What are Wellness Benefits in Health Insurance?

Apart from the financial support that comes with health insurance plans, there are other lucrative perks, too. The ‘wellness points’ attached to the health insurance renewal is its main attraction feature. Wellness benefits in health insurance come in the form of wellness points that can be encashed either as concessions on premium payments or in form of membership benefits at any empaneled organization. These wellness-oriented health insurance policies target at making individuals proactive towards healthy living. So, let’s understand how to take advantage of these wellness points to the fullest.

How Do Wellness Programs in Health Insurance Work?

Wellness programs in health insurance focus on preventive care, helping individuals maintain good health while reducing long-term medical expenses. These programs often include benefits like regular health check-ups, vaccinations, screenings, and fitness incentives. Some insurers even reward healthy habits, such as walking or exercising, with redeemable points or discounts on premiums. By encouraging proactive healthcare, wellness programs help detect potential health issues early, preventing serious conditions. Not only do these initiatives support overall well-being, but they also contribute to a more cost-effective healthcare system, making health insurance more beneficial for policyholders in the long run.

What’s Covered in Health Insurance Wellness Programmes?

Health insurance wellness programmes typically offer a range of preventive and health-enhancing benefits, including:

1. Routine health check-ups – Regular GP visits to monitor overall well-being.
2. Vaccinations – Coverage for essential immunisations to prevent illnesses.
3. Diagnostic screenings – Tests to detect health conditions early.
4. Dental and vision care – Preventive treatments for oral and eye health.
5. Fitness incentives – Subsidised gym memberships, wellness coaching, and discounts on fitness plans.
6. Health rewards – Points or discounts for tracking steps or completing health assessments.
7. Mental health support – Access to counselling and stress management resources.

IRDAI Guidelines for Health Insurance Wellness Programs

As per the recent amendment by IRDA, in the health insurance plans, every insurance company needs to:

1. to summarize the wellness benefit points to the respective policyholders on an annual basis.
2. be clear about the medium of communication for the above-mentioned reward points.
3. be clear about the means of redeeming the scored wellness benefit points.
4. be accountable for any discrepancy in the administration of the reward program.

Benefits of opting for Health Insurance Wellness Programs

“Prevention is better than cure” is the concept that fuelled the need for introducing wellness features in health insurance plans. These wellness features encompass a plethora of benefits for the insured and the insurer.  They aim at motivating the insured to prioritize his health first.

Different types of wellness benefits offered under health insurance plans

1. Redeemable voucher to get health boosters and supplements
2. Redeemable vouchers for membership of empaneled yoga institutes and gyms
3. Concession on the payment of insurance premium at the time of health insurance renewal
4. Increment in the amount of sum insured
5. Free health diagnostics and check-ups at empaneled hospitals
6. Redeemable pharmaceutical vouchers at empaneled outlets
7. Free or relatively lower expenses for outpatient treatment and consultation.

*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C apply ** Please note that no wellness benefits program under any health insurance plans includes a concession to third-party merchandise or services. Also Read: Boosting Bone Health: A Guide to Calcium-Rich Foods

1) Reward Points to promote a healthy lifestyle

The reward points collected based on healthy living can avail concessions on various medical tests and check-ups at all the network hospitals and diagnostic centers. The points can also be redeemed to avail membership at a lower rate at various wellness centers like yoga institutes, gyms, etc.

2) A personal wellness coach

Few insurance brands also provide the lucrative offer of a personal coach. The coach mentors the insured person on his dietary intake, exercise routine, nutrition balance, quitting smoking habits, maintaining a good BMI index, and much more. Targets to be achieved are set by the coach. On achieving the targets, the insured gets points that are redeemable as above.

3) Second Medical Opinion

Certain health plans come with the benefit of providing a second medical opinion wellness benefit. Under this feature, in case of any chronic or severe medical concern, the insured can seek a second medical opinion. This second opinion is not chargeable for the insured. But one needs to clearly understand that no insurance company is responsible for any error arising in the medical opinion.

4) Exciting Concessions on Renewal

Availability of exciting concessions on wellness benefit plans encourages the insured to keep track of his healthy living. Moreover, these wellness benefits are available without paying anything extra to the insurance company. Also, there is no need to separately enroll yourself in the wellness program plan. The insured gets enrolled from the day he or his family gets insured under the family health insurance or individual. *All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C apply Also Read: Preparing Medical Records for Your Online Doctor Appointment

Health insurance wellness benefits program and digital integration

It’s a digital age, where every market needs a technology-driven solution to it. So how could the insurance sector take a back seat?

1. With multiple Android and iPhone-based health and wellness applications trending in the market, it is easy for any enthusiastic individual to track his routine health and wellness vitals. The insured can then integrate the result of these applications with their health plan provider to enjoy the wellness benefit rewards.
2. Then few health insurance companies have personal wellness programs to motivate people towards a healthy life. The insurers then provide a ‘cumulative bonus’ for every claim-free year.
3. Insurance companies today also make use of smart wearable health monitoring devices to track the reward points of their insured individuals. They make use of digital badges and other rewards to promote healthier lifestyles among citizens.

Also Read: 3 Reasons Why You Should Get Health Insurance in Today’s Changing Times

Conclusion

Wellness programs in health insurance plans are a win-win situation for the insurer and the insured. For example, an insured person who lives a healthy lifestyle is less prone to chronic illness and their chance of filing the claim is very low. On the other hand, wellness points inspire the insured to embrace a healthy life and save his hard-earned money on preventable medical expenses. The preventive care offering thus inspires the individuals to enjoy the monetary and wellness benefits at the same time. So do you keep track of your number of steps or calorie intake or even heart rate?  How many wellness points have you scored yet?  And how do you plan to invest your wellness points?

FAQs

What is the wellness benefit in health insurance?

A wellness benefit in health insurance refers to coverage for preventive healthcare services, such as regular check-ups, screenings, vaccinations, and other measures to maintain overall well-being and avoid illness.

What comes under wellness reimbursement?

Wellness reimbursement typically includes costs for preventive care services like annual health exams, vaccinations, gym memberships, and fitness programmes, depending on the insurer’s policy.

What is the meaning of wellness coverage?

Wellness coverage refers to insurance that supports preventive healthcare, offering benefits such as routine medical check-ups, screenings, and wellness programmes aimed at maintaining good health and preventing future medical issues.

Do I have to pay extra to enroll in wellness programs?

In many cases, wellness programmes are included in your health insurance policy without additional costs. However, some insurers may require a small fee or a specific plan to access additional wellness services. Always check the terms of your policy. * Standard T&C apply. Insurance is the subject matter of solicitation. For more details on benefits, exclusions, limitations, terms, and conditions, please read the sales brochure/policy wording carefully before concluding a sale.