Health Insurance in Pune

Pune, renowned as one of India's largest IT hubs, has consistently been rated among the most livable cities in the country. However, Pune grapples with various challenges, including uncontrolled urban expansion, heavy rainfall, water pollution, and costly healthcare services. Obtaining health insurance in Pune becomes imperative to ensure financial protection against unforeseen health emergencies in the city without depleting your savings.

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      Health Statistics of Pune

      • Approximately 10% of the residents in Pune have a comorbidity.
      • Diabetes and high blood pressure are the most common comorbidities in Pune.
      • Around 30.7% of children below the age of 5 are stunted, and 32.7% are underweight in Pune.
      • 80% of the people in Pune have mental health problems.
      • Pune has the 6th largest prevalence of lifestyle diseases among corporate employees.
      • 80% of the people in rural areas suffer from visual impairment.
      • Anaemia, obesity, and dental issues are common among kids in Pune.

      Why Do You Need Health Insurance in Pune?

      Here are some compelling reasons why it is essential for everyone to purchase health insurance in Pune:

      1. Mental Health is a Crucial Concern

        According to a study conducted by Mpower, a mental health service provider, 85% of women and 70% of men in Pune face mental health issues. While depression is the most common mental health issue among women, anxiety and panic disorders are prevalent among Pune men. Treatment of a mental illness may continue for a long time and, hence, create a financial burden. By obtaining health insurance coverage for mental health, your insurer will pay for your treatment, including the cost of the hospital room, diagnostic procedures, OPD consultations, counselling & therapy sessions, rehabilitation, medications, etc., depending on the policy.

        People also read: Does Health Insurance Cover Psychological Disorders?

      2. Health Insurance for Respiratory Health

        Garbage burning has become quite a nuisance in Pune. In December alone, the city recorded 458 cases of open garbage burning, a significant increase from 151 cases in November. As a result, the air quality in Pune has significantly deteriorated, falling into the 'poor' category. The polluted air can lead to health issues like chest infections, dry cough, asthma, lung cancer, etc., that can be expensive to treat. A comprehensive critical illness insurance plan can help alleviate the financial burden of these diseases by covering the medical expenses associated with hospitalization, doctor consultations, diagnostic tests, and pharmacy bills.

      3. Prevalence of Vector-borne Diseases

        Pune has seen a high incidence of vector-borne diseases like dengue and chikungunya in recent years. In 2022, Pune reported the maximum number of these diseases in Maharashtra. Changes in weather conditions, such as heavy rainfall and stagnant water, have contributed to the rise in dengue and chikungunya cases in Pune. To ensure access to the best possible treatment for these diseases without straining your finances, having health insurance for vector-borne diseases is invaluable.

      4. Rise in Medical Inflation

        Healthcare costs in India are increasing steadily, with a yearly inflation rate of 14%. In the event of hospitalization, the average expense amounts to approximately Rs 1 lakh per day, and in severe cases, it can escalate to a staggering Rs 20-40 lakh. Given these circumstances, buying mediclaim insurance can help you get the best medical treatment at a nominal premium.

      5. High Out of Pocket Expenditure

        A study has found that a significant number of Indian households continue to incur high out-of-pocket expenses for healthcare. This indicates a lack of awareness about the benefits of health insurance. To mitigate the risk of depleting your savings in the event of a medical emergency, it is crucial to have the best health insurance plan in place.

      Major Health Problems in Pune

      Take a look at some of the major health problems in Pune:

      1. Vector-borne diseases

        Pune reports a large number of vector-borne diseases every year. As per the data by Pune Municipal Corporation (PMC), more than 2600 suspected and 200 confirmed cases of dengue have been reported in the city. Experts attribute Pune’s local climate and weather conditions as the ideal breeding ground for Aedes mosquitoes, which spread these diseases.

      2. Hypertension

        Another major health issue in Pune is hypertension, also known as high blood pressure. The city has witnessed a surge in hypertension cases, with a staggering 71,611 new cases reported in just six months from April to September 2023. Poor lifestyle and bad food habits are said to be the reason for this surge in cases. Moreover, hypertension not only increases the risk of heart attacks but also leads to other serious conditions, such as blindness, strokes, cancer, and renal failure.

