Do All Health Insurance Plans Cover Treatment Costs for Paralysis?

Coping with paralysis is a daunting task as there is an emotional, physical and financial strain on the patient as well as loved ones. In some cases, there is hope for nearly full recovery, but many tend to remain lifelong. The only way to face this challenge is to prepare yourself mentally, physically and financially. A crucial aspect of this is planning for health insurance as it gives you some financial security and coverage for major healthcare expenses.

Paralysis is a loss of muscle function in your body which could be caused by injury to or disease of the brain or spinal cord. Stroke, Multiple Sclerosis, Peripheral Neuropathy, and Cerebral Palsy are some examples of conditions that may lead to paralysis, which could be temporary or permanent, and / or partial or complete.

The different types and degrees of paralysis are described below:

Types of Paralysis:

  • Monoplegia: Only one arm or leg is affected
  • Hemiplegia: Only one side (right leg and arm or left leg and arm) is paralyzed
  • Diplegia: Both sides of the body are paralyzed
  • Paraplegia: Affects only the lower limbs
  • Quadriplegia: Affects all four limbs
  • Facial Paralysis: Generally, one side of the face is paralyzed

Degrees of Paralysis:

  • Complete - When there is no muscle movement at all
  • Partial - When some control over muscles is still left
  • Permanent - When control over muscles never comes back
  • Temporary - When some or all muscle control comes back
  • Flaccid - When muscles get flabby and shrink
  • Spastic - When muscles are tight and hard and jerk around oddly

Do All Health Insurance Plans Cover Paralysis?

An important point to note is that paralysis is not covered by default by all health insurance plans. Policies that could cover these conditions would do so, depending on the ailment (cause), type and degree of paralysis. Listed below are a few cases:

  1. Existing Paralysis prior to Policy Issuance: It could be unlikely to get health insurance cover when the applicant is already paralyzed. Moreover, if the cause of paralysis is a symptom or after-effect of a specific ailment (such as stroke or cerebral palsy), that condition may be excluded, and so it could lead to the application not being accepted. If that condition is viewed as a Pre-existing Disease (PED), the coverage may be allowed at higher premium loading.
  2. Onset of Paralysis during Policy Year/s: If paralysis occurs due to a disease that is covered by the policy, and the applicable waiting period has been served, the hospitalization costs could be covered. In many cases, it could be challenging to move a patient to a hospital depending on their condition. Domiciliary Hospitalization could also be covered by few insurers, if the terms and conditions state the same (E.g., Stroke with Partial Paralysis).
  3. Rehabilitation for Paralysis: Physiotherapy and exercise, occupational therapy, medication, nerve transfer surgery are various options available for rehabilitation.  Depending on the benefits and features offered by your plan, treatment methods such as physiotherapy and medications could be covered.
  4. Other Important Features to Note:
    1. A regular health insurance plan could cover paralysis as an add-on benefit with a higher premium. If this cover is not offered as a part of the base plan, you could inquire about the possibility of an add-on benefit/rider for extra premium.
    2. Many insurers apply a waiting period to avail coverage for paralysis-related treatment
    3. The coverage could have sub-limits or maximum capping on the amount permitted towards treatment
    4. Some insurers provide the coverage via Disability Benefit, which could be a lumpsum amount
    5. A few insurers allow coverage up to the Sum Insured amount, which is most beneficial

The details of the coverage amount, features of the plan and other benefits offered are mentioned in the terms and conditions document called Policy Wordings/Customer Information Sheet. It is important to review this document before zeroing on a health insurance policy for yourself and your family.

Health Insurance is a complex product to navigate that varies across plans and insurers. SANA.Insure is a health insurance portal that offers guidance when comparing and selecting health plans catering to your requirements. We suggest the best options after collecting details from you regarding your health and healthcare needs.

We invite you to visit our health insurance portal, to select, compare and purchase the best health insurance policy based on your needs. Our Health Insurance Experts will be glad to assist you with additional information. Please get in touch with us via WhatsApp chat (8278271818) or via phone call (1800 202 8118).

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