Top Health Insurance Trends in India 2025

Posted on: Dec 24, 2024 | 3 mins | Written by: HDFC ERGO Team

Top Health Insurance Trends in India 2025

The Indian health insurance sector has witnessed a major shift and significant changes after the global outbreak of the COVID-19 pandemic. The health sector is taking shape and form with new technological advancements, eventually altering our thoughts regarding healthcare and health insurance coverage.

Increased obligations towards policyholders now bind the health insurance industry. To stay in a healthy, competitive business, they need to prove their worth and relevance, especially during challenging circumstances.

As 2024 closes, we are heading towards another new year, marking a new beginning. It is a golden opportunity to revise certain tactics and enhance business trends due to increasing consumer demands and business growth prospects.

Although the health insurance sector in the country is usually slow to alter and risk-aversing in nature, the insurance providers have to grasp the opportunity to reassess their position and strengthen it further.

What people would look for in 2025 while buying health insurance?

People have become more cautious, especially after the COVID-19 outbreak, regarding the necessity and importance of health insurance. We have carefully highlighted a prospective agenda for the insurance providers to enhance their progress trajectory in future.

After careful research and analysis, we have identified 5 strategic imperatives that prove to be beneficial for insurance companies to boost their growth and expansion in the next few years, starting from 2025.

Health insurance trends in 2025

As each sector evolves with age due to the changing times and altering necessities and demands, the health insurance sector is also revealing itself in new ways. We have identified 5 plausible imperatives that may aid in boosting the growth of the health insurance sector. These 5 trends include the following:

1. Maintaining a digital approach

With the increase in digital trends in almost every sector, the health insurance sector must also adapt to this new trend. Enhanced engagement in digital ecosystems and building user-friendly and exclusive customer intelligence support will help here. Other than that, producing various services and products that befit the digital world and re-engineering the existing value chain as a complete set of exclusive digital services will also prove to be beneficial. Basically, the trend is to adopt a more digital approach and mindset to attract business.

2. Customer-centric ecosystems

Due to the changing approaches, it is best to reimagine customer values. Ensure the establishment of a solid network of trusted partners, aligning with the existing capabilities and improvising as per requirements. It is best to design for enhanced and advanced digital collaboration. It is best to align with the existing operating model for user-friendly and multi-nodal value creation.

3. ESG embedding

Improving and elevating your current ESG understanding of your organisation is best. ESG embedding will help you go a long way in this respect, especially if your chief ethos purpose remains social responsibility. To prove your trustworthiness, keep all the ESG results and actions transparent.

4. Talent run

A concrete business plan for the future is essential to stay in business in the long run. Harnessing the power and prospects of culture will serve you well beyond your imagination. Try maintaining an updated workforce, inculcating the power of the advancing gig culture and economy. Try to make improvisations, additions, and alterations to your existing human resources practices.

5. Premium execution

To enjoy prospective business growth and potential, try to make your organisation more outcome-oriented. Try to establish a competent change-management capacity, establishing transformation management in the company. Adapting to an agile and flexible delivery model will also help your business grow and expand.

Other trends:

Apart from these, there are certain other trends too. These are:

1. Consumer-driven healthcare

The shift towards consumer-driven healthcare is very likely to continue. This implies that people will ensure enhanced control over their decisions regarding healthcare and become all the more responsible towards paying for this care.

2. Enhanced technological usage

With the advancement of technology, the healthcare insurance industry will become outdated if they do not adapt to this major shift. This includes telemedicine, remote monitoring, enhanced usage of Artificial Intelligence, machine learning, etc.

3. Value-based care models

We are already witnessing the rise of value-based care models. This trend is likely to continue as they have been critically crafted to deliver high-standard care at reasonable prices.

4. Mental health and behavioural health

COVID-19 has made IRDAI announce that it will be included as standard coverage for every health insurance plan. These 2 aspects are likely to gain further momentum shortly. Insurance companies have already recognised the importance of covering these sorts of health issues, and this is expected to expand.

5. Health insurance premiums

With the changing nature of health insurance coverage, the premiums are also expected to go through certain minor changes. Depending on the revised terms and conditions, individuals are expected to finalise.

Factors to consider while buying a health insurance plan

Some of the significant factors that you need to consider mandatorily while buying any health insurance include the following:

• Waiting period: This is the term referring to the tenure during which the policyholder cannot raise any claim against the purchased health insurance. It is prevalent for certain specific ailments as well as pre-existing diseases. Your policy paper will mention all these details. Ensure to read and understand them well before purchasing.

• Co-payment: This is the part of the claim amount that you have to pay as the policyholder along with your insurance provider. The higher the co-payment option is, the lower the premium and vice versa. Certain insurance providers maintain a mandatory co-payment option, while others maintain a voluntary one.

• Coverage span: A standard comprehensive health insurance coverage includes pre- and post-hospitalisation coverage up to a specified tenure. This tenure may vary from one insurer to another, depending on the chosen plan.

• Daycare procedures: Usually, a standard comprehensive health plan allows coverage for daycare procedures. This implies medical procedures that require less than 24 hours of hospitalisation, like cataract surgery, dialysis, etc.

• Room rent capping: Depending on the nature of the chosen plan, room rent capping usually exists. This means that if the room charge exceeds that limit, then the policyholder has to settle the excess dues out of his/her pocket. These room rent limits tend to be comparatively higher, especially in the case of senior citizen health insurance or critical health insurance, etc. You must clarify with your insurer before finalising.

• New age treatment coverage: The nature of medical treatments is advancing well, mainly due to various technological advancements. Certain new-age treatment processes include robotic surgery, stem cell therapy, etc.

• Add-on coverage: You can customise and expand the coverage protection span of your health insurance by opting for befitting add-ons or riders to it by paying an additional premium. However, be sure to opt for only the most necessary and relevant ones. Otherwise, it will eventually result in unnecessary financial drainage.

• Claim settlement process: Ideally, the claim settlement process must be hassle-free and user-friendly. Consider the customer reviews in this respect to understand the scenario well.

• Compare: Before zeroing in on any one plan, study multiple competent plans of various companies to make an informed decision. Consider the premium, coverage span, claim settlement process, etc., to grab the best deal.

Conclusion

As time passes, the nature of expectations evolves. This leads to certain transformations in the respective industries. As the vision of the health insurance sector has become bolder, insurance providers need to design their paths and strategies well, keeping their focus anchored around their social responsibilities and purpose and transforming their existing business models to meet evolving customer requirements.

Disclaimer: The above information is for illustrative purposes only. For more details, please refer to the policy wordings and prospectus before concluding the sales.

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