      3. Diabetes

        Diabetes is another prevalent health concern in Pune. As per Pune Zilla Parishad (PZP) data, approximately 1.32 lakh people in Pune are diabetic. However, this number is likely to be much higher as 75% of the rural population remains unaware of their diabetic status. To address this issue, experts emphasize the importance of raising awareness and ensuring early diagnosis of diabetes to prevent disease progression.

      4. Obesity

        Obesity has become alarmingly widespread in Pune. As per a survey data, a large percentage of people above 15 years are obese in Maharashtra, with Pune being a major contributor. Increased consumption of junk food and low physical activity among people in Pune have contributed to the rising incidence of obesity in the city.

      5. H1N1 Influenza

        H1N1 influenza or swine flu has a major presence in Pune city. As per Maharashtra Health Department data, Pune reported the maximum number of H1N1 cases in the state in 2022. Experts blame the distinct weather pattern of more monsoon breaks after heavy rain responsible for the high volume of swine flu cases in the city.

      How Much Health Insurance Coverage Do You Need in Pune?

      Deciding the sum insured of your health insurance policy is a major decision. While choosing a smaller coverage amount can increase your out-of-pocket expenses, a higher sum insured can increase your premiums substantially. Ideally, your health insurance coverage amount should be sufficient to cover all your medical expenses in Pune, especially the treatment of a critical illness. Besides, experts advise that your coverage amount should be at least half of your annual income in Pune.

      In a city like Pune, renowned for its costly healthcare infrastructure, opting for a minimum health insurance coverage of Rs 10 lakh per person is highly recommended. To secure coverage for your entire family in Pune, it is advisable to consider a family floater health insurance plan with a minimum sum insured of Rs 30 lakh.

      For elderly individuals residing in Pune, purchasing a senior citizen health insurance policy with a minimum coverage amount of Rs 20 lakh is recommended, as their healthcare requirements tend to escalate with age.

      Health Insurance in Pune for NRIs

      The accessibility and affordability of health insurance for Non-Resident Indians (NRIs) have improved significantly. NRIs residing outside of Pune, who occasionally visit the city for personal or professional reasons, can now obtain health insurance in Pune for themselves and their loved ones. This health insurance for NRIs policy can also be utilized to cover healthcare expenses if there are plans to relocate back to Pune eventually.

      Moreover, they can buy health insurance for parents living in Pune and support them during a medical emergency in Pune. In fact, as NRIs already fulfil their tax obligations in their country of residence, they become eligible for an 18% GST refund when purchasing an Indian health insurance plan.

      People also read: GST Refund on Health Insurance for NRIs

      Is Government Health Insurance Enough to Cover Medical Expenses in Pune?

      No.

      In 2012, the Maharashtra Government implemented a prominent health insurance - Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) - to offer comprehensive cashless healthcare services through a network of hospitals. Since the coverage of MJPJAY is limited and the process of claiming insurance is complex, the scheme does not provide comprehensive coverage. To comprehend why Mahatma Jyotirao Phule Jan Arogya Yojana fell short of adequately covering medical expenses in Pune, refer to the table below:

      Categories Mahatma Jyotirao Phule Jan Arogya Yojana (MJPJAY) Private Health Insurance
      Scope of Coverage You can avail coverage for identified illnesses under 34 medical specialities. Private healthcare plans offer comprehensive coverage for a wide range of diseases and medical conditions across all areas of specialization.
      Sum Insured The beneficiary family can only receive a maximum health insurance coverage of Rs 1.5 lakh, with an exception of Rs 2.5 lakh in the case of a renal transplant. You can get insurance coverage for an amount as high as Rs 6 crore.
      Eligibility Only people with Annapurna ration cards, white/yellow/orange ration cards, and Antyodaya Anna Yojana ration cards (AAY) can avail the MJPJAY scheme.
      Eligibility extends to children residing in government orphanages, senior citizens housed in old age homes, families of construction workers, approved journalists with families recognized by the Department of Government Information and Public Relations (DGIPR), female inmates of Government Mahila Ashram, and students of Government Ashram Shala.
      Anyone can purchase a health insurance plan according to their financial and health needs.
      Network Hospitals You can avail cashless treatments in 28 network hospitals of Pune. You can avail of cashless treatment in hundreds of network hospitals in Pune.
      Procedures Covered The scheme covers 996 medical surgeries/therapies/procedures and 121 follow-up packages. Private health insurance policies provide coverage for a range of medical procedures, including surgeries, day care treatments, pre-hospitalization costs, outpatient treatment, and post-hospitalization expenses. The extent of coverage depends on the specific plan selected by the individual.
      Post-hospitalization expenses The scheme covers post-hospitalization expenses incurred on doctor consultations/medicines for up to 10 days after getting discharged from the hospital. Most of the plans cover 60 days of post-hospitalization expenses. This may, however, vary according to your chosen plan.

