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Does My Health Insurance Plan Cover Coronavirus?

Charlie Ali by Charlie Ali
3 years ago
in Health
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Does My Health Insurance Plan Cover Coronavirus?
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The above question might be striking your mind as the coronavirus outbreak is on its peak and is responsible for over thousands of deaths every day around the world. Spending the entire day at home and watching updates on the number of lives lost puts you in a nervous state of mind, doesn’t it?.

COVID-19 known as the deadly coronavirus has taken the entire world by storm. What started in Wuhan, China has now drastically affected the world including India. As of 15th April 2020, over 19 lakh COVID-19 positive cases have been recorded causing close to 1,26,000 deaths worldwide. In India itself, the count for positive cases has risen to over 11 thousand causing 377 deaths. Preventive measures are being taken by the government agencies and the entire country is following the orders of complete lockdown. People with travel histories are also being tracked and quarantined at their home.

What if you get infected by COVID-19? Are you prepared to fight it? Will your health insurance plan cover it?

The Insurance Regulatory and Development Authority of India (Irdai) in its recent notice mentioned, all claims related to COVID-19 treatment will be liable to coverage under the standard health plan. A standard health plan covers all the medical expenses in case of hospitalization or any viral infection. This plan now will also include the life-threatening coronavirus.As per further appeal by the Irdai, insurance companies have also introduced policies which are specifically created for COVID-19. These plans will cover all those individuals who test positive for the virus.

However, some insurers may not accept your claim for COVID-19 under the standard health plan due to certain factors. Following are the factors:

If the disease is declared as an epidemic or pandemic

Some insurers may reject your claim under the standard health policy if the disease is declared as an epidemic or pandemic by the World Health Organisation.

Considering COVID-19 has already been declared as a pandemic by the WHO, it is very important to check, whether your health insurance policy has this term enlisted in it. Yet, some policy providers like Future Generali have assured full support to their existing policyholders against the pandemic.

Thus, you must not panic and confirm with your health insurer if your policy covers COVID-19 or not. Most policies today, do cover unfortunate events like pandemics and epidemic. So make it a point that you read your policy documents well and connect with your insurer in time.

In case of planned treatment

According to this term, if you are suffering from any disease that has the same symptoms as that of the coronavirus, then your regular health insurance policy claim might not get settled.

For example, if you are suffering from cold, cough, breathlessness for a few days and plan to have a treatment for it, your policy may not cover it even if it results into the coronavirus infection.

So, if you already happen to have coronavirus and you are looking out for an insurance policy to get your claims settled, then mostly your claims will not be reimbursed under the newly bought health insurance policy. Previously planned treatment is not covered under a newly purchased health insurance. As the outbreak of coronavirus has created a sense of emergency in the country, the disease can be covered under your regular health policy but if planned, it cannot be covered.

If you or your family member have a recent travel history to affected nations

You can be covered under the general health insurance policy if you are diagnosed positive after having a travel history from any COVID-19 affected country as long as you are quarantined in India. The special coronavirus plans will however not defend you, if you have a travel history to affected countries like China, Hong Kong, Kuwait, Macau, Italy, Japan, Singapore etc.

Your claim cannot be settled even if you get the disease through any of your family member with a travel history.

If you are tested positive for COVID-19 during the policy waiting period

What is a policy waiting period?

A policy waiting period is a duration set by the insurer from the date of purchase of the policy. The policy can cover you for certain diseases only after the policy waiting period is over. Most insurance policies accept your claim only after the waiting period.

Your claim for the treatment of coronavirus during the policy waiting period will not be accepted if the terms state that the disease is excluded during the waiting period. Most policies do not accept claims of diseases during the waiting period. You must have a check on your policy for the inclusions and exclusions mentioned in the waiting period conditions.

The new special coronavirus insurance policies also have a waiting period of approximately 15 days. If you are tested positive with the virus within the 15 days waiting period, then your claim will not be resolved by the insurer. For normal respiratory treatments, the waiting period is set at 30 days but since the nation is suffering by the outbreak, these new special policies with less waiting period have been introduced by insurers to safeguard people against coronavirus.

If you are not admitted in a hospital for at least 24 hours

Every general health insurance policy or mediclaim in India does not include outpatient treatment, so a minimum of 24 hours of hospitalisation is mandatory for your policy to cover the claim.

It is the same in case of Coronavirus, the health insurance claims will only be payable after a hospitalisation of 24 hours. Some insurance companies like Future Generali have stated that, if you are suffering from coronavirus, then your treatment will be covered as any other illness, provided you are hospitalised for at least 24 hours. 

What do the special COVID-19 plans offer you?

Many insurance companies after the appeal by the Insurance Regulatory and Development Authority of India have come out with corona specific plans to cover the masses against the scare of COVID-19.

Advantages of the COVID-19 specific plans:

  • The plans will provide a lump sum amount to you for dealing with the expenses arising from the hospitalization due to coronavirus.
  • A common man like us can opt for such plans as they are available with a very affordable premium.
  • These plans are a solution to safeguard you against COVID-19 if you are not covered by any other health insurance.

Terms and conditions:

Here are some terms and conditions that are very important for you to know before you get yourself a COVID-19 specific plan.

  • During the tenure of the policy, you should not be in contact with a person suffering from COVID-19.
  • If you are suffering from cough, cold, shortness of breath, fever and other symptoms, you will not be liable for the claim stated in the policy.
  • You or your family members should not have a travel history to countries like China, Hong Kong, Italy, Japan, Iran, Macau, Kuwait after 1st December 2019.

Once all these above conditions are met, you can save yourself from the virus with special insurance plans for COVID-19. For more information on Coronavirus cover visit this link.

 Coronavirus is creating a negative impact on our country and with the death count rising every hour, you need to get yourself insured for being able to put on a fight against the virus. If you have not invested in your health so far or your policy does not cover a pandemic like the COVID-19, then its time for you to look for the right health insurance options and choose the right one as per your requirement.

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