Child Health Insurance: Investing in the Well-being of Future Generations

From the moment your bundle of joy arrives, you experience unparalleled happiness and, concurrently, an enormous feeling of responsibility.  As a parent, you need to provide for everything for your child with exceptional care, at least until they become an adult. The rapidly increasing environmental pollution, contaminated food and today’s prevalent sedentary lifestyle and poor food habits result in children today being increasingly susceptible to health problems. This, compounded by the high cost of healthcare in India, makes an increasingly good case for the purchase of child health insurance.

The high rate of medical inflation in India, at 14 %t in 2022 – 23, is even more reason to purchase health insurance for kids to ensure that all their healthcare needs are adequately addressed. 

What is Child Health Insurance?

Health insurance for kids is a policy specially designed to cover their specific healthcare requirements. Like all health insurance policies, it plays a dual role by ensuring your financial well-being and that of your child by monetarily supporting you when your child requires hospitalisation for any reason like illness or injuries. Such policies also pay for your child’s vaccination and clinical check-up expenses. 

You may generally purchase health insurance for your child at various stages of life, from medical insurance for newborns to when your child is a teen and until age 25.

Care Health Insurance offers Care Plus Youth with newborn health coverage along with an adult from the age of 91 days for your baby and individual health coverage from the age of 5 to the maximum age of 25 years for your child. This plan offers optional coverage for maternity, wherein newborn health coverage for your baby is included. The sum insured ranges from Rs 3 lacs to Rs 25 lacs.

Why Should You Buy Child Health Insurance?

Purchasing a children's medical services health plan is helpful for your child for the following reasons:

Injury Prone 

Young children need to be more careful and know how they should take care of themselves. Infants in their stages of learning to move and walk may get hurt easily. Children are thus overall injury-prone. Health insurance for children ensures that the health insurance company covers the cost of treatment for their injuries, and you can get the treatment done at the best facilities.

Weaker Immunity 

Your child has weaker immunity than you; they catch infections or get affected by diseases faster than we do. Your child's health insurance covers the often high expenses for the treatment.

More Exposure 

Children are unmindful and do not observe precautions to avoid diseases and infections. They often do not follow the best health practices and fall ill more often.

Poor Lifestyle 

How many of our children go out of the house to play in playgrounds or fields? This is a decreasing number; correspondingly, we see increasing screen time for children. Healthy eating habits are being ditched for junk food over homemade food. All this is directly contributing to an increase in lifestyle diseases. Health insurance for kids covers the treatment of such diseases and conditions.

What Does Child Health Insurance Include?

Policies providing health insurance for kids normally have the following inclusions:

In-Patient Hospitalisation 

Expenses incurred for treating your child in case of hospitalisation lasting more than 24 hours are covered. This includes room rent, the cost of the ICU, if applicable, nursing charges, cost of medicines.

New-born Baby Cover 

Medical insurance for newborns includes neonatal care expenses. It is often covered if the maternity benefit is purchased with the mother's health insurance policy.

Day Care Treatment 

Daycare treatments for your child, those that do not require a stay in excess of 24 hours, are covered.

Pre and Post-Hospitalisation Expenses 

You will get reimbursed for related expenses incurred 30 to 90 days before and 60 to 180 days after your child’s hospitalisation. The exact coverage is per the terms and conditions of your child's health insurance policy.

Vaccination Expenses 

Your newborn health coverage policy pays for all the vaccination expenses for your baby for the first year. This, too, is a part of the maternity benefit if purchased along with the mother’s health insurance policy.

OPD Treatment 

Outpatient treatments, dental treatment expenses and medical diagnostic tests are covered.

Ambulance Charges 

Expenses incurred on ambulance charges are reimbursed as per the limits mentioned in your child's health insurance policy.

Domiciliary Hospitalisation: 

The same is covered if the attending doctor prescribes treatment at home or if there are other reasons for home treatment.

Exclusions in Policies Offering Health Insurance for Kids

Medical expenses incurred  on the treatment  due to the following are usually excluded in a child health insurance policy:

• Any injury received while participating in adventure sports
• Pre-existing diseases within the mandatory waiting period
• Congenital disabilities
• Behaviour or personality disorder
• War, civil unrest, nuclear war or terrorist attack

Please read the terms and conditions of your child's health insurance policy in detail to understand the detailed list of inclusions and exclusions.