      Wellness and Prevention Tips in Pune

      Given below are some of the wellness tips for people living in Pune:

      1. Consume nutritious food while avoiding the intake of high-carbohydrate, high-fat, sugary, and salty foods.
      2. Prioritize personal hygiene and refrain from getting soaked in the rain.
      3. Ensure optimal exposure to morning sunlight to increase your body’s Vitamin D levels.
      4. Engage in simple stretching routines and perform exercises to relax your eyes and neck at work.
      5. Keep your houses, society complexes and other surroundings clean and dry.
      6. Stay hydrated to maintain healthy skin throughout the year, regardless of the season.
      7. Make sure to incorporate ample probiotics in your diet, such as curd, yoghurt, etc..
      8. Use insect repellents and mosquito nets, and wear full-sleeved clothes while going out, especially in the evening.
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      Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

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      *We will respond in the first instance within 30 minutes of the customers contacting us. 30-minute claim support service is for the purpose of giving reasonable assistance to the policyholder in pursuance of the claim. Settlement of claim (including cashless claim) is the responsibility of the insurer as per policy terms and conditions. The 30-minute claim support is subject to our operations not being impacted by a system failure or force majeure event or for reasons beyond our control. For further details, 24x7 Claims Support Helpline can be reached out at 1800-258-5881. Product information is authentic and solely based on the information received from the Insurer. Policybazaar is acting only as a facilitator and claims settlement shall be at the sole discretion of the Insurer. As per the Insurance guidelines, you are allowed to cancel the policy with-in 15 days from the date of Issuance of policy. For more details, please read the Plan Brochure carefully or talk to our advisor at the time of purchase.

      *All the health insurance plans cover hospitalization expenses including COVID-19 treatment cover up to the specified limits. You can also buy specific COVID-19 health insurance policies such as Corona Kavach Policy and Corona Rakshak policy.

      **All savings and online discounts are provided by insurers as per IRDAI approved insurance plans. #Tax Benefits are subject to changes in tax laws. GST Exemptions depend on fulfilment of qualification criteria and submission of relevant documents.

      *₹1748/month is the starting price for a 1 crore health insurance for an 18-year-old male, with no pre-existing diseases. Discount on renewal premium is subject to the number of wellness points earned in the health insurance policy. For more details about the plans, please read the sale brochure carefully to get upto 100% discount on renewal premium.

      *₹400/month is the starting price for ₹ 5 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹541/month is the starting price for ₹ 10 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹762/month is the starting price for ₹ 1 Crore Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹243/month(₹ 8/day) is the starting price for a 5 lakh health insurance for a 20-year-old male, non-smoker, living in Bengaluru with no pre-existing diseases

      *₹2020/month is the starting price for ₹ 1 Cr Health insurance for a 50 year old male & 50 years old female, living in Bangalore with no pre-existing diseases rounded off to nearest 10.

      *₹390/month (₹13 per day) is starting price for 1 cr. Health insurance for 25 years old male, with pre-existing diseases, residing from tier 1 city rounded off to the nearest 10.

      *No medical tests are required unless requested by the insurer’s underwriter. In-case of pre-existing diseases relevant medical proof would be required as per the terms and condition of the policy opted.

      *The values taken for effective cost calculation are indicative values and may change as per the selected plan.

      *Coverage upto double the amount of Sum Insured is available on certain covers for a minimum plan of Rs. 5 Lakh on the first claim only to an individual of upto 45 years of age with no pre-existing diseases. The benefit is available with or without extra cost depending on the plan chosen.

      *Coverage of pre-existing diseases is provided by insurer as per their underwriting policy.

      *The scope of coverage may vary from plan to plan.

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