Does Health Insurance in India cover all diseases?

Health insurance is the perfect way to guard against high medical expenses and protect your savings. Even healthy individuals can fall sick or be injured unexpectedly and require urgent treatment. This could mean high medical bills, along with the added pressure of being unable to work when unwell. Having a comprehensive health insurance plan ensures there is less stress and a degree of financial stability in these scenarios. Additionally, it safeguards against future medical inflation in healthcare.

These plans cover a wide variety of medical issues (varies depending on insurer and specific plan). It is crucial to assess your medical needs when buying or renewing health insurance. For example, for diabetics it is important to look at the waiting period for pre-existing diseases as well as check the availability of diabetes-specific health plans.

When reviewing different aspects of a plan, you should ensure that the critical illnesses and features you desire get covered under the policy you purchase.

Factors governing diseases covered in health insurance plans

Navigating through a health insurance policy document can be challenging given the complex list of terms and conditions. We are here to break them down and simplify them for you.

  • Disease-specific Information in Policy Brochure and Terms and Conditions document: For a basic overview of information on ailments  covered under a particular policy the policy brochure should be checked. Detailed information on conditions and critical illnesses covered and related particulars are mentioned in the terms and conditions document. Therefore, it is always crucial to check the terms and conditions mentioned in the Customer Information Sheet or Policy Wordings.
  • Excluded List of Diseases: To confirm what is and isn’t covered, the terms and conditions document mentions a detailed list of, critical illnesses and/ ailments or conditions that are not covered i.e. excluded in that specific plan. For example, sterility and infertility issues are generally excluded.
  • Specific Diseases: Some plans in India cover specific diseases and add-on options to provide maximum coverage to the policyholders. These specific conditions are usually covered after pre-defined waiting periods are served. Additionally, these specific diseases could have certain associated conditions such as a sub-limit or a maximum cap on the expenses covered.
  • Day-care procedures: While all plans may not cover all diseases, many do cover all or most day-care procedures. The actual number as well as list of procedures covered would be detailed in the policy wordings.
  • Pre-existing Diseases: Pre-existing diseases refer to conditions, injury or ailment, which already exists for up to 48 months prior to purchasing a policy. A lot of people with pre-existing diseases don’t take health insurance because of the myth that they are not eligible for cover. However, by purchasing a policy early and disclosing such conditions you would be covered after the defined waiting period.
  • Critical Illness Policies: Critical illness plans cover serious and long-term illnesses that require expensive medical treatment. Even chronic conditions and critical illness such as cancer can be covered after the specified waiting period. Conditions such as kidney failure or stroke require recurring care, so having a dedicated plan can reduce the financial burden.

When deciding your requirements and what you want covered, it would be beneficial to also assess factors such as network hospitals, claim settlement ratio and lifetime renewability options, along with conditions and critical illnesses covered. SANA.Insure is here to guide you, from understanding various health insurance concepts, to in-depth plan and features or benefits comparisons, to how to buy as well as claim settlement.

SANA.Insure is a portal that helps with selecting the best health insurance plan for you and your family. We make understanding terms and conditions easy, with our Health Insurance Experts ready to assist you through the process. We analyze your family details, prevailing health and future medical needs to provide you several options tailored to your requirements.

We invite you to visit to receive customized suggestions factoring in the diseases and conditions you want coverage for. You can also get in touch with us over WhatsApp chat on 8278271818 or call us on 1800 202 8118, and our Health Insurance Expert will assist you to buy the best plan with the right benefits.

Wish you a healthy and happy life!

Click "SUBMIT" to choose the best Health Insurance Plan SUBMIT