Benefits Offered by a Child Health Insurance Policy

You should purchase a health insurance policy for your child to enjoy the following benefits:

1. Comprehensive Medical Coverage: Health insurance for children covers your child for a wide range of expenses related to medical treatment such as vaccinations, hospitalisation costs, OPD consultations, and treatment of injuries caused by an accident. It also often includes free periodic health check-up facilities.
2. Financial Security: Health insurance for your child covers the expenses for any hospitalisation, thus safeguarding you financially and eventually providing your child with financial security.
3. Treatment Without Compromise: We always wish to provide our children with the best. However, healthcare in India is costly and is increasing at a dizzying rate. Purchasing a health insurance policy for your child ensures that you can afford the very best treatment without any compromise.
4. Cashless Hospitalisation: If you get your child treated in the network hospitals of your health insurance company, a list that normally encompasses the best hospitals, the insurer will settle the bills directly without you having to pay anything.
5. Tax Deductions: Under the old tax regime, you will enjoy a maximum tax deduction of Rs 25,000 under Section 80D of The Income Tax Act, 1961.

How Do You Choose the Appropriate Child Health Insurance Policy?

You may follow the tips below to choose an appropriate health insurance policy for your child:

1. Check for Sum Insured: Compare the sum insured offered by various policies with the requirement you calculated, keeping in mind your child’s health and the family health history of both parents. Match the same as well as you can. Undercoverage means you may have to pay out of pocket in the event of a claim, and buying an unnecessarily high sum insured will mean a high premium amount.
2. Check the Policy Coverage: Check the coverage offered by the health insurance policy. It should cover common ailments and particular illnesses based on your family’s health history.
3. Purchase New-born Baby Cover: Purchase an optional cover for newborn health coverage when planning to start your family. This will ensure that your baby has health insurance protection from Day 1.
4. Understand the Exclusions in the Policy: There are specific exclusions in all health insurance policies for children. Go through and understand the exclusion list of the policies you have shortlisted so you know what your child needs to be covered for.
5. Purchase Appropriate Add-On Covers: Personalise your child health insurance policy by opting for suitable add-on riders. 
6. Check the List of Network Hospitals: Go through your health insurance company's list of network hospitals. You need to have some hospitals situated near where you live, as well as any other specialised hospitals or ones that you may prefer.

Care Health Insurance offers Care Joy – a policy designed for young couples starting a family. Care Joy offers newborn baby cover from Day 1 and the option to add your child to the regular policy from Day 1.

Common Mistakes While Purchasing a Child Health Policy

Please avoid the following mistakes many people make when purchasing health insurance for children. These seemingly innocuous mistakes make them pay heavily later:

1. Opting for Low Sum Insured: This is usually done to reduce the premium outflow. A policy with a sum insured lower than that required as per the estimated needs of your child may not prove to be enough in case of hospitalisation. The policy may then not cover the claim, and you may end up having to pay from your pocket or, worse, compromise on the treatment of your child.
2. Non-Disclosure of Your Child’s Health Condition: Insurance is based on the principle of utmost good faith. A health insurance company issues your child’s policy, assuming you have disclosed all material facts. Hiding anything may result in the rejection of your claims or even the cancellation of the policy.
3. Not Paying Attention to Co-Payment Clause: Many people make this mistake. While a higher co-pay does mean lower premiums, it also means that you will compulsorily pay a predetermined percentage of the claim amount, adversely impacting your savings. 
4. Going Solely With Your Group Insurance Policy: You may rely on the coverage provided by your employer's group mediclaim policy.  Remember that such policies have lower coverage and come with many limits and sub-limits. There may need to be more to cover your child's healthcare expenses. It is wiser to supplement the coverage offered by the group mediclaim policy provided by your employer with a personal health insurance policy for your child.

In a Nutshell!

While you enjoy the parenthood experience, keep in mind your responsibilities towards your child. Purchase a health policy for your child as soon as possible to safeguard your child’s health and financial well-being.

>> Also Read: How to Buy the Best Health Insurance for Children?

Disclaimers: All plan features, benefits, coverage, and claims underwriting are subject to policy terms and conditions. Kindly refer to the brochure, sales prospectus, and policy documents carefully.