Need Health Insurance protection from Coronavirus? Here's a Complete Guide

If you are exploring the market for information on the right health insurance plan that covers you for Covid-19-related expenses, your search ends here! In this article, we will look at some specific Coronavirus Health Insurance policies as well as regular plans that cater to Covid-19 treatment costs.

Specific Health Insurance Plans for Coronavirus

In July 2020, health and general insurance companies launched two standard Covid-19 health insurance policies, under the directive of IRDAI. As a result of the pandemic, a lot of customers were urgently seeking health insurance protection from probable hefty hospitalization bills. In addition, given the sudden demand of and surge in health insurance policy sales, the regulator issued some related guidelines for coverage, installment premium payment, better claims management and others.

• Corona Kavach, which is an indemnity policy meant for Covid-19 hospitalization costs, and
• Corona Rakshak, which is a fixed benefit policy in which the sum insured amount will be paid to the policy holder in case of Covid-19 hospitalization.

Do Regular Health Insurance Plans cover Covid-19 treatment?

Aside from launching specific health insurance policies for Coronavirus, the regulator also instructed insurers to ensure that all their regular health insurance plans adequately cover treatment expenses related to Covid-19. This means that your existing health insurance policy will take care of hospitalization expenses for Coronavirus treatment. Moreover, if you are in the process of choosing a health insurance plan for yourself and your family, you can be rest assured that admissible Covid-19 treatment costs will be taken care of by your policy.

Are all Covid-19-related expenses covered by Regular Health Insurance Plans?

Expenses pertaining to hospitalization (as advised by the doctor) on account of Covid-19 will be covered by your plan. Typically, these would be diagnostic test at government authorized centers, ambulance charges, in-patient hospitalization, ICU charges etc. Some plans even cover domiciliary (at-home) hospitalization, alternate treatments (AYUSH), pre- and post-hospitalization charges for specified number of days etc. Remember – nearly all regular health insurance plans have a waiting period of an average of 15 days (some have 7 days while others specify 30 days as waiting period) before Coronavirus treatment costs can be claimed.

Expenses that are generally not covered include dietary supplements, diagnostic expenses incurred prior to the policy start date, day-care treatment, OPD costs, tests undergone at non-authorized centers and treatment availed outside India.

However, the exact nature and extent of coverage will vary between plans and insurers. Moreover, a lot of patients have been developing long-term complications post recovery from Coronavirus, hence having a comprehensive health insurance policy would be ideal for extended coverage.

What about Medical Claims for Covid-19?

The claims management process for Covid-19 treatment would be the same as that for any other medical expenses, as laid down by the insurer. The good news, however, is that the regulator has instructed insurance companies and Third-Party Administrators (TPAs) to expedite the processing and timelines of Coronavirus claims.

Some Covid-19 claims that are typically not accepted are for self-hospitalization (without doctor’s advice), inadequate or incomplete documentation (lack of hospital bills, discharge papers, lab reports etc.).

Important Policy Features to seek when looking for Regular Health Insurance Plans for Coronavirus

1. Ample Coverage Amount: First and foremost, decide on an adequate amount of Sum Insured that will sufficiently cover yourself and your family members. A low Sum Insured might mean a small amount saved on premium payable in the short run, but it would lead to being underinsured in the long run, especially in times of urgent need such as treatment for Coronavirus.
2. Basic Features: Look for a plan that has a wide range of benefits offered in the base plan. This means you will get more value for the money you spend towards premiums.
3. Optional Benefits: Opt for a policy that offers multiple add-on riders which can help you customize your plan to your liking. While these optional covers come at extra premium, they are beneficial for people who are looking for specific features that are not offered in the basic plan option.
4. Waiting Period: Select a health insurance policy that has lower waiting periods to ensure that you become eligible to claim for expenses sooner.
5. No-Claim Bonus: A plan that gives you a higher percentage of No-Claim Bonus for a greater number of times (for every claim-free year) is ideal.
6. Restoration Benefit: Look for a policy that offers you the option of restoring or reinstating your Sum Insured amount upon multiple claims in a policy year.
7. Domiciliary Hospitalization: In situations when the doctor advises the insured member / patient to be treated at home (for reasons like lack of hospital facilities or inability of the patient to be transported to the treatment facility), domiciliary hospitalization benefit is highly advantageous.
8. AYUSH: A plan that covers you for alternate forms of treatment would be a good choice.

NOTE: The exact details of which expenses heads are covered, when and to what extent, or which policy benefits are offered as a base plan or as an add-on rider would be different for insurers and plans. This information is mentioned in the policy terms and conditions document of every plan. The Policy Wordings or Customer Information Sheet must be read and understood thoroughly prior to finalizing your choice for a health insurance plan.

SANA.Insure helps you understand these difficult and complex policy terminologies by explaining them in simple language. With over a hundred health insurance plan options available on our portal sana.insure, you will be able to find the perfect option for yourself easily. Please connect with us via WhatsApp chat on 8278271818 or call us on 18002028118, and a Health Insurance Expert will be happy to guide you with the right advice and information.

Wish you a healthy and happy life!