What Is Zonal Health Cover? Why Should One Opt for It? | 7231


What Is Zonal Health Cover? Why Should One Opt for It?

When it comes to a health insurance plan, many people consider age, health, and income as the major elements to choose from. But, people miss an aspect called the city. It is an important point to determine, as it decides the expense of medical coverage. The hospitalization cost in smaller urban communities is lower when compared with the metro cities, where lifestyle diseases are increasing.

The majority of the insurance providing companies passes on the advantage to policyholders of smaller towns. Generally, the zones are characterized under 1, 2 and 3. Commonly, metro cities fall under Zone 1, whereas Zone 2 covers the Tier 1 cities and the remaining cities of the country are considered as Zone 3. However, this segmentation varies from insurer to insurer.

Zone-based health insurance schemes tend to pay premiums as per the treatment cost prevailing in a particular city. Here are the details of the zone-based health plans:

A) Premium: It depends on the medicinal expenses expected to evolve in a specific city. However, different cities are classified differently, such as Zone 1, 2 and 3. The benefit of zone-based valuation can bring down your premium by up to 10-20%. For example, if someone of 30 years of age is a resident of Delhi, he or she would require to spend Rs 10,043 to purchase a health insurance policy of Rs 10 lakh. But, when shifting to Agra, which falls under Zone 3, the premium cost will come down to Rs 8995.

B) Change in Residence: If a policyholder changes his or her residence from a metro city to a smaller town, the information needs to be shared with the insurance provider company with the goal that proper zone evaluation can be done. After the assessment is completed, the insured person can claim for a complete refund. Today, some individuals show more belief in the infrastructure and medical advancement available in the metro cities as compared to the smaller towns. Thus, if a policyholder moves from a metro city to a small town but still wants to be treated in the big city, he can select it by paying an additional premium.
C) Advanced treatment: Some health insurance policies confine the inclusion of coverage benefits only if a policyholder shifts from a Zone 3 city to Zone 1 city for seeking advanced-level treatment. For example, in SBI General Health Insurance Plan, if an individual equipped with a Zone 2 inclusion moves to a Zone 1 city, he will get only 80% of the insured sum. Although there exist several arrangements that embed a co-payment feature for experiencing treatment in advanced and smart cities, there also exists a quantum of confinement that fluctuates from policies to policies. Thus, it is quite essential for everyone to discover as to how your health plan will function if one requires an advanced level treatment.


Zone-based health insurance plans tend to lessen the premium expense. Be that as it may, before choosing a medical coverage policy, you need to comprehend how payouts are made for the treatment conveyed outside the home city. In higher age sections, it is encouraged to pay an additional premium to get Pan India health insurance inclusion. So, if you are up to buying a health plan, go through the above-mentioned facts and elements to make a prudent decision.


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