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Why preventive-care health insurance is a win-win for individuals and insurers

Through preventive care, policyholders not only safeguard their health but also reduce the likelihood of incurring expensive treatments or extended hospital stays in the future. For insurers, this translates to a decrease in claims, leading to reduced payouts, enhancing their sustainability and profitability.

November 08, 2023 / 11:04 AM IST
Health insurance policyholders

Focus on preventive healthcare can help policyholders and insurers

The adage 'prevention is better than cure' has great relevance in the realm of health insurance. Coverage for preventive care, a crucial component of many health insurance plans, is changing the way we approach healthcare.

Preventive care in health insurance refers to measures taken to prevent diseases or injuries rather than curing them or treating their symptoms. This includes regular check-ups, screenings, vaccines, and patient counselling. By focusing on prevention, individuals can detect potential health issues early, thereby reducing the risk of more severe complications later.

Also Read: How staying fit benefits your health as well as your health insurance premium

For instance, regular mammograms can detect breast cancer at an early stage, making treatment more effective. Similarly, vaccinations can prevent certain diseases altogether. Preventive care not only ensures better health outcomes but also reduces the overall cost of healthcare. When potential health issues are detected and addressed early, it can prevent the need for more expensive treatments or hospitalisations later on.

This article delves into the importance of preventive-care coverage in health insurance and navigates its benefits for both individuals and insurers.

What does preventive-care coverage entail?

Preventive-care coverage encompasses a wide range of services aimed at preventing illnesses or detecting them at an early stage. These services include vaccinations, screenings for various diseases, wellness check-ups, and health education. The primary goal is to ensure that potential health problems are identified and addressed before they develop into more severe conditions.

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Advantages for individuals

Detection of diseases at an early stage: Regular screenings can detect conditions like cancer, diabetes, and cardiovascular issues in their initial stages, leading to more effective treatments. Additionally, proactively maintaining one's health offers individuals peace of mind, alleviating anxiety about their well-being.

Promotion of a healthier lifestyle: Vaccinations protect individuals from various contagious diseases. Health check-ups provide information about one’s well-being, empowering individuals to make informed choices regarding their lifestyle and habits.

Financial savings: Investing in preventive services offers a multitude of benefits, both financially and health-wise. Early detection not only proves to be cost-effective but also minimises the need for extensive hospital stays. Additionally, individuals can enjoy an enhanced quality of life by addressing health concerns promptly. Furthermore, a focus on prevention ensures the sustainability and efficiency of the healthcare system. Thus, the initial costs of preventive measures are dwarfed by the long-term advantages they bring.

Advantages for insurers

Data collection and risk evaluation: Regular check-ups and screenings offer insurers valuable data that can be used to more accurately evaluate risks and tailor policies.

Cost efficiency through preventive care: Both individuals and insurers reap substantial benefits from preventive healthcare measures. When policyholders prioritise regular screenings and early detection, they not only safeguard their health but also reduce the likelihood of incurring expensive treatments or extended hospital stays in the future. For insurance companies, this proactive approach translates to a decrease in claims, leading to reduced payouts. This not only optimises their financial health but also enhances their sustainability and profitability.

Improved customer loyalty: Including comprehensive coverage for preventive care can greatly enhance customer satisfaction. Satisfied policyholders are more likely to renew their policies and recommend the insurer to others.

Although the advantages of preventive care are clear, there are obstacles to its implementation. It is crucial to determine the appropriate frequency and nature of exams, striking a delicate balance between excessive testing and potentially overlooking early signs of diseases. Socio-economic factors can affect access to preventive care.

Not all individuals have the same level of awareness or the financial means to receive regular check-ups. To address this issue, insurers can offer tiered plans that cater to different economic segments, ensuring that preventive care is accessible to all.

Additionally, technology can be used to improve preventive care. Digital health platforms, telemedicine, and health apps can make screenings and consultations more attainable, particularly in remote areas. These digital interventions can also provide personalised health insights and reminders, helping individuals stay proactive about their well-being.

Proactive measures are the key to the future of healthcare, requiring collaboration between individuals, insurers, and healthcare providers. This approach benefits both individuals and insurers, setting a positive example for future healthcare models and creating a mutually beneficial outcome for all parties involved.

Shilpa Arora is the Co-Founder and Chief Operating Officer of Insurance Samadhan
first published: Nov 8, 2023 10:55 am

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