Transfer (NEFT) process.

AABY helpline number and address

For assistance regarding AABY:

• LIC Toll-Free Number: 1800 33 4433
• Official website: licindia.in
• You can also contact the local LIC branch or your nodal agency for help with application and claim processes.

FAQs

1. Is AABY a health insurance policy?

No, it is a life and accident insurance scheme. It does not cover hospitalization or medical expenses like a traditional health insurance policy for family.

2. Can a person have AABY and a separate health insurance policy?

Yes, and in fact, it is recommended. AABY can offer accidental and death benefits while a health insurance policy covers medical costs.

3. Who pays the premium for AABY?

The premium is shared between the central government and either the state, nodal agency, or the individual.

4. How many family members are covered?

Only one member per eligible family is covered under the AABY scheme.

Conclusion

The Aam Aadmi Bima Yojana is a thoughtful and inclusive initiative by the Indian government to offer a security net to those who form the backbone of the unorganized workforce. While it is not a health insurance policy, it serves a critical purpose in cushioning low-income families against the financial shocks of accidental death or disability. For those already exploring a health insurance policy for family, AABY can act as a valuable additional cover, ensuring more holistic financial protection.

Disclaimer: The information provided in this blog is for educational and informational purposes only. It is not intended as a substitute for professional advice, diagnosis or treatment. Please consult a certified medical and/or nutrition professional for any questions. Relying on any information provided in this blog is solely at your own risk, and ICICI Lombard is not responsible for any effects or consequences resulting from the use of the information shared.